LIBRARY OF CONGRESS* 



CIiap..___ x _\:. Copyright No... 



NTS OF WEIGHTS AND MEASURES, 
CUSTOMARY AND METRIC. 







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LIMITED STATES OF AMERICA. 


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19 


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Metric 




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Weight 

and 
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Measure. 


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60 [i 3 


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63.I 


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170 


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180 [33 


180 [33 


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210 


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24.644 - 


400 


385-8 


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405-7 


390 


25.271 


410.2 


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25.876 


420 [73 


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422 


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441.7 


432.1 


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29.574 


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1 24.8 


1 137-3 


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1 291.6 


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1 432.8 


59.147 


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1 445-9 


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2 409. 2 


88.721 


3 • • • 


3 • • • 


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3 74-5 


3 103.2 


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3 183. 1 


4 362 


147.869 


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33 39o.6 



HANDBOOK 



OF 



MATERIA MEDICA, PHARMACY, AND 
THERAPEUTICS. 



POTTER. 



NOTICES OF THE PRESS 

OF PREVIOUS EDITIONS OF 

DR. POTTER'S HANDBOOK 



From the American Journal of the Medical Sciences : 

" The author has very skilfully steered his course between the pessimism that marks 
a system of therapeutics based solely on the results given by experiments and observations 
in the chemical and physiological laboratories, and the optimism of hasty empirical general- 
izations upon meagre clinical data, and upon this we consider that the greatest claim can 
be made, that this book is a safe one for the junior practitioner. . . . The author, 
then, has fully attained the purpose which he set before him at the commencement." 

From the Medical Record : 

" This is an old and valued friend which needs no commendation, much less an 
introduction. It ought to be in the library of every physician and student. It is the 
most convenient and most concise work on therapeutics and materia medica in the 
English language, and is at the same time thoroughly reliable. Though necessarily 
largely a compilation, nevertheless there is much that is original, the author being one 
of the most prominent of American therapeutists." 

From the Australasian Medical Gazette : 

" We have pleasure in commending the fourth edition of this excellent work to our 
readers. It is a monument of persistent industry. There is no better book in the 
English language for the student and practitioner. . . . Dr. Potter's book is thor- 
oughly practical, and Part III contains an enormous amount of information, for which 
the student ought to be grateful. . . . The chapter on prescriptions is especially 
well done, in fact the best we have seen." 

From the Journal of the American Medical Association : 

" Dr. Potter has embodied many original ideas in the preparation of this work, 
some, if not all of which will prove of very great value to the reader." 

From the Medical Bulletin ; 

"The author's statements are concise, exact, compact, and his diction faultless; no 
one, perhaps, in this country at least, excels him in the perspicuity of his condensations and 
the completeness of his work in respect to the many details involved in authorship." 

From the New York Medical Journal : 

" Dr. Potter's Handbook will find a place, and a very important one, in our colleges 
and the libraries of our practitioners. It contains almost everything that can be found in 
the larger works in a more concise form and brought up to a rather more recent date. . . . 
Under the head of prescription writing considerable attention is paid to the subject of in- 
compatibilities, and the student will here find many valuable hints for his guidance in 
this difficult subject. Besides this, there are, under the head of special therapeutics, very 
many formulas for the treatment of particular diseases and abnormal conditions, arranged 
alphabetically for easy reference. This will be especially valuable to young practitioners, 
and will frequently save the trouble of looking through large works and monographs for 
suitable formulae in the treatment of special cases. This department is fuller in this 
book than in any with which we are acquainted." 

From the Therapeutic Gazette : 

" The author has aimed to embrace in a single volume the essentials of practical 
materia medica and therapeutics, and has produced a book small enough for easy carriage 
and easy reference, large enough to contain a carefully-digested, but full, clear, and well- 
arranged mass of information. No new remedy of any acknowledged value is omitted 
from this list. Under each the section on physiological action and therapeutics has been 
written with care. ... In the enumeration of drugs suited to different disorders a 
very successful effort at discrimination has been made, both in the stage of disease and in 
the cases peculiarly suited to the remedy. It is no mere list of diseases followed by a 
catalogue of drugs, but is a digest of modern therapeutics, and as such will prove of 
immense use to its possessor." 

*V*The price of this book is $4.50, net, in cloth binding, or $5.50, net, in full 
leather ; for which it will be delivered free to any address. Thumb Index in each copy. 



HANDBOOK 



OF 



MATERIA MEDICA, PHARMACY, 
AND THERAPEUTICS, 



INCLUDING THE 



PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL THERA- 
PEUTICS OF DISEASE, OFFICIAL AND PRACTICAL 
PHARMACY, AND MINUTE DIRECTIONS FOR 
PRESCRIPTION WRITING. 



BY 
SAM'L O. L. POTTER, A.M.,M.D.,M.R.C.P.Lond., 

professor of the principles and practice of medicine and clinical medicine in the collegi 

of physicians and surgeons of san francisco ; medical superintendent of st. mark's 

hospital; author of the " quiz-compends of anatomy and materia 

medica," " an index of comparative therapeutics," several articles 

in Foster's "practical therapeutics," and "speech and its 

defects ; " formerly a. a. surgeon u. s. army, and 

brigade-surgeon n. g of california. 



SIXTH EDITION. FULLY REVISED AND GREATLY ENLARGED. 



PHILADELPHIA: 

BLAKISTON, SON & CO. 

1012 WALNUT STREET. 
I8 97 . 



^l 



^ v ' 



*N 



^«&\ 



f\<b< 



Copyright, 1 89 7, 
By P. BLAKISTON, SON & CO. 



Press of Wm. F. Fell & Co. 

I220-24 SANSON! ST. 

PHILADELPHIA. 



TO MY WIFE 

WHOSE DEVOTED CARE AND 

PATIENT ENCOURAGEMENT, 

DURING THE PAST NINETEEN YEARS, 

HAS SUPPORTED THE AUTHOR 

IN EVERY EXIGENCY OF 

HIS PROFESSIONAL LIFE. 



PREFACE TO THE SIXTH EDITION 



This edition is one-eighth larger than its immediate predecessor, and 
is almost a new book, although retaining the general plan and the special 
features which have proved so acceptable in previous editions. The text 
has again been subjected to a thorough and critical revision, has been 
largely rewritten, and is greatly expanded by the introduction of new 
matter. Ninety-seven pages have been added, containing forty-six new 
articles and one hundred and seventy rewritten ones, besides many 
hundred sentences incorporated into the original text. 

In the section on Materia Medica, etc., there have been inserted thirty- 
three new articles, including those on Cactus, Carbonic Acid, Formalin, 
Oil of Myrtle and Oxygen ; also briefer notices of new preparations and 
remedies, such as Aseptol, Aseptolin, Borine, Bromelin, Dulcin, Ferratin, 
Kola, Lactophenin, Lycetol, Lysidin, Malakin, Migranin, Trikresol, 
Tannigen, Solanum, etc. Serum-therapy has achieved such importance 
during the past two years that it cannot be ignored in any work which 
professes to keep abreast of the progress in therapeutics. The author has 
deemed this subject worthy of full though concise treatment, under the 
new titles Toxins, Antitoxins and Animal Extracts, in the first part of 
the book, and has inserted brief cross-references thereto under the appro- 
priate disease-headings in the section on therapeutics. 

The list of rewritten articles in the first part includes those on Ace- 
tanilid, Antipyrin, Aurum, Bismuth, Boric Acid, Caffea, Calcium, Can- 
nabis, Chloral, Chloroform, Chlorine, Cinchona, Cod-liver Oil, Creosote, 
Duboisia, Grindelia, Hyoscyamus, Iodine, Magnesium, Nux Vomica, 
Opium, Paraldehyde, Phenacetin, Phosphorus, Physostigma, Pilocarpus, 
Pulsatilla, Sassafras, Sodium, Strontium and Tobacco. Besides these, 
the articles on Alcohol, Carbolic Acid and Digitalis were entirely re- 
written for the fifth edition and may be ranked equally as new matter. 

In the section on Therapeutics, new articles are inserted on Abasia, 
Acne Rosacea, Actinomycosis, Chyluria, Collapse, Tubercular Laryngitis, 
Tubercular Meningitis, Tubercular Peritonitis, Acute Tuberculosis, Tuber- 
culous Affections and Myxcedema. One hundred and nineteen articles 
in this portion of the book have been rewritten, and the text of the sec- 
tion has been everywhere expanded by the incorporation of many hundred 

ix 



X PREFACE. 

items from recent authorities, current medical literature and the author's 
personal experience in practice. 

In the Appendix the article on The Treatment of Poisoning has been 
carefully revised and enlarged, with the object of bringing the contained 
information into available shape for rapid reference in emergencies. The 
List of Latin Words and Phrases has been increased by the addition of 
five pages, and is believed to be the most complete list of this kind now 
published. The Index has been entirely recast and considerably in- 
creased in size, and contains the name of every substance mentioned in 
the text. 

Having been called upon for a sixth edition of this book within ten 
years after its first appearance, the author feels that he may be pardoned 
for assuming that his efforts have met with an unusual degree of appre- 
ciation on the part of his profession. He believes that his object, as set 
forth in the preface to the first edition, has been accomplished in so far 
that the book has taken rank as a reliable working companion to teach- 
ers, practitioners and students of medicine. Having enjoyed for a 
decade the pleasure of seeing the glow of professional favor upon his 
work, he is encouraged to strive for the continuance thereof, as long as 
he may be permitted to labor to that end. 

Sam'l O. L. Potter. 

College of Physicians and Surgeons, 
San Francisco, January, 1897. 



EXTRACTS FROM THE 
PREFACE TO THE FIRST EDITION 



The author's intention has been to produce a book which would em- 
brace in a single volume the Essentials of practical Materia Medica and 
Therapeutics, treating of each subject in as concise phraseology as possible 
consistent with the delineation of every important feature. He has also 
endeavored to formulate such minute and definite directions for the fram- 
ing of Prescriptions as might elucidate what to many is a very difficult 
problem. Furthermore, he has tried to present as much information 
upon the subject of Pharmacy as every physician should possess, in order 
to handle the implements of his profession with confidence, and to direct 
their use by others with pharmaceutical accuracy. 



PREFACE. XI 

The complete fulfilment of these aims would be realized if the book 
should take rank as a working companion to the advanced student and 
the junior practitioner; and be deemed by them a reliable guide through 
the forest of observations and experiments on drug actions and uses, which 
makes progress slow for the already over-burdened mind, when ploughing 
through the more exhaustive and exhausting text-books. 

Although this book is essentially a compilation, as all books of its class 
must be, there will be found in its pages much original matter derived from 
the writer's own experience in professional life. The arrangement of the 
matter will be found to be in some respects unique. After full consider- 
ation of the many arrangements of the Materia Medicain vogue, a modified 
alphabetical plan was adopted, by which the advantages of the alphabetical 
order might be retained, while permitting the grouping together of agents 
which are closely related, physiologically and therapeutically, under the 
title of the principal member of the class — the chief, as it were, of that 
particular clan. Thus, under the title Amyl Nitris will be found mention 
also of the Ethyl, Sodium and Potassium Nitrites, and their congener Nitro- 
Glycerin, all of which are closely allied to the first-named and to each 
other, in respect of their actions and uses. A very elaborate section on 
Drug Classification is placed before the Materia Medica, in order to 
supplement such deficiencies in grouping as are inevitable in an alpha- 
betical arrangement. 

In detailing the characteristics of an important drug, its physical pro- 
perties and chemical constituents are first briefly enumerated, then its 
preparations are described in the official language of the pharmacopoeia, 
usually somewhat abbreviated ; any important unofficial preparations are 
also noted, and all the compounds into which it enters are enumerated. 
Next the physiological action is taken up, its characteristic features being 
first described ; then the actions resulting from an ordinary medicinal dose, 
next those produced by small doses continued, and finally those from a 
toxic dose. These are followed by a brief account of its antagonists, 
antidotes and incompatibles, if any; and a concise summary of its thera- 
peutical applications closes the article ; — the whole presenting, it is hoped, 
a clearly defined word-picture of the drug under consideration. Every 
article and preparation comprised in the last edition of the U. S. Pharma- 
copoeia is fully noticed, while all the prominent unofficial agents receive 
such mention as their respective importance seems to demand. 

The second part of the book is devoted to Pharmacy, and has been 
written from the standpoint of a conviction that many young practitioners 
would gladly dispense their own medicines, if provided with a few prac- 
tical directions on the subject ; thereby saving many a dollar from the 
drug store, preventing in their own practices at least the " renewals" 
which constitute so bad a feature of modern pharmaceutics, and gaining 



Xll PREFACE. 

for themselves a practical acquaintance with their professional weapons 
which cannot but make them better physicians and more accurate pre- 
scribes. In this section of the book Prescription Writing receives full 
consideration, and many standard formulas are given as samples of pre- 
scriptions of each kind in extemporaneous use. 

In the third part the subject of Special Therapeutics is treated of elab- 
orately, and in the form of an alphabetically arranged Index to the treat- 
ment of diseases, as laid down by the most recent authorities. Every 
indication for the use of a drug is referred to its author by his initial, and 
to the most prominent articles are appended a few selected formulae, to 
serve as guides to the neophyte in prescribing. 

Nearly all the regular text-books have been laid under contribution in 
the preparation of the book, but especial use has been made of the works 
of Brunton, Ringer, Wood, Phillips, Waring and Bartholow, in their 
latest editions; as well as of the writer's verbatim notes of two courses of 
didactic and clinical lectures delivered by Professors Da Costa and Bar- 
tholow in the Jefferson Medical College and Hospital and in the auditorium 
of the Pennsylvania Hospital. On page 566 will be found a full list of 
the authorities referred to by initials in the section on Special Therapeu- 
tics. 

The Appendix contains numerous Tables, comprising diagnostic hints, 
Latin terms and phrases, formulae for hypodermic use, metric equivalents, 
and specific gravities and volumes ; also Notes on temperature in disease, 
on the use of the clinical thermometer, the treatment of poisoning, and 
the examination of urine ; also Formulae representing the most noted 
patent medicines. 

The Index has received special attention, from a conviction that, if well 
made, it is the best part of a good book. Every title, synonym and other 
reference of importance is included therein, double and treble entries 
being made in every instance which seemed to require such repetition. 

The term "officinal," as applied to drugs recognized by the pharma- 
copoeia, has been discarded, the word " official " being used instead ; for 
the simple reason that the idea to be conveyed is expressed more correctly 
by the latter term than by the former one. When none but official drugs 
and preparations were kept in the officina or drug store, it was eminently 
proper to call them " officinal," but inasmuch as this class does not now- 
adays constitute much over one-fourth part of the officinal stock, it is a 
wilful debasement of our professional weapons, as well as an inexcusable 
misnomer, to apply the shop-title to them any longer. 

Cooper Medical College, San Francisco, 
December, 1886. 



TABLE OF CONTENTS. 



PAGE 

INTRODUCTION, 17 

Materia Medica, 17 

Pharmacy, 17 

Therapeutics, 17 

Empirical Therapeutics, 18 

Rational Therapeutics, 18 

Constituents of Vegetable Drugs, 20 

Alkaloids, 21 

Glucosides, 22 

Resins, . . 22 

Administration of Medicines, 23 

Transfusion, 25 

The Hypodermic Method, 25 

Dosage of Medicines, 28 

Average Adult Doses of Official Preparations, 29 

Classification of Medicines, 30 

Stimulants and Sedatives, 31 

Agents acting chiefly on the Nervous System, 31 

Agents acting on the Organs of Special Sense, 37 

Agents acting on Respiration, 39 

Agents acting on the Circulation, 41 

Agents acting on the Digestive System, 42 

Agents acting on Metabolism, 49 

Agents acting on Excretion, 52 

Agents acting on the Generative Apparatus, 55 

Agents acting on the Cutaneous Surface, 57 

Agents acting on Microbes, Gases, Ferments, etc., 59 

Agents acting upon each other, 61 

Antidotes and Antagonists, 61 

Physiological Antagonism, 62 

Table of Antagonistic Poisons, 64 

PART I.— MATERIA MEDICA AND THERAPEUTICS, 65 

Abrus to Zingiber (alphabetically arranged), 65-492 

PART II.— PHARMACY AND PRESCRIPTION WRITING, ... 493 

Pharmacopceias and Dispensatories, 493 

Weights and Measures, 494 

Metric System, 496 

Approximate or Domestic Measures, 497 

Specific Gravity and Specific Volume, 498 

xiii 



XIV TABLE OF CONTENTS. 

PAGE 

Prescriptions, 499 

Analysis of a Prescription, 499 

Procedure in Writing a Prescription, 500 

Use of Latin in Prescriptions, 503 

Principles of Combination, 505 

Metric Prescriptions, 506 

Abbreviations, 508 

Renewals of Prescriptions, 508 

Prescription Blanks, 510 

Incompatibility, 511 

Chemical Incompatibility, 511 

Pharmaceutical Incompatibility, 513 

Therapeutical Incompatibility, 514 

Rules for Avoidance of the Dangers of Incompatibility, 514 

Extemporaneous Pharmacy, 516 

Filling a Prescription, 517 

Stock Solutions, 518 

Rules for the Pharmaceutical Student, 518 

Official Pharmacy, 519 

Official Operations, • 519 

Pharmaceutical Operations, 519 

Preparations, 527 

Official Preparations, 527 

Pharmaceutical Preparations, 527 

Aceta to Vina, 528-565 

Excipients for Emulsions, . 533 

Excipients for Mixtures, 544 

Excipients for Pills, 549 

PART III.— SPECIAL THERAPEUTICS, 566 

References and Bibliography, 566 

Abasia and Astasia to Yellow Fever, . 567-815 

APPENDIX, 816 

Latin Terms, Phrases, etc., used in Prescriptions, 816 

Latin Numerals, 828 

Latin Verbs, Participles, Prepositions, etc., 829 

Genitive Case-endings, 829 

Hypodermic Formulae, 830 

Chlorodyne, Comparisons of Ten Formulae therefor, 832 

Patent Medicines, 833 

Tables of Differential Diagnosis, 837 

Forms of Bright' s Disease, 837 

Cancer, 838 

Carditis, Endo- and Peri-, 838 

Cerebral Concussion and Compression, 838 

Chancre and Chancroid, 838 



TABLE OF CONTENTS. XV 

PAGE 

Cholera, 839 

Croup and Diphtheria, 839 

Epilepsy and Hysteria, 839 

Gout and Rheumatism, 839 

Hematemesis and Hemoptysis, . . . 840 

Phthisis, Tubercular and Non-tubercular, 840 

Pleurisy and Pneumonia, 840 

Scarlet Fever, Measles and Smallpox, 840 

Typhus and Typhoid, 841 

Vomiting, Cerebral and Gastric, 842 

Yellow Fever and Bilious Remittent, 842 

Notes on Temperature in Disease, 842 

Clinical Thermometry, 842 

Temperature in Phthisis, 844 

Temperature in Typhoid Fever, 844 

Temperature in Scarlatina, 844 

Temperature in Measles, 844 

Temperature in Diphtheria, 844 

Co-relation of Pulse and Temperature, 844 

Clinical Examination of the Urine, 844 

Deposits in Urine, 846 

Necessary Apparatus, . 846 

The Treatment of Poisoning, 847 

Antidotes and Antidotal Measures, 847 

Antagonists and Antagonistic Measures, 851 

Poisons, their Antidotes and Antagonists, 851 

Tables. 

Table of Specific Gravities and Volumes, 862 

Table of Drops and Weights of a Fluidrachm, 863 

Table of Weights and Measures, 863 

Table of Metric Conversions, 864 

Table of Equivalent Weights and Measures, Inside of Cover. 

Table of Prescription Doses and Quantities, Inside of Cover. 

INDEX, 865 



EXPLANATION. 

Numerals unqualified, under the subtitles Preparations in Part I, denote grammes for 
solids and cubic centimeters for liquids. 

For Signs and Abbreviations used, see pages 495 to 497. 



ERRATA. 

Page 95, line 14 from bottom, — for " Five " read " Four." 

Page 207, line 23 from bottom, — for " Tincture" read " Tinctura." 

Page 239, line 4, — for " Pyridin " read " Pyridine." 

Page 263, line 23, — for " Paulinia " read " Paui/inia.'" 

Page 289, line 6, — for " Urson " read " Ursone." 

Page 456, lines 18 and 25, — for " Karst " read " Kast." 

Page 465, line 6 from bottom, — for " Pistacea " read " PistaciaV 

Page 813, line 19, — strike out the comma after " Emulsi." 

Page 844, line 10, — for" 104.7 " read " 104 " ; and in the following line after the 

word "hours" insert " and 105 by the second day." 
Page 845, line I from bottom, — before "Morphine" insert ''Glycerin (see page 292)." 



XVI 



INTRODUCTION 



Pharmacology, (Pharmakon, a drug, Logos, a discourse,) — is a gen- 
eral term which properly includes all matters pertaining to the study of 
medicinal agents in the widest possible sense, embracing all of Materia 
Medica and Pharmacy, with so much of Therapeutics as relates to drugs. 
The term is however frequently employed in a more restricted sense, 
including only the physiological action of drugs; a subject to which the 
title Pharmacodynamics is much more appropriately applied. 

Materia Medica is that branch of medical science which treats of 
the substances used as medicines, their origin, composition, physical 
characteristics, chemical properties, modes of preparation and adminis- 
tration, physiological and toxicological actions. 

Pharmacodynamics, (Pharmakon, a drug, Dunamis, power,) — is the proper title for 
that portion of the Materia Medica which relates to the physiological action of drugs, 
that is, the influence of drugs upon the healthy human body to modify its physiological 
activity. 

Toxicology is another subdivision, and includes the effects of drugs when adminis- 
tered in poisonous doses, together with the study of the drug-antagonists for the most 
dangerous symptoms produced and the appropriate chemical antidotes for the poison. 

Pharmacy is the art of preparing medicines for use and dispensing 
them on the order of the therapeutist. It includes a knowledge of the 
Materia Medica, an acquaintance with the theories and manipulations of 
chemistry, and an intimate practical knowledge of many special opera- 
tions peculiar to itself. 

Therapeutics, (Therapeuein, to attend upon,) — includes all that re- 
lates to the science and art of healing ; and embraces the application, not 
only of medicines, to the alleviation or cure of disease, but of all other 
agents which may aid in the accomplishment of the same result. 

The operations of Nature herself, as well as of the substances described 
in the Materia Medica, and those of all other remedial measures, as food, 
climate, clothing, heat, cold, electricity, etc., are all embraced in the 
general term Therapeutics, which may be divided into two grand divi- 
sions, viz. : — 

Natural Therapeutics, including the operations of the Vis Medica- 
trix Naturae, — the modes and processes of healing which occur indepen- 
2 l7 



1 8 INTRODUCTION. 

dently of Art, for the spontaneous decline and cure of disease. There 
is no more completely established dogma in science, than that The Living 
Organism is in itself adequate to the cure of all its curable disorders. This 
Natural Law enables the homoeopath to relate his sugar cures, aids the 
medical skeptic to hold to his infidelity, and helps all physicians out of 
more close places than most of them are willing to acknowledge before 
their clientele. This part of the subject is not taught in the schools ex- 
cept in connection with pathology, and by the chair of Theory and Practice 
of Medicine. It is deserving of a special chair and of more systematic 
treatment than it receives. 

Applied Therapeutics embraces the application by Art of agents for- 
eign to the living organism, for the purpose of aiding Nature to restore 
the body to a healthy condition. This division is the portion of the sub- 
ject which is taught separately and systematically in the schools, and 
therefore is alone considered in the following pages. 

Other divisions of the general subject of Therapeutics employed in pro- 
fessional literature and conversation are those entitled " Empirical " and 
" Rational Therapeutics." 

Empirical Therapeutics is a term applied to the use of medicinal 
or other therapeutical agents for the sole reason that they have been tried 
previously with successful results in cases apparently identical with the one 
under treatment. By those who advocate this method it is styled the 
Therapeutics of Experience, and claimed to be an accumulation of 
means of combating disease simply by observation and experiment, inde- 
pendently of physio-pathological reasoning (Hartshorne). It was neces- 
sarily the original method in Therapeutics, has conferred many rich gifts 
upon medical science, and has been advocated by many great physicians, 
its latest and ablest expounder being the eminent and lamented Niemeyer. 

The use of Opium to relieve pain, — that of Cinchona for malarial fevers, — of Colchi- 
cum in gout, — of Potassium Iodide in syphilis, — of the Bromides in epilepsy, — of Cod- 
liver Oil in phthisis, — are examples of the empirical use of remedies. But, after all has 
been said for it that can be said, the fact remains that it is essentially an unscientific 
method, a mere elaboration of the prevailing popular habit of recommending Mrs. A. to 
use pepper tea, because it cured Mrs. B. of " the very same trouble." Permitted to reign 
supreme, it would be destructive to all exactness in therapeutical progress. The so-called 
" experience" of one observer is too often overbalanced by the experience of another 
equally competent and trustworthy ; and as few are encouraged to record their failures 
with remedies, there can be no scientific comparison of the failures with the reported suc- 
cesses. For this reason empirical methods would tend to a minimum degree of accuracy 
in a science which, in the very nature of things, can never be an exact one ; — though 
undoubtedly such methods will always prevail to some extent. 

Rational Therapeutics embraces the use of remedies for reasons 
based on a knowledge of (i) the pathological conditions present in the 
subject, and (2) the physiological action of the agent employed. This 
method is the very antithesis of empiricism, and has been the leading 
idea in every revolt against empirical therapeutics in the past. Humor- 



INTRODUCTION. 1 9 

alism, Chemicism, Solidism, Stimulism, Galenism in the 2d century, 
Paracelcism in the 16th, and Hahnemannism in the 19th, all originated 
in efforts to find a more rational system of administering medicines than 
the prevailing empiricism of the day. 

The illustrious Albrecht von Haller, the father of Physiology and the 
author of the doctrine of Irritability, was the real originator of modern 
physiological therapeutics. In the preface to his Swiss Pharmacopoeia 
{circa A.D. 1755), occur the following remarkable directions, — the first 
recorded of their kind : — 

" Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscela ; 
odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes qute inde 
contingunt affectiones, quis pulsus, quis calor, quae respiratio, qusenam excretiones, attend- 
endum. Inde adductum phenominorum in sano obviorum, transeas ad experimenta in 
corpore aegroto." 

" In the first place the remedy is to be tried on the healthy body, without any foreign 
substance mixed with it; having been examined as to its odor and taste, a small dose is 
to be taken, and the attention directed to all effects which thereupon occur ; such as upon 
the pulse, the temperature, the respiration, the excretions. Having thereby adduced their 
obvious phenomena in health, you may pass on to experiment upon the sick body.'''' 

Forty or more years after these rules were laid down ex cathedra by 
Haller, the central idea contained in them was incorporated, as one of the 
main pillars, into a medical edifice then being erected in Germany. In 
the course of construction this pillar became so hidden beneath a super- 
structure of palpable absurdities, that the medical profession, in its anxiety 
to steer clear of the whole mass, almost forgot the corner-stone of truth, 
appropriated from the teachings of one of its own greatest teachers. 
While, however, the masses of the profession, blinded by prejudice, turned 
away from everything which savored of drug-experiment, a few in every 
country were quietly working on the lines of Haller's dogma that drug- 
proving is the only true basis of drug-using. As a result of their labors, 
the present generation sees the development of an idea, announced 
nearly 140 years ago, but now inspiring the minds of teachers and students 
all over the civilized world. Medical Colleges are recognizing physio- 
logical drug-experimentation as a part of their regular curricula ; labora- 
tories are fitted up in many of the schools with costly instruments of 
precision, for the more exact prosecution of this study j and under the 
direction of such men as Wood, Ringer, Murrell, Brunton, Hildebrandt, 
Liebermeister, Husemann, Schmiedeberg, etc., systematic researches are 
being conducted upon animals to ascertain the physiological action of 
every agent hitherto used in medicine. The alkaloids, and other com- 
ponent principles of vegetable drugs, are being subjected to the same 
rigid observation, as is also every new compound which chemistry gives 
to medicine. Journals, in every civilized country, teem with the results 
of these labors ; and no medical student is permitted to pass the graduat- 
ing ordeal until he has mastered the essential characteristics of the physio- 



20 CONSTITUENTS OF VEGETABLE DRUGS. 

logical action of the important medicaments so far as established. What 
has hitherto been the conviction of but a few, is daily growing into a 
fixed canon of professional belief, that physiological experimentation with 
drugs must be the basis of their therapeutical employment, and that all 
real advance towards the establishment of therapeutics as a science, must 
be made upon the lines laid down by Haller, namely — drug-proving upon 
the healthy human organism. Still, in the words of Brown-Sequard, 
" Therapeutics will cease to be empirical, only when this last kind of 
knowledge shall be fully obtained ; " — but its fulness will never be fully 
realized, unless the results have been thoroughly considered with full 
regard to the differences due to the action of drugs in different doses on 
the human organism in health and disease. 

A thoroughly-prepared materia medica of half-a-dozen standard drugs, 
such as Aconite, Arsenic, Belladonna, Mercury, Opium and Quinine, 
based upon their actions and uses in different doses and under different 
states of the organism, would be of more real value to the physician who 
wishes to do his work accurately and with his eyes open, than all the con- 
tents of the dispensatories, plus the entire literature of the "new reme- 
dies," and every symptom in the ten quarto volumes of the largely dis- 
credited and partly repudiated homoeopathic Materia Medica. 

If our medical students would each devote but one month, of his annual 
college vacation, to the personal investigation of some one feature of the 
action of some one drug, under such safe-guards against error as would 
secure the acceptance of the resulting observations, — what a mine of 
therapeutic gold would soon yield its solid truth to eager eyes ! Formally 
laid down by Haller in 1755, cultivated to some extent by Alexander in 
1768, Crumpe in 1793, Thommassini, Curtis, etc., — urged by John 
Hunter, Sir Thomas Watson, Dr. King Chambers, and many other lumi- 
naries of the medical profession, — the scientifically guarded proving of 
drugs on the human organism has lain, like the similar work of Jenner, 
neglected these many years, waiting for another Koch to re-inaugurate 
the work. 



CONSTITUENTS OF VEGETABLE DRUGS. 



The Constituents of Vegetable Drugs may be classified as Soluble and 
Insoluble, the first group containing those ingredients which may be 
extracted by suitable menstrua, the second such as resist the action of all 
ordinary solvents. 

The Soluble Constituents comprise both Inert and Active Princi- 
ples, the inert being chiefly starch, gum and pectin, which may be readily 



CONSTITUENTS OF VEGETABLE DRUGS. 21 

separated by water. The active principles are alkaloids, acids, salts, 
glucosides and other neutral principles, volatile oils, resins, etc. Some 
few of these may be extracted by Water alone (e. g., Morphine), and in 
some cases the addition of acids or alkalies to the water will effect the 
chemical solution of many ingredients which are insoluble in water alone. 
As a rule, however, Alcohol is the most generally applicable of all simple 
solvents, but from its hardening the cell-membranes instead of softening 
them it prevents the osmosis of their contents. Drugs subjected to alco- 
holic or ethereal menstrua should have their cells thoroughly broken or 
torn, so that the solvent may be brought into actual contact with the 
principles contained in them. The degree of disintegration required 
depends upon the size of the cells, ducts, tubes, intercellular spaces, etc., 
in which the active principles are enclosed. A very finely powdered state 
is however open to objection from the packing of the particles together 
into an almost impenetrable mass when treated by the solvent. The 
average size of vegetable cells is about -g-^-g- of an inch, while resin cells 
and other cavities are larger, averaging perhaps about y^- inch. The 
Pharmacopoeia prescribes in each instance the degree of fineness of the 
powdered drug employed in making certain of its preparations, or its 
bruising, slicing, etc., when such operations will answer. [Compare the 
article on Comminution in Part II.] 

Alkaloids are active, nitrogenous principles existing in plants, from 
which they are extracted by chemical art. They are organic bases, com- 
bining with acids to form crystalline salts without the production of water. 
They are regarded as compound ammonias, that is to say, one or more 
atoms of H in ammonia (NH 3 ) are in them replaced by various radicals; 
and they may be considered to be products of albuminous decomposition 
in the plant-cells during the process of growth. Like ammonia, they all 
contain N, with C and H ; most of them also contain O, though a few 
are devoid of the latter element, and occur as oily liquids, namely — Nico- 
tine, Coniine, Sparteine, Piperidine, Lupuline, Lobeline, Muscarine and 
Pilocarpine. Alkaloids are alkaline in reaction, the solid ones (except 
Berberine) are colorless; they are sparingly soluble or insoluble in water, 
but readily soluble in alcohol ; while their salts are more soluble in water 
than in any other liquid. Their solutions are intensely bitter. They are 
easily decomposed by alkalies or alkaline carbonates; and are precipitated 
from their solutions by a solution of Iodine in Potassium Iodide, by Po- 
tassio-mercuric Iodide, and by Picric, Phospho-molybdic and Phospho- 
tungstic Acids. They generally have a powerful physiological action. 
They are closely related to Pyridene, and some of them may be synthet- 
ically prepared from pyridene bases. The names of alkaloids terminate 
in Latin in — in a, in English in — i?ie. 



22 CONSTITUENTS OF VEGETABLE DRUGS. 

Of the alkaloids 15 are official, under either their own names or those 
of their salts, besides Veratrine, which is described as a mixture of alka- 
loids. Of the official salts of alkaloids there are 10 Sulphates, 6 Hydro- 
chlorates, 3 Hydrobromates and 1 each Bisulphate, Acetate, Salicylate 
and Valerianate. The official alkaloids are as follows, viz. : — 

Apomorphina, (Apomorphine). Hyoscyamina, (Hyoscyamine). 

Atropina, (Atropine). Morphina, (Morphine). 

Caffeina, (Caffeine). Physostigmina, (Physostigmine). 

Cinchonina, (Cinchonine). Pilocarpina, (Pilocarpine). 

Cinchonidina, (Cinchonidine). Quinina, (Quinine). 

Cocaina, (Cocaine). Quinidina, (Quinidine). 

Codeina, (Codeine). Strychnina, (Strychnine). 

Hyoscina, (Hyoscine). Veratrina, (Veratrine). 

Unofficial but Important Alkaloids, are the following, viz. : — 

Aconitina, (Aconitine). Duboisina, (Duboisine). 

Berberina, (Berberine). Emetina, (Emetine). 

Brucina, (Brucine). Gelsemina, (Gelsemine). 

Colchicina, (Colchicine). Homatropina, (Homatropine). 

Conhna, (Conime). Muscarina, (Muscarine). 

Curarina, (Curarine). Pelletierina, (Pelletierine). 

Glucosides are organic compounds belonging to the group of Neutral 
Principles existing in plants ; which, when acted upon by acids or certain 
ferments, split up into Glucose and other substances (alcohols, aldehydes, 
phenols), different in each case. Few, if any, of these compounds, con- 
tain any N, — but among them are some very active agents. The official 
glucosides number six, and like other neutral principles, are designated 
by titles which end, in Latin in — inum, in English in — in, viz. : — 

Chrysarobinum, (Chrysarobin). Picrotoxinum, (Picrotoxin). 

Elaterinum, (Elaterin). Salicinum, (Salicin). 

Glycyrrhizinum, (Glycyrrhizin). Santoninum, (Santonin). 

The most important unofficial glucosides are Digitalin, Digitaleln and Digitoxin, 
the active principles of Digitalis. 

Besides these, there are several other substances recognized by pharma- 
copceial names which terminate in — inum, — in, but which have no re- 
lationship to the group of Glucosides. Among them are the following : — 

Aloinum, (Aloin), — a neutral principle from Aloes. 
Benzoinum, (Benzoin), — a balsamic resin from Styrax Benzoin. 
Cannabinum, (Cannabin), — a resin from Cannabis Indica. 
Chinoidinum, (Chinoidin), — a mixture of alkaloids from Cinchona. 
Glycerinum, (Glycerin), — a liquid and sweet principle obtained by the decomposi- 
tion of vegetable or animal fats or fixed oils. 
Juniperinum, (Junipenn), — a principle from Juniper. 
Lupulinum, (Lupulin), — the glandular powder of the Hop plant. 
Piperinum, (Piperin), — a neutral principle obtained from Pepper. 

Also Benzin, Naphtalin, Pancreatin, Pepsin, Pyroxylin, Chinolin, Resorcin, Antipy- 
rin, Phenacetin, Kairin, Thallin, Piperazin, and other organic compounds, which are not 
derived from the vegetable kingdom. 

Resins are brittle, amorphous, solid exudations from trees ; charac- 
terized by being insoluble in water but soluble in alcohol, and by soft- 



ADMINISTRATION OF MEDICINES. 23 

ening or melting when heated and solidifying again on cooling." They 
are oxidized terpenes, consist of an acid or a mixture of acids, and dis- 
solve in alkalies, forming a kind of soap. They may be obtained from 
oleo-resins, as turpentine, by simple distillation, the volatile oil passing 
over and the resin remaining behind ; or by heating the part of the plant 
in which they are contained, as in the case of guaiacum resin. [Com- 
pare the title Resin^e, in Part II.] 

Gum -resins are natural mixtures of gum and resin. When they are rubbed up with 
water the gummy matter dissolves and the resin is suspended in the form of an emulsion. 
[Compare the title Emulsa, in Part II.] 

The Insoluble Constituents of vegetable drugs are Cellulose, 
Lignin and Sclerogen, which make up the cell-walls of vegetable sub- 
stances, and are extremely intractable. 



ADMINISTRATION OF MEDICINES. 



Medicines may be introduced into the circulation by various routes, 
including the mouth, the stomach, the rectum, the respiratory tract, the 
veins and arteries, the subcutaneous cellular tissue, and the integument 
itself. 

The Mouth is the usual receptacle for medicines intended for the 
stomach, but may itself be employed for the introduction of minute quan- 
tities of powerful agents. A drop of the tincture of Aconite placed on 
the tongue is quickly absorbed, and soon manifests that fact by its symp- 
toms. The small tablets used for hypodermic administration, if placed 
under the tongue, are readily conveyed into the system, and used in this 
way form a very convenient means of medication with alkaloids and 
other active principles. 

The Stomach is the most convenient organ for the absorption of 
medicines and the one most frequently employed. After having been 
swallowed the remedies find their way into the current of the circulation, 
through the walls of the gastro-intestinal bloodvessels and the lacteals. 
When the stomach is empty and its mucous membrane healthy, crystalloidal 
substances in solution pass through the walls of its vessels with great rapid- 
ity. Colloidal Substances (fats, albumen, gum, gelatin, etc.) require to be 
digested and emulsified before they can be absorbed. Iodine and Iodides 
should be given on an empty stomach, so that they may diffuse rapidly 
into the blood ; if administered during digestion the acid gastric juice 
and the starch of the food will alter their chemical constitution and 



24 ADMINISTRATION OF MEDICINES. 

weaken their action. Acids should be given, as a rule, on an empty 
stomach, especially when they are intended to check the secretion of the 
acids of the gastric juice. Alkalies, of which Sodium Bicarbonate may 
be taken as the type, are given after meals to neutralize excessive acidity, 
and before meals to stimulate the acid gastric secretions. Silver Oxide 
and Nitrate should be administered after the digestive process is ended ; 
if given during digestion, chemical reactions destroy or impair their 
special attributes and defeat the object for which they were prescribed. 
Metallic Salts (especially corrosive sublimate), also Tannin and pure 
Alcohol, impair the digestive power of the active principle of the gastric 
juice, and should only appear in the stomach during its period of inac- 
tivity. Malt Extracts, Cod-liver Oil, Phosphates, etc., should be given 
with or directly after food, so that they may enter the blood with the 
products of digestion. Bismuth should be given before meals, as it is 
usually employed for its local sedative action on the gastric mucous mem- 
brane. Potassium Per?nanganate should be given after meals, for on an 
empty stomach it would irritate the mucous membrane and might possi- 
bly produce ulceration thereof. Arsenic and other irritant and dangerous 
drugs (such as Copper, Zinc and Iron salts), should be given directly 
after food, except where local conditions require their administration in 
very small doses on an empty stomach. Morphine by hypodermic injec- 
tion should only be given when the patient is lying down, unless pre- 
viously habituated to its use. Pilocarpine, administered to produce 
sweating, should be given when the patient is in bed in a warm room. 
Ammonium Acetate acts as a diaphoretic when the recipient is warm in 
bed, but as a diuretic when the patient is in a cold room. Sulphonal 
should be given two or three hours before its hypnotic action is desired, 
as it is very slow of solubility and absorption. 

Under some circumstances it becomes necessary to introduce medicines directly into 
the stomach, as in cases of the patient's inability to swallow through narcotic poisoning 
or other causes. The stomach-pump or the stomach-tube may then be employed to 
convey both food and medicine to that receptacle. In obstruction of the oesophagus, as 
from stricture or malignant disease thereof, it may become necessary to make an opening 
through the abdominal wall and the wall of the stomach itself. Nasal feeding, by the 
use of a soft catheter with a hard rubber funnel inserted into its end, is a very efficient 
method of conveying liquids into the stomach. The eye end of the catheter is oiled and 
passed gently along the floor of the nose and down the pharynx ; the fluid being then 
poured into the funnel. In many cases, especially insane ones, the patient will so con- 
strict the muscles of the throat as to force the catheter into the mouth ; but if it is with- 
drawn until nearly out of the pharynx, the presence of the fluid as it drops down will 
excite swallowing, and the patient may be fed as well as if the tube was in the oesopha- 
gus. This method is particularly serviceable in cases of acute tonsillitis or other pain- 
ful affections of the mouth and palate, also after excision of the tongue, when swallowing 
is to be avoided as much as possible. 

The Rectum will absorb many substances applied in the form of 
Enemata or Suppositories. Those most suited to this route are the salts 
of the alkaloids in solution, especially those of Morphine, Atropine and 



ADMINISTRATION OF MEDICINES. 25 

Strychnine, the latter being absorbed more rapidly per rectum than by 
the stomach. Acid solutions, if not too frequently repeated, are also well 
administered by this channel. Nutritive enemata must be small, not 
exceeding three or four fluid ounces, or they will not be retained. They 
become necessary in many cases, especially in cases of gastric ulcer, in 
order to afford rest to the stomach. It is often found advantageous to 
have the food predigested before being administered by the rectum, for 
which purpose Pancreatin is used. [Compare the articles entitled Injec- 
tiones and Suppositoria in Part II and Enemata in Part III.] 

The Respiratory Tract admits of the rapid absorption of medicinal 
substances through its extensive blood-supply. The inhalation of vapors 
or atomized fluids, the insufflation of powders into the nares, fauces, 
larynx, etc., and the use of a medicated nasal douche, are methods whereby 
this channel may be utilized. [Compare the article entitled Inhala- 
tiones, in Part II.] 

The Veins are only used as a route of medication in emergencies, 
when the other channels are not available, and where immediate action is 
necessary to the preservation of life, the operation being a highly dan- 
gerous one. The injection intravenously of Saline Solutions in the col- 
lapse of cholera, diabetic coma, etc., — Blood ox Milk as a last resort in 
excessive hemorrhage, epilepsy, uraemia, the collapse of cholera, etc., — 
and a solution of A??imonia for the bites of venomous reptiles, Hydro- 
cyanic-acid poisoning, Opium narcosis, Chloroform asphyxia, etc., are 
the instances admitted in practice. 

Arterial Transfusion has also been performed successfully in a number of cases, and 
is considered safer than venous transfusion when a large quantity of fluid has to be in- 
troduced into the circulation. A special apparatus is employed for these purposes, 
known as Aveling's Transfusion Syringe, but the ordinary Dieulafoy's aspirator slightly 
modified, may be used with safety and convenience. The danger of the operation lies 
in the liability of the introduction of air into the circulation, an occurrence which may 
cause instant death in the human subject. 

The Hypodermic Method is the introduction of medicines into 
the organism by injecting them into the subcutaneous areolar tissue, from 
which they are quickly absorbed by the lymphatic and capillary vessels. 
The great advantage of this method is the absolute certainty as to the 
quantity of drug actively affecting the organism, a very essential question 
when using small quantities, as when powerful alkaloids are employed. 
Another is the avoidance of reactions between the drug and the secretions 
of the stomach, which may destroy the activity of the former, or seri- 
ously change its character. The medicines must be in solution, of neu- 
tral reaction and freshly prepa?-ed, the usual menstruum being distilled 
water ; though filtered spring water will answer just as well, and much 
better than distilled water which has been standing several days, and ex- 
posed from time to time to the air. The solution is to be injected beneath 



26 ADMINISTRATION OF MEDICINES. 

the skin, by a hypodermic syringe, care being taken to avoid puncturing 
a vein. The most suitable localities for the injection are the exter?ial 
aspect of the arms and thighs, the abdomen, the back, and the calves of 
the legs. On the external aspect of the thigh, just in front of the great 
trochanter, there is an area of some two inches square, over which the 
insertion of a fine hypodermic needle is not felt, so barren is the skin in 
that region of sensitive nerve filaments. A few years ago the sight of a 
hypodermic syringe in a physician's hand suggested an injection of mor- 
phine to the patient and to the patient's friends, and many a physician 
has acquired the reputation of giving morphine on every possible occa- 
sion because he administered drugs by this method. It is therefore well 
to inform the patient that another drug is being so administered when 
such is the fact. In this age«of toxin and antitoxin treatment the hypo- 
dermic syringe has become a necessity, as many of these agents are inert 
when given by the stomach. Whenever such preparations are employed 
their injection must be administered under strict aseptic conditions, ap- 
plied to the syringe and needle as well as to the site of the operation, and 
the contents of the syringe should be discharged very slowly into the tis- 
sues beneath the skin, giving time for the fluid to diffuse itself without 
rupturing the tissue. 

The classic practice of pinching up a fold of the integument before inserting the hypo- 
dermic needle is entirely wrong both in theory and in practice. It is never done by per- 
sons who habitually use this instrument on themselves, and they are admittedly the most 
expert of all operators in this line. It increases the liability to local soreness, and often 
produces bruises and ecchymoses which might be avoided by following the method de- 
scribed below. 

After nearly filling the syringe with the solution to be used, the needle, if separate, 
should be screwed on tightly; and with the instrument held in a vertical position, point 
uppermost, the excess of solution over the amount required should be ejected, thus ex- 
pelling air-bubbles and filling the needle itself. A site having been selected, where there 
is no danger of penetrating a vein or artery, the needle should be quickly inserted at a 
right angle with the surface, and carried on into the subcutaneous tissue for fully one-half 
its length. It should be held steadily and not moved around so as to avoid injuring the 
tissue. The piston should be pressed down slowly, and when the injection has been 
delivered the needle should be quickly withdrawn, and no attention paid to the few drops 
of solution which may follow it. The very finest needles should alone be used, except 
in cases where the patient is struggling and liable to break the needle off by his move- 
ments. The point of the needle should be perfect and its surface highly polished. It is 
far better to use a new needle every day than to risk one's reputation for skill on a blunt- 
pointed and rough-surfaced instrument. The writer buys Green's short and finest needles 
by the dozen and uses a new one on every patient. He has injected a strychnine solu- 
tion in this manner on some 300 patients during the last three years, three and four times 
daily in the same upper arm for a month in each case, without having produced any more 
serious result than a hypersemic zone around some punctures in a very few instances. If 
the solutions are freshly prepared with clean water, the needles sharp, clean and bright, 
and the injections delivered beneath the skin and not into it, there is no danger of pro- 
ducing abscesses or even indurations with the agents ordinarily employed in this manner. 

Compressed Tablets for hypodermic use are prepared by the prominent manufac- 
turers, and are furnished in glass tubes containing from 20 to 25 tablets each. The 
writer prefers those made by John Wyeth and Brother of Philadelphia, for many reasons. 
They are very small, are entirely free from any foreign material, are sufficiently soluble, 
and are put up in short tubes which can be carried in cases to fit the vest pocket. The 
tablets may be readily dissolved in a teaspoon at the bedside, or in the syringe itself if 



ADMINISTRATION OF MEDICINES. 



2/ 



the instrument has a screw-hole large enough to admit the tablet before screwing on the 
needle. A regular line of Hypodermic Tablets includes the agents named in the follow- 
ing list, though many others are prepared by the manufacturing chemists. 

List of Hypoder7?iic Tablets, 



Aconitine (crystals), gr. t |q. 
Apomorphine Hydrochlorate, gr. j 1 ^-. 
Atropine Sulphate, gr. ^ , T ^, 3L. 
Caffeine, gr. i. 



Colchicine, 

Corrosive Sub. and Urea, gr. ^. 

Digitalin (soluble), gr. y-ig. 

Duboisine Hydrochlorate, gr. y^-. 

Ergotin, gr. y. 

Gelsemine Hydrochlorate, gr. -£§. 

Hyoscine Hydrobromate, gr. yjyo, tAj. 

Hyoscyamine, gr. T ^, fo 



Morphine Sulphate, gr. |-, y, ^, \. 
Morphine & Atropine, No. I. 

Morphine Sulph., gr. $. 
Atropine Sulph., gr. 5^. 

Morphine & Atropine, No. 2. 

Morphine Sulph., gr. \. 
Atropine Sulph., gr. yi^. 

Nitroglycerin, gr. ^, T ^, 3 V 
Physostigmine Sulphate, gr. y^-. 
Picrotoxin, gr. -gL. 
Pilocarpine Hydrochlorate, gr. i. 
Sodium Arsenate, gr. yL-. 
Sparteine Sulphate, gr. -g 1 -^. 
Strychnine Nitrate, gr. ^, ^, T ±^. 
Strychnine Sulphate, gr. ^, 3L, T ^. 



[For Formulae for Hypodermic Solutions, see Appendix.] 

Parenchymatous Injection is the delivery of a medicine deeply into the tissues, 
either to affect a muscle itself or to locally influence some important nerve-trunk. The 
principal agents used in this manner are Strychnine for palsied muscles, Chloroform for 
sciatic and other neuralgias, Salts of Cocaine for local anaesthesia, and Carbolic Acid for 
deep-seated inflammations. 

The Integument is an active absorbent of crystalloidal substances 
when its epidermis or cuticle is removed, and many substances may be 
made to pass through the latter and produce their characteristic effects on 
the system. By this route there are four methods of introducing medica- 
ments into the circulation, viz. : — the Endermic, Enepidermic and Epi- 
dermic Methods and Inoculation. 

The Endermic Method obviates the difficulty of absorption through 
the cuticle by removing the latter with a blister, and then powdering the 
medicament over the surface of the denuded derma. Before the intro- 
duction of the hypodermic method this procedure was quite common, but 
it is rarely employed now, as it is both painful and unpopular. 

An ordinary Cantharides-plaster, followed by a poultice to raise the blister, may be 
employed ; but a quicker method is to place upon the skin a piece of lint soaked in 
Stronger Water of Ammonia, covering it with a watch-glass or a piece of oiled silk to 
prevent evaporation. The blister raises rapidly and should be removed with scissors, and 
the medicine in powder then placed on the raw surface. Morphine, Atropine, Quinine 
and Strychnine, are the agents generally used in this manner. 

The Enepidermic Method consists in placing the medicine in simple 
contact with the epidermis, no friction being used to hasten its penetra- 
tion. Chloroform and oleic acid solutions of the alkaloids pass by osmo- 
sis in this manner with comparative ease, but aqueous solutions act very 
slowly, and alcoholic ones with great difficulty if at all. Drugs are readily 
absorbed from the surface of hot, moist poultices, a fact to be remem- 
bered in directing such applications for children, as narcotic poisoning 
may follow the liberal use of opium in this manner. A good belladonna 



28 DOSAGE OF MEDICINES. 

plaster will cause dilatation of the pupils and may produce the character- 
istic belladonna rash all over the body. 

The Epidermic Method or Inunction consists in the use of fric- 
tion to promote the passage of the medicament between the cells of the 
epidermis. Mercurial ointment, cod-liver oil, and other fats, oleates, 
etc., are rubbed into the skin of the armpits, the popliteal space, and 
other parts of the body, for their local and systemic effects. Oil inunc- 
tions are an excellent method of introducing fatty substances into children 
and persons who cannot take oils by the stomach. The inunction of 
castor oil will produce a purgative effect. 

Inoculation is the introduction of medicinal agents through the 
scraped or punctured skin by an operation similar to that employed for 
vaccination. 



DOSAGE OF MEDICINES. 



The Doses given throughout this book are for adults ; for children the 
following rule (Young's) will be found the most convenient. Add 12 to 
the age and divide by the age, to get the denominator of a fraction, the 
numerator of which is 1. Thus, for a child two years old, 2 + 2 12 = 7, 
and the dose is one-seventh of that for an adult. Of powerful narcotics 
scarcely more than one-half of this proportion should be used. Of mild 
cathartics, two or even three times the proportion may be employed. 

Children bear Opiates badly : — but on the other hand they stand comparatively large 
doses of several other drugs ; such being Arsenic, Belladonna, Ipecacuanha, Calomel 
and other preparations of Mercury, also Squill, Rhubarb and several other purgatives. 
Pilocarpine has very little effect on children, though it readily induces perspiration and 
salivation in adults. 

For Hypodermic Injection, the dose should be two-thirds or three-fourths of that 
used by the mouth ; by rectum five-fourths of the same. Strychnine acts more actively 
when given per rectum than by the stomach. 

Conditions which modify the action of medicines, and therefore 
affect their dosage, are — age, body-weight, temperament and idiosyncrasy, 
drug-habits, intervals between doses, time of administration, condition of 
the stomach, temperature of the body, cumulative drug-action, mode and 
form of drug-administration, disease, climate, race, etc. 

The Dosage of Medicines is the weakest part of the therapeutic 
armament, the flaw in our weapons which may be the cause of their failure 
at any moment, perhaps the most critical one for a life. If the accumu- 
lated rubbish of ages, which has been called therapeutic knowledge, is 
ever to be given scientific shape, ever placed in process of becoming a 
science, the question of dosage must form one of the principal corner- 



DOSAGE OF MEDICINES. 29 

stones in the foundation. Drugs have widely differing actions on the 
human organism in health and in disease, according as they are adminis- 
tered in different doses, in different menstrua, and during different con- 
ditions of the subject's health. This difference, when between extremes 
of dosage, is often so wide as to separate actions directly contrary to each 
other, — that of the very large one opposing the action of the very small 
dose : — a truth hidden by one set of dogmatists under their former doc- 
trine now rule of " similars," and' avoided by the great mass of the med- 
ical profession, through dread of the bogy-name, " irregular." 

In the British Pharmacopoeia a minimum and maximum dose is stated for all the 
more important medicines, the quantities being intended to represent average doses in 
ordinary cases for adults. In the preface to that work it is however distinctly stated that 
these doses "are not authoritatively enjoined " and that "the practitioner must rely on 
his own judgment and act on his own responsibility in graduating the doses of any thera- 
peutic agents which he may wish to administer to his patients. ' ' As a matter of fact 
most British practitioners ignore the doses given in their pharmacopoeia, or at best con- 
sider them as mere indications. The German Pharmacopoeia has appended to it a table 
giving the maximum single dose and the maximum daily dose for a number of drugs and 
preparations, but they are of little value in practice except to catch an unwary physician 
in a legal proceeding for mal-practice. 

In the following pages an effort has been made, whenever possible, to 
indicate the different doses of active agents for different purposes, and 
the proper intervals for repetition in certain cases, as determined by the 
accumulated experience of clinicians, which is the only safe guide in this 
respect. The average doses of the official preparations should be memor- 
ized by the student, and the following rules will be found useful for that 
purpose. 

Average Adult Doses of Official Preparations. 

Acids (dilute), tr^x ; — except Dilute Hydrocyanic Acid, the average dose of which 
is rr^iij . _ 

Alkalies. Liquor Potassse, n\x, well diluted. Carbonates, gr. xv, Sodium Borate 
(Borax) gr. xx, Bicarbonates, gr. xxx. 

Alkaloids and their Salts, form three groups, (1) those of the Solanaceae, etc., 
the average dose of which is gr. T ^, (2) those from Nux Vomica, gr. -£■$, (3) those 
from Opium, gr. i; — except Codeine, gr. j, Narcotine (which is not a narcotic), gr. iij, 
Quinine and the other Cinchona alkaloids, gr. x. 

Aquae (Waters), ^j ; — except Aqua Ammonise, n\x, Aqua Chlori, rr^xv, and Aqua 
Creosoti, gij. 

Extracts, gr. v ; — except Ext. Physostigmatis, gr. rfe, Ext. Aconiti, gr. \, Ext. 
Belladonna?, gr. A, Ext. Colchici Radicis, gr. j, Ext. Colocynthidis, gr. j, Ext. Cannabis 
Indicae, gr. \, Ext. Opii, gr. \, Ext. Stramonii, gr. \, and Ext. Aloes, gr. iij. 

Fluid Extracts, n\x ; — except the fluid extracts of Aconite, tt\J, Belladonna, TT\jrj, 
Colchicum-root, tt\v, Colchicum-seed, ttyj, Digitalis, TT\J, Nux Vomica, mjj, Sanguina- 
ria, rr\jj, Squill, IT^ij, Stramonium, n\ij, and Veratrum Viride, TT\jrj. 

Infusions and Decoctions, Hjjj ; — except Infusion of Digitalis, ^ij. 

Mixtures, ^ j ; — except the Mist. Glycyrrhizae Comp. (for children), gj, and Mistura 
Ferri Composita, 3 iij. 

Oils, Fixed, 3 ss ; — except Oleum Phosphoratum, rr^iij, and Oleum Tiglii (Croton 
Oil), mj. 

Oils, Volatile, rr\jj ; — except Oleum Amygdala? Amarse, TT^ss, and the Oils of Co- 
paiba, Erigeron, Cubeb, Eucalyptus, Juniper, Sandal-wood and Amber, of each 1t\x. 

Pills, gr. v; — except those of Phosphorus, Ferrum Iodide, Opium, Blue Mass, and 
Compound Antimony, which are given in smaller doses. 



30 STIMULANTS AND SEDATIVES. 

Powders, form two classes, (i) those given in grains, including Pulv. Antimonialis, 
gr. v, Pulv. Morphinae Comp., gr. x, Pulv. Ipecac, et Opii, gr. x, Pulvis Opii, gr. j, 
Pulv. Cretae Comp., gr. xx, and Pulv. Jalapse Comp., gr. xxx ; (2) those given in dose 
of 3J or more, including Pulv. Glycyrrhizoe Comp., Pulv. Rhei Comp., and Pulv. Ef- 
fervescens Comp. 

Resins, gr. v ; — except Resin of Podophyllum, the average dose of which is gr. ss, 
and Resin of Copaiba, gr. ij. 

Spirits, gss or more, according to the amount of alcohol desired to be taken ;— ex- 
cept Spirit of Camphor, rr^x, and Spirit of Nitroglycerin (Spt. Glonoini), rr\,iij. 

Syrups, 3J ; — except Syrup of the Iodide of Iron, TT\,x, and Compound Syrup of 
Squill, Tr^x. 

Tinctures, gss; — except the tinctures of Aconite, rr\j, Belladonna, TT^x, Can- 
tharides, TT\v, Capsicum, H\v, Colchicum-seed, TTVxx, Digitalis, n\x, Chloride of Iron, 
TT\_x, Gelsemium, Tr^x, Iodine, Vi\v, Ipecac and Opium, TTVx, Lobelia, Tr^x, Nux Vomica, 
TT\x, Opium, TT^xv, Physostigma, Vt\x, Stramonium, n\x, Strophanthus, TT^v ; also the 
tinctures given in larger doses, namely, Hyoscyamus, 55 ij, and Camphorated Opium, 
3 ij. It is well to remember that children bear the above dose of tincture of Belladonna 
without difficulty, and that tincture of Aconite should always be given in doses of a drop 
or less. 

Wines, 3 j ; — except those of Antimony, Colchicum and Opium, the average dose of 
which is TTbx. 

Vinegars, number only 2, that of Opium, nyc, and that of Squill, TtLxxx. 



CLASSIFICATION OF MEDICINES. 



In the present state of knowledge respecting the 'actions and uses of 
medicinal agents, no really scientific classification of these substances is 
possible. Some writers have adopted a system based on the natural rela- 
tions of the various articles to each other, while many classify them 
according to their effects on the human system, and others make no 
attempt at arrangement but treat of them in alphabetical order. The 
latter method has been chiefly followed in this work, from a conviction 
that every medicine should first be studied as an individual, both with 
respect to its physiological actions and its therapeutical applications. 
When the student has thus made himself familiar with the characteristic 
features of each article of the Materia Medica, he may begin, by compar- 
ing one with another, to seek acquaintance with their more delicate lights 
and shades. Some system of classification then becomes imperative as 
an aid to the memory, and as the titles of the groups to which the various 
agents belong in any physiological classification are also used to express 
their actions and uses, the following synopsis is inserted as an appropriate 
introduction to the section on Materia Medica and Therapeutics. 

Stimulants and Sedatives. 
These are general terms employed in various classifications with very 
little discrimination. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 3 1 

Stimulant {Stimulus, a goad), — is a term which is used in various 
senses when applied to medicinal agents. Alcoholic preparations, which 
are true narcotics, are commonly termed "stimulants," and the same 
expression is employed to designate any agent which excites even briefly 
the organic action of any part of the system. All excessive stimulation 
reacts into depression, and most of the agents which stimulate the nerve 
centres at first will soon depress and finally paralyze them. In many 
cases the action is one of progressive stimulation primarily and progres- 
sive paralysis afterward, affecting the centres in the inverse order of their 
development, the highest or latest developed centres being affected first, 
the lowest or oldest ones last. These laws are well exemplified in the 
action of Alcohol upon the nervous system. [See the article entitled 
Alcohol in Part I.] 

Diffusible Stimulants are those which have a prompt but transient effect on the general 
system, such as Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the functions 
of the cord, as Strychnine, Picrotoxin, Ergot, Atropine, Phosphorus. Cardiac Stimu- 
lants increase the action of the heart, as Alcohol, Atropine and Morphine in small 
doses, Strychnine, etc., also Squill, Convallaria, Cimicifuga and Digitalis, which slow 
but strengthen the cardiac action. Respiratory Stimulants directly stimulate the respira- 
tory centre, as Ammonia, Strychnine, Apomorphine, Belladonna, etc. Vaso-motor Stim- 
ulants, as Alcohol, Chloroform, Ether (all three in very small quantities), Ammonia, 
Strychnine, Digitalis and Squill, acting on the vaso-motor centre; and the Nitrites, Bella- 
donna, Electricity, Volatile Oils, etc., acting as local dilators of the vascular system. 
Cerebral Stimulants , as Alcohol, Opium, Belladonna, Caffeine, Cocaine, Theine, Canna- 
bis, Chloroform, Ether, Tobacco, etc. Renal Stimula?its, as the diuretic group. Stom- 
achic Stimulants, as the Aromatics, Volatile Oils, Vegetable Bitters, Mineral Acids, Nux 
Vomica, Mustard, Capsicum, etc. Hepatic Stimulants, as Nitro-muriatic and Nitric acids, 
and the cholagogue purgatives Podophyllum, Jalap, Leptandra, Euonymin, Iridin, etc. 
Intestinal Stimulants, as Mercurials, Elaterium, Colocynth, Jalap, Scammony, Podophyl- 
lum, etc., which affect the glandular apparatus, — and Belladonna, Physostigma, Nux 
Vomica, Rhubarb, Senna, Aloes, Frangula, Cascara, etc., which chiefly affect the mus- 
cular fibres and the intestinal nerves. Cutaneous Stimulants, as the diaphoretic group, 
and the rubefacients Mustard, Capsicum, Turpentine, Ammonia, etc. 

Sedatives (Sedo, I allay), — are agents which exert a soothing influ- 
ence on the system by lessening functional activity, depressing motility 
and diminishing pain. 

General Sedatives include the narcotics and anaesthetics. Local Sedatives include Aco- 
nite, Opium, Ice, etc. Pulmonaiy Sedatives, as Hydrocyanic Acid, Veratrine and the 
nauseants and emetics. Spinal Sedatives, as Physostigma, Gelsemium, Potassium Bro- 
mide. Stomachic Sedatives include Arsenic, Bismuth, Silver Nitrate, Sodium Bicarbon- 
ate. Vascular Sedatives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. 
Nervotis Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the 
group of spinal depressants. 

Agents Acting Chiefly on the Nervous System. 
Motor-Excitants are agents which increase the functional activity 
of the spinal cord and the motor apparatus, producing disturbances of 
motility, heightened reflex excitability, and tetanic convulsions when 
given in large doses, their ultimate effect being motor paralysis from over- 
stimulation. 



32 



AGENTS ACTING ON THE NERVOUS SYSTEM. 



The most important members of this class are Nux Vomica and fgnatia, with their 
alkaloids Strychnine and Brucine, also Thebaine, the tetanizing alkaloid of Opium. It 
also includes Morphine and Atropine, which, though at first sedative, when given in large 
doses produce convulsions. The respiratory centre in the medulla is stimulated by Strych- 
nine, Atropine, Ammonia, and small doses of Alcohol, Ether and Chloroform. The 
motor convolutions in the brain are stimulated by Alcohol in moderate doses, as also for 
a brief period by Ether and Chloroform. 

The end-organs of the motor nerves are stimulated by the local use of Electricity, 
Strychnine and friction ; and are irritated by the internal administration of Aconitine, 
Nicotine, Camphor, Pilocarpine and Pyridine. Other members of this class are embraced 
in the following list : — 



Nux Vomica. 

Ignatia. 

Strychnine. 

Brucine. 

Thebaine. 

Morphine.* 

Atropine.* 



Alcohol, f 

Ether, f 

Chloroform. 

Ammonia. 

Absinthe. 

Buxine. 

Calabarine. 



Ergot. 

Ustilago. 

Gossypium. 

Picrotoxin. 

Aconitine. 

Nicotine. 

Camphor. 



Digitalis. 

Convallaria. 

Cimicifuga. 

Pilocarpine. 

Pyridine. 

Rhus Toxicodendron. 

Electricity. 



Motor Depressants lower the functional activity of the spinal cord 
and other parts of the motor apparatus and in large doses paralyze them. 
Drugs which depress the cerebral motor convolutions, the motor centres in 
the medulla, the motor nerve-trunks and nerve-endings, or the muscular 
contractility itself, produce impairment of the motor power, and in large 
doses may cause complete paralysis of the part or parts involved. Some 
act indirectly by reducing the spinal circulation, as Aconite, Digitalis and 
large doses of Quinine, others by a direct paralyzant action on the centres. 
The principal members of this class are comprised in the following list: — 



Curare. 
Physostigma. 
Conium. 
Gelsemium. 
Opium, Morphine, 

Apomorphine. 
Belladonna, Atropine. 
Stramonium. 
Hyoscyamus. 
Muscarine. 
Pulsatilla. 
Grindelia. 
Phytolacca. 
Pilocarpus. 
Quebracho. 



Aconite. 
Veratrum. 

Tobacco. 

Lobelia. 

Digitalis. 

Arnica. 

Ailanthus. 

Saponine. 

Sparteine. 

Ergot(at last). 

Quinine (large doses). 

Camphor. 

Alcohol (large doses). 

Ether (large doses). 

Chloroform (large). 



Chloral. 

Bromides. 

Potassium Salts. 

Many metallic Salts. 

Amyl Nitrite. 

Nitroglycerin. 

Hydrocyanic Acid. 

Potassium Cyanide. 

Methyl-strychnine. 

Many Methyl compounds. 

Ammonium Cyanide. 

Ammonium Iodide. 

Many compound Ammonias. 

Galvanism. 

Cold. 



The motor centres in the medulla are powerfully depressed by Opium, Morphine, Aco- 
nite, Conium, Chloral, Physostigma, and large doses of Alcohol, Ether, and Chloroform. 
These last three are also paralyzers of the motor convolutions in the brain, arresting all 
voluntary movements when administered in sufficient quantity. The anterior cornua of 
the cord are greatly depressed by Physostigma, Carbolic Acid, and other agents, and the 
motor nerves by Conium, Methyl-Strychnine, etc., both actions resulting in paralysis of 
the limbs. Curare, even in small doses, paralyzes the end-organs of the motor nerves, 
and Belladonna, the compound Ammonias, Methyl compounds, etc., exercise a similar but 
less powerful influence. Galvanism is also an effective local depressant of motor activity. 



* In large doses. 



f In small doses. 



AGENTS ACTING ON THE NERVOUS SYSTEM. 33 

Local Stimulants increase common sensibility to the extent of pro- 
ducing pain, chiefly by direct action upon the end-organs of the sensory 
nerves in the skin, though some act probably by stimulating the local cir- 
culation, as in inflammation. The principal members of this group are — 



Farad ism. 


Chloroform. 


Volatile Oils. 


Heat. 


Carbolic Acid. 


Acrid Essential Oils. 


Cold. 


Creosote. 


Metallic Salts. 


Alcohol. 


Mineral Acids. 


Veratrine (at first) . 


Ether. 


Ammonia. 


Cantharis (at first). 



Local Anaesthetics and Anodynes {An, without, Aistheysis, per- 
ception, Odunay, pain), — reduce the functions of the sensory nerves until 
they lose the power of receiving or conducting sensations. Some act by 
direct depression of the end-organs in the skin, etc., others by impair- 
ing the conductivity of the sensory nerves, while some act indirectly by 
reducing the local circulation. The Anodynes diminish, and the Anaes- 
thetics destroy, for a time, the sensibility of the skin or mucous membrane. 
The chief agents of this class are named in the following list. 

Local Anodynes. Local Anesthetics. 

Acetanilid. Extreme Cold, Ice. 

Aconite, Aconitine. Ether Spray. 

Belladonna, Atropine. Ouabain. 

Opium, Morphine. Cocaine. 

Carbolic Acid. Antipyrin. 

Chloroform. Erythrophlcein. 

Chloral. Hydrocyanic Acid. 

Veratrum, Veratrine. Carbolic Acid. 

Volatile Oils. Creosote, Guaiacol. 

Oil of Turpentine. Iodoform. 
Galvanism. 

Cerebral Excitants, — are remedies which increase the functional 
activity of the cerebrum, without producing any subsequent depression, or 
any suspension of the cerebral functions. They act partly by increasing 
the action of the heart and consequently the rapidity of the circulation, 
partly by a direct action upon the gray matter of the brain. The chief 
members of this group are — 

Alcohol (at first). Ammonia (inhaled). Tobacco. 

Ammoniac. Coffee, Caffeine. Strychnine. 

Asafetida. Tea, Theine. Acetic Acid (inhaled). 

Camphor. Guarana, Guaranine. Valerian. 

Cannabis. Coca, Cocaine. Ether. 

Deliriants excite the functions of the higher brain to such a degree as 
to disorder the mental faculties, producing intellectual confusion, loss 
of will-power, delirium and even convulsions. They are all narcotics 
(though all narcotics are not deliriants), and may be listed as follows. 



Belladonna. 


Alcohol. 


Cannabis Indica. 


Stramonium. 


Chloral. 


Lupulus (at first). 


Hyoscyamus. 


Ether. 


Opium (at first). 


Turpentine. 
3 


Chloroform. 


Nitrous Oxide Gas. 



34 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Cerebral Depressants lower or suspend the functions of the higher 
cerebrum after a preliminary stage of excitement. Under this head may 
be included the Narcotics, General Anaesthetics, and several of the Anti- 
spasmodics, all acting on the cells of the convolutions ; at first stimu- 
lating the brain-functions, they produce after a time stupor, coma and 
insensibility. 

The most useful of this class are the Bromides, Zinc and Caffeine, as they also dimin- 
ish reflex excitability and thus secure rest of the nervous system. Some of them are 
decidedly dangerous, as they may paralyze the heart or the medulla and its centres of 
organic life before the consciousness is much disturbed ; such being Chloroform, Aconite, 
Opium, and the irritant poisons, also Carbolic Acid. 

Narcotics (Narkay, stupor), — are agents which lessen the relation- 
ship of the individual to the external world. At first more or less exci- 
tant to the higher brain and stimulant to the mind and to all the bodily 
functions, the next stage of their action is one of profound sleep charac- 
terized by increasing stupor, and, if the dose has been sufficient, is 
followed by coma and insensibility (narcotism), and finally by death 
from paralysis of the medullary centres which govern the functions of 
organic life. Narcotics and stimulants are closely related, Alcohol and 
Opium being good illustrations, in the different stages of their action, of 
stimulation followed by narcosis. [Compare the sub-title Stimulants, 
ante, page 31, and the title Alcohol in Part I.] 

Narcotics, in proper medicinal doses, give us the power of lowering 
morbidly acute perception, of relieving pain and allaying irritation, 
nervous agitation and spasm, of inducing sleep, and of regulating the 
vital functions by rest — all of which are means of great therapeutical 
value. The chief narcotics are — 

Opium, Morphine. Alcohol. Carbolic Acid. 

Belladonna, Atropine. Ether. Hydrocyanic Acid. 

Hyoscyamus. Chloroform. Oil of Turpentine. 

Stramonium. Chloral Hydrate. Other Essential Oils. 

Cannabis Indica. Bromal Hydrate. Carbonic Acid Gas. 

Opium is the typical member of the group. Humulus (hops) and Lactucarium, 
(lettuce), are generally included among the narcotics, but their action is so feeble that 
they are seldom used for such purpose. 

Hypnotics {Heupnos, sleep), — are remedies which produce sleep. 
In this wide sense the term includes the narcotics and the general anaes- 
thetics, but it is usually restricted to those agents which, in the doses 
necessary to cause sleep, do not disturb the normal relationship of the 
mental faculties to the external world (Brunton). Another definition of 
Hypnotics is — that they produce sleep without suspending the conscious- 
ness of pain, Narcotics doing both. The Hypnotics may be subdivided 
and listed as follows: — 

(1) Pure Hypnotics, — which directly induce a sleep closely resem- 
bling the normal, without causing narcotic or other dangerous cerebral 
symptoms. The Bromides are the type of this subdivision, but the list 



AGENTS ACTING ON THE NERVOUS SYSTEM. 35 

is constantly growing smaller as experience reveals toxic powers in the 
action of its members. 

(2) Narco-hypnotics, — which induce sleep by direct depression of the 
cerebral functions and in larger doses are narcotic, suspending the con- 
sciousness of pain and producing coma. Opium is the type of this class. 

(3) Indirect Hypnotics, — which induce sleep by removing or sup- 
pressing any cause (not mental) which interferes therewith. Such are 
the non-narcotic analgesics,* acting against pain ; the respiratory stimu- 
lants,! relieving dyspnoea; the pulmonary sedatives,^ relieving cough; 
the motor depressants, § restraining excessive motor activity; also the 
vascular and cardiac tonics, *[ antagonizing cerebral hyperaemia and regu- 
lating the cardiac action. 

The principal members of each of the above sub-divisions are included 
in the following list. 

Pure Hypnotics. Narco-hypnotics. Indirect Hypnotics. 

Bromides. Chloral Hydrate. *Antipyrin. 

Paraldehyde. Opium, Morphine, Narceine. * Acetanilid. 

Sulphonal. Hyoscyamus, Hyoscine. * Phenacetin. 

Trional. Duboisine. | Strychnine. 

Tetronal. Cannabis Indica. J Hydrocyanic Acid. 

Urethane. Humulus. § Conium. 

Chloralamid. Piscidia erythrina. | Gelsemium. 

Cannabin Tannate. Ether. Chloroform. \ Ergot. 

Amylene Hydrate. *[ Digitalis. 

Alcohol. 

Chloral Hydrate is undoubtedly the most efficient of all hypnotics. Paraldehyde is 
one of the most reliable and safe, but its sleep is transient, lasting only a few hours. Stcl- 
phonal and Trional are very efficient in some cases, but often fail entirely. Urethane 
is feeble and uncertain, and the same may be said of Humulus and some other agents 
which are not mentioned above. Piscidia is also somewhat uncertain in action, though 
its hypnotic and anodyne powers have proved very decided in many cases. 

Analgesics or Anodynes {An, without, Algos, pain, Odunay, pain), 
— are remedies which relieve pain either by direct depression of the 
centres of perception and sensation in the cerebrum, or by impairing the 
conductivity of the sensory nerve fibres. Opium is the most efficient of 
all analgesics, because it arrests the afferent impressions at every step 
of their track — at their formation, along the course of their conduction, 
and at the point where they impinge on the sensorium. The Local Ano- 
dynes have been described, and the list of General Anodynes includes the 
following-named agents, viz. — 

Opium, Morphine. Antipyrin. Aconite. 

Belladonna, Atropine. Acetanilid. Chloroform, Ether, etc. 

Cannabis Indica. Phenacetin. Conium. 

Stramonium. Phenocoll. Chloral Hydrate. 

Hyoscyamus. Exalgin. Croton-chloral. 

Gelsemium. Lupulus. 

Anaesthetics (An, without, Aisthaysis, perception), — are agents which 
destroy sensation. Local Ancesthetics have been described. General 



36 AGENTS ACTING ON THE NERVOUS SYSTEM. 

Anaesthetics are certain volatile substances, mostly belonging to the classes 
of alcohols and ethers, which when inhaled produce complete uncon- 
sciousness and loss of sensation (anaesthesia), with lessened motor power. 
Narcotics also produce anaesthesia, but this term is usually restricted to 
the effects of the volatile agents referred to above. The principal mem- 
bers of this group are — 

Ether (Ethyl Oxide). Chloroform. 

Methylene Bichloride. Chlorinated Ethyl Chloride. 

Ethylene Bichloride. Ethyl Bromide. 

Nitrous Oxide. Pental (Tri-methyl-ethylene). 

The list of General Anaesthetics also includes Alcohol and many substitution products 
derived from alcohols and ethers. [Compare the articles entitled Alcohol, ^Ether 
and Chloroform in Part I.] 

Antispasmodics {Anti, against, Spasmos, a spasm), — are agents 
which prevent or allay spasm of voluntary or involuntary muscles in any 
portion of the organism. Some of the agents belonging to this class act 
by stimulation of the higher nervous centres, the coordinating power, and 
the circulation, as Alcohol and Ether in small doses, Camphor, Musk, 
Valerian, etc. ; others by a depressant influence on the motor centres, as 
the Bromides, and still others by paralysis of the end-organs of the vaso- 
motor nerves, as Amyl Nitrite. A few depress all the vital functions, as 
Aconite, Tobacco, Lobelia, Hellebore, and Prussic Acid ; and a long list 
stimulate the bowels to expel gaseous accumulations, namely, Asafetida, 
Cajuput, Valerian, Musk, Aromatic Oils, etc. They are used in convul- 
sive affections, especially asthma and other spasmodic diseases of the 
respiratory organs, hysteria, chorea, angina pectoris, epilepsy, etc. The 
principal antispasmodics are as follows, viz. — 

Alcohol. Aconite. Ammoniac. 

Ether. Lobelia. Castor. 

Chloroform. Tobacco. Musk. 

Amyl Nitrite. Hellebore. Galbanum. 

Nitrites. Opium. Sumbul. 

Bromides. Belladonna. Ipecacuanha. 

Potassium Iodide. Stramonium. Senega. 

Potassium Nitrate. Hyoscyamus. Silver Salts. 

Arsenic. Hydrocyanic Acid. Zinc Salts. 

Valerian. Physostigma. Copper Salts. 

Conium. Curare. Asafetida. 

The Cerebellum is affected by a few drugs, their action upon its 
several lobes producing various disturbances of equilibrium. 

Alcohol is the principal agent acting upon this portion of the brain, and different pro- 
ducts of the still seem to affect different portions of the cerebellum. For instance, intoxi- 
cation by wine or beer is said to cause lateral falling, that by whiskey an inclination to fall 
face downwards, cider a backward tendency (Brunton). Apomoi'phine in large doses 
produces a tendency to move in a circle, and therefore probably affects the cerebellum or 
the corpora quadrigemina. 



AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 37 

Agents Acting on the Organs of Special Sense. 

Mydriatics (Meudos, moisture), — are agents which produce dilatation 

of the pupil of the eye (mydriasis). Some act locally, others when given 

internally, and the principal ones (Atropine and its congeners) act both 

locally and internally, producing at the same time paralysis of the ciliary 

muscle resulting in temporary loss of accommodation, the eye remaining 

focussed for distant objects, and the intra-ocular tension being increased. 

The principal mydriatics are the following named, — 

Atropine. Homatropine. 

Belladonnine (internally only). Gelsemine (locally only). 

Hyoscyamine. Muscarine. 

Daturine. Cocaine. 

Duboisine. Anaesthetics (at last). 

The dilating action of Atropine and its congeners is due to stimulation of the end- 
organs of the sympathetic nerve, increasing the power of the radiating muscular fibres ot 
the iris, and also to paralysis of the end-organs of the motor oculi (3d cranial) nerve, 
lessening the power of the circular fibres or sphincter iridis. When administered inter- 
nally the drug is carried by the circulation to the eye, acting thereon locally as if instilled 
directly upon the conjunctiva. Cocaine acts by stimulating the terminations of the sym- 
pathetic. Anesthetics produce mydriasis late in their action, which is central. Atropine, 
Duboisine and Homatropine are the mydriatics used by ophthalmologists. 

Myotics (Meuo, I close), — are agents which produce contraction of the 
pupil. The alkaloid Physosiigmine (Eserine) is the chief local myotic, 
and the only one used in ophthalmic practice. It acts by stimulating the 
circular muscular fibres of the iris, at the same time contracting the cili- 
ary muscle so that the eye is accommodated for near objects only, and 
diminishing intra-ocular tension ; in all of which it exactly antagonizes 
the action of Atropine. 

Muscarine, Pilocarpine and Nicotine are also local myotics, acting upon the end-organs 
of the oculo-motor nerve. Anaesthetics in the early stage of their action cause contraction 
of the pupil by lessening reflex action ; later, when they begin to paralyze respiration the 
accumulation of venous blood irritates the centres and produces dilatation, which during 
anaesthesia is a sign of failing respiratory power. The myotic action of Opium is ot 
central origin, probably paralysis of the local reflex excitability. The chief myotics are 
as follows : — 

Physostigma, Eserine. Muscarine. Lobeline (internally). 

Opium, Morphine. Gelsemine (internally). Nicotine (locally). 

Pilocarpus, Pilocarpine. Carbolic Acid (internally) . Anaesthetics (at first). 

Accommodation is impaired or paralyzed by the following named 
drugs, acting upon the ciliary muscle, viz. — 

Atropine. Homatropine. Cocaine. 

Daturine. Physostigmine. Gelsemine. 

Hyoscyamine. Pilocarpine. 

Intraocular tension is increased by Atropine (large doses), Hyoscyamine and Daturine ; 
and is decreased by Physostigmine and by Cocaine. Gelsemine paralyzes the external 
ocular muscles, especially the levator palpebrae and external rectus, by its action on the 
terminal nerve filaments. 



38 AGENTS ACTING ON ORGANS OF SPECIAL SENSE. 

The Sensibility of the Eye is increased by Strychnine, the field of 
vision becoming extended, and the vision rendered more acute. If the 
drug be administered hypodermically the improvement will be more 
marked in the eye corresponding to the side of the body where the injec- 
tion was made. 

The sensibility for color is affected by drugs, Strychnine increasing the field for blue, 
Eserine diminishing it for red and green, and Santonin causing objects to appear at first 
of a violet and afterwards of a greenish-yellow color. 

Visions are produced by several drugs, their action being probably 
on the cerebral sight-centres (angular gyrus and occipital lobes) rather 
than on the eye. Alcoholic delirium is a familiar instance, while Canna- 
bis Indica often causes pleasant visions, and Sodium Salicylate in some 
persons produces very disagreeable ones. Digitalis may produce subjec- 
tive sensations of the continued presence of light. Bromides in excess 
may produce visions of such intensity that their subject remembers them 
distinctly for years afterwards. 

Amblyopia, or impairment of vision from nerve-changes, is produced 
temporarily by Quinine, and may be permanently induced by Tobacco, 
Alcohol, Lead and Urea. 

The Ear is affected by several drugs. Strychnine and Morphine 
increase the excitability of either the auditory nerve or the centre for 
hearing (superior temporo-sphenoidal convolution), making that faculty 
much more acute. Quinine, Antipy?in and Salicylates produce hyper- 
emia of the auditory apparatus, causing subjective noises, as humming, 
buzzing or ringing, which are very unpleasant. Hydrobromic Acid and 
the Bromides, also Ergot, will diminish the congestion and to a great 
extent will neutralize or prevent these noises. 

Quinine in large doses is believed by some to have produced permanent injury of the 
sight and the hearing, but authentic cases of such action are extremely rare, if indeed 
they can be found at all. Temporary deafness is often caused by Quinine, but it usually 
disappears soon after the administration of the drug is stopped. 

The Sense of Smell is also increased by Strychnine, and decreased 

by all cerebral depressants and by those agents which produce changes in 

the nasal mucous membrane, e. g., Potassium Iodide. 

The cerebral centre for this faculty is situated at the tip of the temporo-sphenoidal lobe, 
and the terminal branches of the olfactory nerve are distributed upon the mucous lining 
of the upper portion of the nasal fossae. Strychnine probably stimulates the former, and 
all drugs acting upon the latter region would have more or less effect upon the power of 
distinguishing smells. 

The Taste is not much affected by drugs except as each makes its 
peculiar impression on the nerves of taste, and may overcome that of 
another agent. Smell has much to do with taste in many instances, the 
expedient of holding the nose while swallowing Castor Oil being familiar 
to every one. 



AGENTS ACTING ON RESPIRATION. 39 

The " after-taste " of drugs is often different to their original taste ; thus Bitters are 
said to leave a sweet after-taste, and the same is claimed for Quinine if given in acid 
solution so as to be entirely dissolved, and if washed out of the mouth with water imme- 
diately after swallowing. Substances which are excreted from the system in the saliva 
(as Iodides) leave a very persistent after-taste. 



Agents Acting on Respiration. 
The Respiratory Centre is situated in the medulla oblongata, close to 
the termination of the calamus scriptorius. It probably consists of thoracic 
and diaphragmatic Inspiratory Centres, the act of expiration being consid- 
ered normally a passive one, due to the natural contraction of the walls 
of the air-vesicles, and the return of the diaphragm and thoracic walls to 
the position from which they were moved by the inspiratory effort. An 
Expiratory Centre must also exist for the initiation of forced expiration, 
as in the production of voice, cough, sneezing, etc. The chief Inspira- 
tory Nerves are the pulmonary branches of the vagus. The Expiratory 
Nerves axe the nasal branches of the fifth, the superior and inferior laryn- 
geal, and the cutaneous nerves of the chest and abdomen. 

Respiratory Stimulants exalt the function of the respiratory centre, 
quickening and deepening the breathing. Such agents, besides Opium in 
small doses, are — 

Chloralamid. Brucine. Digitalis. Quebracho. 

Strychnine. Thebaine. Zinc salts. Tobacco (briefly). 

Atropine. Apomorphine. Copper salts. Alcohol (briefly). 

Duboisine. Emetine. Ammonia. Ether (briefly). 

Strychnine also stimulates the vagus tract. Electricity applied to the nerve-trunks or 
to the inspiratory muscles, is a direct respiratory stimulant. Veratrine, Eserine, and Mus- 
carine stimulate the vagus terminations, quickening the respiration, but afterwards slow it 
by depressing the respiratory centre. Aconite stimulates the end-organs of the vagus 
when given in small doses. 

Respiratory Depressants lower the activity of the respiratory 
centre, rendering the respirations slow and shallow. The chief agents of 
this class are — 



Cold. 


Gelsemium. 


Alcohol. 


Caffeine. 


Opium. 


Aconite. 


Ether. 


Colchicine. 


Physostigma. 


Veratrine. 


Chloroform. 


Nicotine. 


Muscarine. 


Hydrocyanic Acid. 


Chloral. 


Quinine. 


Lobeline. 


Conium. 


Saponin. 


Camphor. 
Carbolic Acid. 



The eleven last named first excite the centre for a brief period and then depress it. 

Pulmonary Sedatives diminish cough and dyspnoea by lessening the 
irritability of the respiratory centre or the nerves of respiration. Some 
act by directly depressing the respiratory centre, as those enumerated 
under the preceding head ; others by removing some irritant from the 
passages, or by lessening local congestion, as the expectorant group ; and 



40 AGENTS ACTING ON RESPIRATION. 

others by lowering the excitability of the vagus end-organs in the lungs, 
and of other afferent filaments throughout the respiratory tract. 

Opium has the most powerful influence as a sedative to the respiratory centre, and muci- 
laginous or saccharine substances soothe the local irritation, hence the latter are so fre- 
quently used as vehicles for the former in cough-mixtures. Hydrocyanic Acid has a 
similar sedative action, hence the use in coughs of Prunus Virginiana and other substances 
containing it. £el/ado?ma stimulates the respiratory centre, but at the same time lessens 
the excitability of the vagus terminations in the lungs, and completely arrests secretion 
from the bronchi. Stramonium acts similarly. The principal pulmonary sedatives may 
be enumerated as follows : — 

Opium. Hydrocyanic Acid. Turpentine. 

Belladonna. Amyl Nitrite. Ethyl Iodide. 

Stramonium. Quebracho. Conium. 

Hyoscyamus. Cannabis. Tobacco. 

Errhines and Sternutatories (En, in, Rhin, the nose ; Sternuio, I 
sneeze), — are agents which produce increased nasal secretion and sneez- 
ing, when locally applied to the mucous membrane of the nose. The 
first term is usually applied to substances which cause increase of the 
mucus without sneezing, the latter to those which invariably produce 
sneezing. The drugs should be in powder for application. The stimulus 
produced by these agents is transmitted by the nasal branches of the fifth 
nerve to the respiratory centre, exciting the sudden and forcible expira- 
tory effort called sneezing ; also to the vaso-motor centre, contracting the 
smaller vessels throughout the body and producing a general rise in the 
blood-pressure. The principal agents of this class are — 



Tobacco, as snuff. 


Euphorbium. 


Capsicum. 


Ipecacuanha. 


Sassy Bark. 


Hellebore. 


Sanguinaria. 


Saponin. 


Ammonia. 


Veratrum Album. 


Ginger. 


Cubebs. 



The last two named may be used as simple Errhines, as the vapor of dilute Ammonia- 
water or the smoke of burning Cubebs do not excite sneezing generally. 

Expectorants (Ex, out of, Pectus, the breast), — are remedies which 
modify the secretion of the broncho-pulmonary mucous membrane, and 
promote its expulsion. They may be divided into — 

Nauseating Expectorants, — in large doses act mechanically by ex- 
pelling the mucus in the act of vomiting, in small doses by increasing 
osmosis from the inflamed mucous membrane. The members of this sub- 
division generally increase secretion and tend to lower the blood-pressure. 
The chief of them are the following named : — 

Antimony, Tartar Emetic. Apomorphine. Potassium Iodide. 

Ipecacuanha, Emetine. Quebracho. Lobelia. 

Pilocarpus (Jaborandi). Alkalies. Lobeline. 

Stimulant Expectorants, — are largely eliminated by the bronchial 
mucous membrane, which they stimulate, altering the secretion and facili- 
tating expectoration. These remedies generally diminish secretion and 
increase blood-pressure. They are — 



AGENTS ACTING ON THE CIRCULATION. 41 



Ammonium Chloride. 


Acids. 


Nux Vomica. 


Ammonium Carbonate. 


Squill. 


Strychnine. 


Benzoin and Benzoic Acid. 


Garlic. 


Senega. 


Balsams of Peru and Tolu. 


Onion. 


Saponin. 


Wood Tar, and Tar. 


Turpentine. 


Liquorice. 


Oleum Pini Sylvestris. 


Sulphur. 


Saccharine Substances 



Besides the above many other remedies may act as expectorants, some by relieving 
bronchial spasm, as Opium, Stramonium and Tobacco, — others by soothing the irritable 
respiratory centre, as Opium and Chloral, — and the ciliary excitants by reflex action 
through their impression on the nerves of the mouth. 

Ciliary Excitants, — promote the expectoration of bronchial mucus 
by their reflex excitation of the tracheal and bronchial cilia, when dis- 
solved in the mouth. Gum Acacia, Ammonium Chloride, Potassium 
Chlorate, and native Chloride of Sodium have this action. 



Agents Acting on the Circulation. 

Cardiac Stimulants rapidly increase the force and frequency of the 

pulse in depressed conditions of the cardiac apparatus. One of the most 

useful agents of this class is Alcohol in some form, its action being largely 

due to a reflex influence excited through the nerves of the mouth and 

stomach. It should therefore be given in but slightly diluted form, and 

in small quantities frequently. Ether is next in value and still more rapid 

in action, and Heat is one of the most powerful and available of the class. 

Ammonia has an energetic action as a stimulant to the vaso-motor centre, 

as well as a reflex one upon the heart similar to that of Alcohol. The list 

of cardiac stimulants includes the following, viz. : — 

Alcohol. Hydrastinine. Sparteine. 

Ammonia. Cocaine. Camphor. 

Atropine. Ether. Chloroform. Aromatic Oil. 

Nitroglycerin. Heat. Turpentine. 

Orchitic Extract. Continuous Galvanic Current. Opium and Morphine, in 

Spermine. Counter-irritation. small doses. 

Cardiac Tonics, when given in moderate doses, stimulate the cardiac 
muscle, slowing and strengthening its contractions. In large doses they 
are apt to produce irregular action of the heart, and some of them have 
more or less of a tendency to cause sudden death by syncope if pushed to 
any great extent. The most important of these agents are — 

Digitalis. Squill. Strophantus. 

Convallaria. Erythrophlcein. Strychnine. 

Cimicifuga. Caffeine. Helleborein. 

Sparteine. Saponin. Adonis vernalis. 

Digitalis acts partly by stimulation of the vagus end-organs in the heart, thus increasing 
cardiac inhibition, and partly by direct stimulation of the cardiac centre in the medulla, as 
well as by a direct influence on the heart muscle itself. Convallaria , Erythrophlceum, 
Squill, and Cimicifuga act similarly but less powerfully, and are correspondingly safer. 
Strophanthus is still better, as it does not affect the vessels, and therefore does not raise 
the blood-pressure. 



42 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Cardiac Sedatives lessen the force and the frequency of the neart's 
action and are used to control palpitation of that organ, and to slow the 
pulse in febrile conditions in sthenic subjects, especially when local inflam- 
mation is the exciting cause. The chief cardiac sedatives are — 

Aconite. Pilocarpine. Senega, Saponin. 

Antimony. Digitalis. Hydrocyanic Acid. 

Veratrum Viride. Ouabain. • Potassium Salts. 

Muscarine. Emetine. Cold. 

Aconite, Veratrum, Muscarine, Pilocarpine, Saponin, and Hydrocyanic Acid are 
direct cardiac poisons, depressing the heart muscle and the cardiac motor ganglia ; Mus- 
carine and Pilocarpine also stimulate the inhibitory ganglia ; Digitalis stimulates the 
vagus centre and the cardiac muscle, and acts as a sedative in many cases by slowing the 
rate and giving it a regular rhythm. Aconite is said by some authorities to relax inhibi- 
tion, by others to stimulate the vagus centre. Antimony depresses the motor ganglia, 
Potassium the cardiac muscle. 

Vascular Stimulants produce dilatation of the peripheral vessels, 
and increase the rapidity of the circulation, thus equalizing the blood- 
pressure and preventing internal congestions. The most useful are Alco- 
hol and Ether, as they stimulate the action of the heart simultaneously 
with the vascular dilatation. The chief members of this group are : — 

Alcohol. Belladonna. Chloral. 

Ether. Stramonium. Chloroform. 

Nitrous Ether. Hyoscyamus. Liq. Ammonii Acetatis. 

Nitroglycerin. Opium (at first). Ipecacuanha. 

Amyl Nitrite. Hydrocyanic Acid. Heat, as Poultices, etc. 

Thyroid Extract. Tartar Emetic. 

The dilating action of Amyl Nitrite and other Nitrites is due to weakening either of 
the muscular walls of the arterioles or to paralysis of the vaso-motor ganglia in them. 
Alcohol, Ether and Opium probably depress the vaso-motor centre. 

Vascular Tonics produce increased contraction of the arterioles and 

consequently increased blood-pressure. The most important are — 

Digitalis. Iron. Ergot. Strychnine. 

Squill. Opium (in small doses). Lead and Silver. 

Strophanthus. Adrenal Extract. Hamamelis. 

These agents act upon the local vaso-motor mechanism in the walls of the vessels, 
which are also directly stimulated by cold produced in any way, as by Ether spray, or 
evaporating lotions containing Alcohol, Vinegar or Ammonium Chloride. 

Vascular Sedatives increase the contraction of the vessels and lessen 
the circulation through them. They are employed to check hemorrhage 
and to cut short a local inflammation. The chief agents belonging to this 
group are — 

Cold. Hamamelis. Opium. 



Ergot. 


Digitalis. 


Lead salts. 


Barium salts. 


Hydrastis. 


Cocaine (locally). 


Zinc salts. 


Sulphuric Acid. 


Antipyrin. 



Agents Acting on the Digestive System. 
Dentifrices {Dens, a tooth, Frico, I rub), — are medicated powders or 
pastes employed to cleanse the teeth and gums. Chalk is the basis gener- 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 43 

ally used, for its mechanical action and its alkaline quality. Antiseptics, 
as Borax, Quinine, Carbolic Acid, etc., should also be employed so as to 
prevent the acid fermentation of food products between the teeth and the 
consequent decay of the dentine. Tincture of Myrrh is an excellent in- 
gredient, being an aromatic local stimulant and disinfectant. 

Many drugs affect the teeth injuriously, such being the Mineral Acids, Persalts of Iron 
and Alum. The first two should be taken through a glass tube, and the mouth should be 
afterwards rinsed with a weak alkaline wash. Opium, Chloral, Cocaine, Carbolic Acid, 
Creosote, Potassium Chlorate, and Aconite are the agents used as local anodynes in tooth- 
ache from caries exposing a nerve filament. Chloral should never be used for this pur- 
pose, for in solution sufficiently strong to be of any service it will cause sloughing of the 
gum, especially if injected thereinto with a hypodermic syringe, as is frequently done by 
ignorant dentists. 

Sialogogues {Seealon, saliva, Ago, I carry off), — are agents which 
increase the secretion and flow of saliva and buccal mucus, either by reflex 
action from the local irritation produced when anything is taken into the 
mouth, or by stimulating the glands during their elimination. The 
principal sialogogues are divided into two classes, the first (topical) 
acting by reflex stimulation, the second (general) acting through their 
systemic influence on the glands or their secretory nerves. They are as 
follows : — 

Topical Sialogogues. General Sialogogues. 

Acids and Alkalies. Pilocarpus (Jaborandi). 

Ether, Chloroform, etc. Muscarine. 

Mustard. Ginger. Physostigma. 

Pyrethrum. Mezereon. Mercurials. 

Tobacco. Cubebs. Iodine compounds. 

Capsicum. Rhubarb. Antimonials. 

Horse-radish. Tobacco. Ipecacuanha. 

Antisialics (Anti, against, Seealo?i, saliva), — are remedies which di- 
minish the secretions of the salivary glands. Atropine is the principal 
agent of this group, acting by paralyzing the terminations of the nerves of 
secretion. Physostigma counteracts this paralysis, but in large doses acts 
as an antisialic by lessening the blood supply to the glands. Opium dimin- 
ishes the reflex excitability of the reflex centre and also diminishes the 
secretion. Others acting locally are — 

Borax. Soda. Lithia. 

Potassium Chlorate. Lime. Magnesia. 

Insipid or nauseous articles of food or medicine. 

Refrigerants (Refrigero, I cool), — are remedies which allay thirst and 
impart a sensation of coolness. They include the Vegetable Acids, the 
Mineral Acids (greatly diluted), Ice, Water if cold, Effervescing drinks, 
Fruit juices, and many diaphoretics. 

Gastric Tonics or Stomachics, — are agents which increase the 
appetite and promote gastric digestion. They include a number of sub- 
stances, dietetic and medicinal, some acting by stimulation of the pro- 



44 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

duction of gastric juice, others by stimulating the local circulation, and 
several by exciting the activity of the nervo-muscular apparatus of the 
stomach. 

The first indication is met by the use of dilute alkaline solutions before meals,— the 
second by administering any of the pungent carminatives, as the Aromatic Oils, Pepper, 
Mustard, etc. , or by Alcohol and Ether in small doses, or by the Aromatic Bitters, as Gen- 
tian, Orange, etc. , or the simple bitters, as Calumba ; — while the third desideratum is 
secured by the use of such agents as Nux Vomica, Hydrastis, Arsenic, the dilute Mineral 
Acids and the Volatile Oils. 

Adjuvants to gastric digestion are the digestion-ferments, Pepsin, Ingluvin, Papain, also 
dilute HC1 acid ; which may be used to supplement the gastric juice when deficient in 
quantity or quality. The juice of the Pineapple contains a very active digestive principle, 
and may be employed as an aid to digestion with excellent results. Pepsin acts in acid 
media, and is only applicable to gastric indigestion; Pancreatin acts in alkaline media, 
is destroyed by acids, and is only applicable to intestinal indigestion ; while Papain 
exercises its proteolytic power in either acid, alkaline or neutral solutions, and is equally 
applicable to either gastric or intestinal indigestion. 

Acids, — considered therapeutically and physiologically, are medicines 
which in concentrated form act usually as caustics, and when given in 
medicinal doses internally check the secretions of organs producing acid 
secretions with which they come in contact, and increase those of organs 
producing alkaline secretions. Thus a dilute acid given before meals will 
check the production of the acid gastric juice, but will stimulate that of 
the alkaline pancreatic juice. 

The chief members of this group are the following, which should be given in very 
dilute form : — 

Acidum Aceticum. Acidum Nitricum. 

Acidum Citricum. Acidum Phosphoricum. 

Acidum Benzoicum. Acidum Sulphuricum. 

Acidum Hydrochloricum. Acidum Nitro-hydrochloricum. 

Ant-acids or Alkalies, — from the same stand-point, are remedies 
which neutralize acids, check alkaline secretions and stimulate acid secre- 
tions, when in contact with the ducts of the organs producing them. Thus 
a dilute alkali given before meals will stimulate the production of the acid 
gastric juice, and if applied to the mouth of the pancreatic duct will 
check the secretion of the alkaline pancreatic juice. The principal 
articles which belong to this group are the following, which should always 
be administered in dilute solution : — 

Liquor Potassse, Liquor Sodse. Potassium Acetate. 

Carbonates and Bicarbonates of Potas- Potassium Citrate. 

sium, Sodium, Lithium, Magnesium Potassium Tartrate. 

and Ammonium. Potassium Bitartrate. 

Calcined Magnesia (Magnesia). Sodium Acetate. 

Lime-water. Chalk. Sodium Citrate. 

Aromatic Spirit of Ammonia. Lithium Citrate. 

The substances named in the first list are direct antacids, lessening the acidity in the 
stomach, and many of them also acting as remote antacids, lessening the acidity of the 
urine, as Potassa and Soda, and their Carbonates and Bicarbonates. Ammonia and its 
Carbonates after absorption are eliminated as urea, and do not lessen the acidity of the 
urine. The salts in the second list are remote antacids, do not lessen acidity in the 
stomach, but do that of the urine, being oxidized in the blood and excreted as Carbonates. 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 45 

Emetics {Eemeo, I vomit), — are agents which produce vomiting. 
They may be subdivided into two groups, (i) Local Emetics, or those 
which act by irritating the end-organs of the gastric, pharyngeal or oeso- 
phageal nerves, and (2) General or Systemic Emetics, which act through 
the medium of the circulation. Both these classes produce the emetic 
action by irritation of the vomiting centre in the medulla, the first by 
reflex, the second by direct stimulation. The principal emetics are the 
following named : — 

Local Emetics. General Emetics. 

Alum. Mustard. Salt. Ipecacuanha. Emetine. 

Ammonium Carbonate. Ouabain. 

Zinc and Copper Sulphates. Apomorphine. 

Subsulphate of Mercury. Tartar Emetic. 

Tepid Water, in quantity. Veratrine. 

Vegetable Bitters, as Quassia, Senega, 

in strong infusions. Squill. 

Tartar Ernetic, Ipecacuanha and probably Apomorphine, act locally as well as systemi- 
cally, for if injected subcutaneously they are excreted by the stomach in part, thus irritat- 
ing the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, and 
Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these 
agents are used medicinally for that purpose. Opium, Morphine and Codeine usually 
produce emesis as one of their after effects. 

Anti-emetics, — are agents which diminish nausea and vomiting, some 
by a local sedative action upon the end-organs of the gastric nerves, 
others by reducing the irritability of the vomiting centre in the medulla. 
The most efficient of the local sedatives is Ice, swallowed in small pieces. 
Astringents are very useful when there is congestion of the gastric mucous 
membrane, as in the vomiting of alcoholism and phthisis, when Silver 
Nitrate and Alum are respectively effective. The most important anti- 
emetics are the following, viz. : — 

Local Gastric Sedatives. General Sedatives. 

Alcohol. Creosote. Opium. 

Alum. Ether. Morphine. 

Arsenic. Ice. Hydrocyanic Acid. 

Belladonna. Opium. Bromides. 

Bismuth. Hydrocyanic Acid. Chloral. 

Carbonic Acid. Silver Nitrate. IS! itro -glycerin. 

Cerium Oxalate. Calomel \ small Food. 

Chloroform. Ipecac j doses. Alcohol. 

Carbolic Acid. Hot Water. Amyl Nitrite. 

Potassium Nitrate. Cocaine. 

Vomiting being set up by irritation of many afferent nerves from various regions of the 
body, or by impulses from the brain excited through impressions on the nerves of special 
sense, the measures for combating it are very diversified. [Compare the title Vomiting, 
in Part III.] 

Gastric Pai?i is best treated by such local sedatives as Bismuth, Hydrocyanic Acid, or 
small doses of Morphine, Arsenic and Belladonna. Cocaine is one of the most efficient 
agents of this class, in 5 to 6 minim doses of a 4 per cent, solution, every hour. As its 
general action is opposed to that of Opium, Bromides, etc., it must act locally, and 
therefore should be given by the mouth. 



46 AGENTS ACTING ON THE DIGESTIVE SYSTEM. 

Carminatives (Carmino, I soothe), — aid the expulsion of gas from 
the stomach and intestines by increasing peristalsis, stimulating the circu- 
lation, and relaxing the cardiac and pyloric orifices of the stomach. 
They also act as diffusible stimulants, both of the bodily and mental 
faculties. The principal carminatives belong to the aromatic oils, alco- 
hols or ethers, and are embraced in the following list : — 



Asafetida. 


Mustard. 


Oil of Eucalyptus. 


Capsicum. 


Pepper. 


Oil of Fennel. 


Cardamom. 


Spirits. 


Oil of Peppermint, 


Chloroform. 


Oil of Anise. 


Oil of Spearmint. 


Ether. 


Oil of Cajuput. 


Oil of Nutmeg. 


Fennel. 


Oil of Caraway. 


Oil of Pimento. 


Ginger. 


Oil of Cinnamon. 


Oil of Valerian. 


Horse-radish. 


Oil of Cloves. 


Camphor. 


Mace. 


Oil of Coriander. 


Serpentaria. 



Cathartics or Purgatives (Kathairo,Purgo, I cleanse), — are agents 
which increase or hasten the intestinal evacuations. According to their 
respective degrees and direction of action they are subdivided into several 
groups, as follows : — 

Laxatives (Zaxo, I loose), or Aperients (Aperio, I open), — include 
those which excite moderate peristalsis, and produce softened motions 
without irritation. Sulphur is the typical laxative. 

Simple Purgatives, — increase peristalsis actively, and stimulate the 
secretions of the intestinal glands, producing one or more copious and 
semifluid motions with some irritation and griping. Senna is the type of 
this group. 

Drastic Purgatives (Drao, I act), — act still more intensely, producing 
violent peristalsis and watery stools, with much griping pain, tenesmus, 
and borborygmi. They irritate the intestinal mucous membrane, cause 
exosmosis of serum from its vessels, and in large dose set up inflammation 
and symptoms of irritant poisoning. Jalap is a typical drastic. 

Saline Purgatives. — This group comprises the neutral salts of metals 
of the alkalies or alkaline earths. They stimulate the intestinal glands to 
increased secretion, and by their low diffusibility impede reabsorption, 
causing an accumulation of fluid in the intestinal tract, which, partly 
from the effect of gravity and partly by gentle stimulation of peristalsis 
excited by distention, reaches the rectum and produces a copious evacu- 
ation. Magnesium Sulphate and Sodium Sulphate are the typical salines. 
They should be given in plenty of water and during active movement 
(as in walking) in order to produce their best effects. 

Hydragogue Purgatives (Hudore, water, Ago, I bring away), — in- 
clude the most active of the drastic and saline groups, those which remove 
a large quantity of water from the vessels. Elaterium is a typical hydra- 
gogue. 

Cholagogue Purgatives (Kohlay y bile, Ago, I bring away), — are 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



47 



those agents which stimulate the flow of bile and produce free purgation 
at the same time, the stools being green-colored, or "bilious," and 
liquid. Podophyllin is the type of this group. 

The principal Cathartics are the following-named : — 



Laxatives. 

Sulphur. 

Magnesia. 

Cassia. 

Manna. 

Figs. Prunes. 

Tamarinds. 

Honey. 

Cascara Sagrack 

Physostigma. 

Ergot. 

Belladonna. 

Stramonium. 

Hyoscyamus. 

Almond Oil. 

Olive Oil. 

Soap. 

Taraxacum. 

Glycerin. 

Oatmeal. 

Bran Biscuit. 

Brown Bread. 



Simple Purgatives. 

Senna. 
Aloes. 
Rhubarb. 
Castor Oil. 
Rhamnus Frangula. 
Ox-gall. 
Calomel. 

Small doses of drastics, 
salines or cholagogues. 

Saline Purgatives. 

Magnesium Sulphate. 
Magnesium Citrate. 
Potassium Sulphate. 
Potassium Tartrate. 
Potassium Bitartrate. 
Sodium Sulphate. 
Sodium Phosphate. 
Sodium Chloride. 
Pot. et Sodium Tartrate. 
Manganese Sulphate. 



Drastics. 

Jalap. Gamboge. 
Colocynth. 
Elaterium. 
Scammony. 
Croton Oil. 

Cathartic Acid, hypoder- 
mically. 

Hydragogues. 

Elaterium. 

Gamboge. 

Potassium Bitartrate. 

Croton Oil. 

Salines in large doses. 

Cholagogues. 

Mercurials. 
Aloes. Rhubarb. 
Euonymin. 
Podophyllin. 
Iridin. 



Intestinal Astringents, contract the walls of the intestinal vessels, 
diminishing the exudation therefrom, and lessening the fluidity of the 
faecal discharges. The more powerful members of this group have also a 
constringing action on the intestinal mucous membrane. The principal 
agents of this class are the following: — 



Astringents. 

Phosphoric Acid. 
Nitric Acid. 
Sulphuric Acid. 
Acetic Acid. 
Eead Acetate. 
Silver Nitrate. 



1 
\ Diluted. 

J 



Constringent s. 

Tannic Acid. 
Vegetable Astringents. 
Alum. 
Zinc Oxide. 
Copper Sulphate. 
Persalts of Iron. 



Hepatic Stimulants and Cholagogues (Kohlay, bile, Ago, I 
bring away), — are two groups of agents acting upon the biliary secretion, 
the first-named increasing the functional activity of the liver and the 
amount of bile formed, the second removing the bile from the duodenum 
and preventing its reabsorption into the portal circulation. Some hepatic 
stimulants are also cholagogues, others are not, while cholagogues proper 
generally act as hepatic stimulants by carrying off the bile and so indi- 
rectly urging the liver to secrete more. The discovery of the entero- 
hepatic circulation of bile has cleared up many of the discrepancies 
formerly existing with regard to the action of drugs upon this gland and 



4 8 



AGENTS ACTING ON THE DIGESTIVE SYSTEM. 



its secretion. The following list includes the principal drugs belonging 
to both groups : — 



Hepatic Stimulants. 



Aloes. 

Podophyllin. 
Mercuric Chloride. 
Sodium Benzoate. 

Phosphate. 

Salicylate. 
Nitro-hydrochloric Acid. 
Euonymin. 
Iridin. 
Phytolaccin. 
Sanguinarin. 
Antimony. 
Arsenic. 
Ipecacuanha. 
Colchicine. 
Colocynth. 
Rhubarb. 



Potassium Sulphate. 
Sodium Sulphate. 

Bicarbonate. 
Ammonium Benzoate. 

Chloride. 
Nitric Acid (dilute). 
Benzoic Acid. 
Baptisin. 
Hydrastin. 
Tuglandin. 
Leptandrin. 
Jalapin. 
Scammony. 
Guaiac. 
Sarsaparilla. 
Physostigma. 
Rochelle Salt. 



Cholagogues. 

Aloes. 

Podophyllin. 
Mercurous Chloride. 
Pil. Hydrargyri. 
Mercury with Chalk, 
Sodium Phosphate. 

Sulphate. 
Potassium Sulphate. 
Colchicum. 
Colocynth. 
Rhubarb. 
Arsenic. 
Euonymin. 
Scammony. 
Baptisin. 
Jalapin. 
Iridin. 



Those in the first column are the most powerful of the stimulant group, the second 
column including the less efficient agents. To secure the best cholagogue effect it is ad- 
visable to combine an hepatic stimulant with an intestinal stimulant which shall produce 
increased secretion from the intestinal mucous membrane and excite peristalsis. 

The glycogenic function of the liver, and the production of urea are 
stimulated by the following-named drugs : — 

Increasing Glycogen. Increasing Urea. 



Amyl Nitrite. 
Sodium Bicarbonate. 
Nitro-hydrochloric Acid. 



Arsenic. Iron. 

Antimony. Phosphorus. 

Ammonium Chloride. 



Hepatic Depressants are agents which lower the functional activity 
of the liver, reducing the quantity of bile secreted, and lessening the pro- 
duction of glycogen and urea. They are as follows, viz.: — 



Lessening Bile. 


Dim in is A ing Glycogen . 


Lessening Ui 


Opium, Morphine. 


Opium. 


Opium. 


Many Purgatives. 


Morphine. Codeine. 


Morphine. 


Lead Acetate. 


Phosphorus. 


Colchicum, 


Quinine (?) 


Arsenic. 


Alcohol. 


Alcohol (?) 


Antimony. 


Quinine. 



Many purgatives act as hepatic depressants and diminish the secretion of bile by lower- 
ing the blood pressure in the liver, and by carrying off the materials from which bile 
might be formed. 

Pancreatic Stimulation may be obtained by the administration of 
Ether, or by galvanism of the gland itself. The secretion is depressed 
by Atropine and by inducing nausea and vomiting. 

Anthelmintics (Anti, against, Helmins, a worm), — are agents which 
destroy (vermicides) or cause the expulsion of intestinal worms (vermi- 
fuges). The chief vermifuges are Castor Oil, Jalap and Scammony, 
while the vermicides may be enumerated as follows, viz. : — 



AGENTS ACTING ON METABOLISM. 49 

Thread Worms Round Worms Tape Worms 

(Oxyuris Vermicularis). {Ascaris Lumbricoides). (Tcenue, etc.). 

Alum. Santonica. Filix Mas. 

Sulphate of Iron. Santonin. Kamala. 

Lime Water. Spigelia. Kousso. 

Quassia. Chenopodium. Granatum. 

Eucalyptol. Azedarach. Pelletierine. 

Sodium Chloride. Senna. ) with the Pepo. 

Tannin. Calomel. / above. Turpentine. 

Veg. Astringents. Naphtalin. Chloroform. 

Naphtalin. Naphtalin. 

The substances enumerated in the first column are all used locally by enema. Adjuncts 
to these remedies are such agents as prevent the excessive secretion of intestinal mucus, 
which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, 
also Ammonium Chloride and Sodium Chloride. 



Agents Acting on Metabolism. 

Restoratives, — are agents which promote constructive metamorpho- 
sis, including the Foods, Haematics, and Tonics, as well as many agents 
called Stimulants in other classifications. 

Foods, — are substances which, when introduced into the body, supply 
material to renew some structure or to maintain some vital process ; being 
distinguished from medicines in that the latter modify some vital action 
but supply no material to sustain such. 

The food of man is derived from all three of the kingdoms of nature, viz., the mineral, 
vegetable and animal, and includes many substances treated of in the Materia Medica, 
as Oils and Fats, Sugar, Starch, Gum, Alcohol, Beverages like Coffee and Tea, Water, 
Phosphate of Lime, Sodium Chloride, etc. 

Hematics (Haima, the blood), — are medicines which augment the 
quantity of haematin in the blood, and thus restore the quality of that 
tissue by enriching its red corpuscles. They consist chiefly of Iron and 
Manganese and their compounds. 

Tonics (Tonnos, tension), — are agents which improve the tone of the 
tissues on which they have specific action, restoring energy and strength 
to debilitated subjects, by a scarcely perceptible stimulation of all the 
vital functions, their effects being apparent in an increased vigor of the 
entire system. The chief tonics are enumerated in the foregoing lists 
under the heads of the organs, or tissues particularly affected by them. 
[Compare the titles Stimulants, Respiratory Stimulants, Cardiac 
Tonics, Vascular Tonics, Gastric Tonics, etc.] 

The most typical medicinal agents which impart a general sense of tone and strength 
are Strychnine, Quinine, Iron and Vegetable Bitters. Those especially acting upon the 
stomach, are Arsenic. Bismuth, Cinchona, Hydrastis and Nux Vomica, — on the spinal cord 
and general circulation, Strychnine, — on the heart, Digitalis, Squill, Convallaria and 
Cimicifuga. — on the nervous system, Phosphorus, Quinine and the Valerianates, — on 
muscular tissue, Tannin, — on the blood, Iron, Manganese, Cod-liver Oil, and other fats. 

4 



50 AGENTS ACTING ON METABOLISM. 

Alteratives, — are certain remedies which alter the course of morbid 
conditions in some way not yet understood, perhaps by promoting meta- 
bolism. They certainly modify the nutritive processes and thereby cure 
many diseases of chronic type. Mercury and Iodine are the most promi- 
nent agents of this class, the former being endowed with the power of 
breaking up newly deposited fibrin, and disorganizing syphilitic deposits, 
while the latter acts energetically upon the lymphatic system and promotes 
absorption. Arsenic also is almost specific in many chronic skin affec- 
tions, and has remarkable power over chronic pulmonary consolidations, 
probably producing fatty degeneration and softening of the effusion, so 
that it may be absorbed or expectorated. The principal alteratives are : — 

Arsenic. Mercury. Iodine. 

Antimony. Colchicum. Iodides. 

Aurum. Guaiacum. Stillingia. 

Mezereum. Sanguinaria. Sarsaparilla. 

Sulphur. Xanthoxylum. Cod-liver Oil. 

Sulphides. Calcium Chloride. Phosphorus. 

Certain therapeutists of laboratory type have, of late years, seen fit to denounce the 
term Alterative as " a cloak for ignorance," but have never been able to present a better 
designation for a class of agents whose effects are among the most thoroughly established 
of clinical facts. 

A subdivision may be made of the Resolvents or Discutients (J?e- 
solvo, I unbind, Discutio, I dissipate), — agents which promote the absorp- 
tion of inflammatory products or other materials of morbid origin, appar- 
ently by stimulation of the lymphatic system. They include Mercury, 
Arsenic, Iodine, and Cadmium, as well as such local measures as Poulticing 
and Counter-irritation. 

Destructive Metamorphosis of the tissues is promoted by a num- 
ber of agents, most of which are classed as Alteratives or as Astringents, 
the most important of which are the following-named : — 

Alkalies. Sulphides and Iodides. 

Vegetable Acids. Sarsaparilla. 

Metals and their salts. Stillingia. 

Colchicum. Xanthoxylum. 

Tannic and Gallic Acids, and substances containing them. 

Destructive Metamorphosis may be diminished by many substances, the 
following-named being the chief ones : — 

Resorcin. 
Chinolin. 
Cocaine. 

Antipyretics (Anli, against, Puretos, fever), — are agents or measures 
which reduce the body-temperature when abnormally high. This may be 
done by two principal methods, and the agents doing either accomplish 
the result by different actions, as follows, viz. : — 



Alcohol. 


Salicin. 


Glycerin. 


Salicylates 


Oils and Fats. 


Quinine. 



AGENTS ACTING ON METABOLISM. 



51 



By Lessening th 
or by 
Promoting the Loss of Heat, by \ 



, .. r tt j 1 f I- Diminishing tissue-change. 
Production of Heat, by < -r, , .? . , . . • & 

J ' s \ 2. Reducing the circulation. 



3. Dilating the cutaneous vessels, and producing in- 

creased radiation. 

4. Producing perspiration, and its evaporation. 

5. Abstracting heat from the body. 



The following list contains nearly all the antipyretics, the number fol- 
lowing each referring to its proper method of action, as enumerated 
above : — 



Quinine. x 
Quinidine. ] 
Cinchonine. ! 
Cinchonidine. ! 
Berberine. x 
Benzoic Acid. 1 
Carbolic Acid. 1 ; 3 
Picric .Acid. l 
Salicin. 1 
Salicylic Acid. 1 
Sodium Salicylate. 1 , 4 
Quinine Salicylate. a 
Methyl Salicylate. x 

(Oil of Gaultheria. ) 
Trimethvlamin. 2 
Salol. 1 



Acetanilid. M 

Antipyrin. 1 , i 
Phenacetin. *, 4 
Chinolin. 1 
Resorcin. 1 
Kairin. 1 , 4 
Kairolin. 1 » 4 
Hydroquinon. 1 
Thallin. 1 ,* 
Pyrocatechin. 1 
Pheno-resorcin. l 
Eucalyptol. 1 
Thymol . x 

Other Essential Oils. 
Alcohol. 1 , 3 
Digitalis. 2 



Aconite. 2 
Camphor. l 
Antimonials. '-> + 
Veratrine. 2 

Colchicum. 2 
Leeching. 2 
Cupping. 2 
Blistering. 2 
Poulticing. 2 
Nitrous Ether. 3 i 
Dover's Powder. 
Cold Bath. 5 
Cold Drinks. 5 
Ice to Surface. 5 
Cold Sponging. 5 
Wet Packing. 5 



Purgation and Venesection produce antipyretic results, but their mode of action is 
doubtful (Brunton). The Body Temperature is raised by Belladonna (or Atropine) and 
by Cocaine, but not to such a degree as to constitute fever or enable them to be classed as 
pyretics. Tuberculin, various albumoses, and certain animal poisons, as that of shell 
fish, will also produce a rise of temperature. 

Antiphlogistics (Anti, against, Pfleggo, I burn), — are measures and 
medicines which are supposed to have some specific power in reducing 
inflammation. The term is becoming obsolete, but frequent references 
are seen yet to the influence of Mercury and Opium in inflammations of 
serous membranes, Antimony and Aconite in inflammations of the respir- 
atory tract and organs, and to the power of Veratrum Viride over puer- 
peral metritis. The chief antiphlogistics are the following: — 



Aconite. 

Veratrum Viride. 
Tartar Emetic. 
Mercury. 
Opium. 
Gelsemium. 



Digitalis. 

Ergot. 

Ipecacuanha. 

Potassium Nitrate. 

Rest, recumbent position. 



Venesection. 
Local Depletion. 
Purgation. 
Counter-irritation . 
Cold. 



Antiperiodics, — are remedies which affect certain periodical febrile 
diseases, lessening the severity of their paroxysms or preventing their re- 
turn. They act probably by arresting the development in the blood of 
successive crops of pathogenic organisms, upon which the disorders are 
supposed to depend. The principal antiperiodics are : — 



Cinchona Bark and its Alkaloids. 
Bebeeru Bark and its Alkaloid. 
Salicin, Salicylic Acid, Salicylates. 



Arsenic. 

Eucalyptol. 

Iodine. 



52 



AGENTS ACTING UPON EXCRETION. 



Agents Acting upon Excretion. 
Diuretics (Deeouraysis, urination), — are remedies which increase the 
renal secretion. They may act in several ways, namely : — 

1. By raising the general blood -pressure by contraction of efferent vessels or vessels in 

other regions of the body. 

2. By dilating the renal arteries and increasing the renal blood-supply, raising the pres- 

sure in the glomeruli. 

3. By stimulating the secreting nerves or cells of the kidney. 

4. By simply washing out the kidneys, as by Water in quantity. 

The following list contains the most important agents of this class, 
which are usually subdivided into the two groups indicated by the sub- 
titles. The numbers refer to the modes of action of the drug in the above 

synopsis : — 



Refrigerant Diuretics. 


Stimulant Diur 


etics. 


Potassium Acetate. 3 


Alcohol. 2 




Gin. 2 


Potassium Bitartrate. 3 


Cantharides. 3 




Carrot. 3 


Potassium Citrate. 3 


Turpentine. 3 




Fennel. 3 


Potassium Chlorate. 3 


Juniper. 3 




Mustard. 3 


Potassium Nitrate. 3 


Savine. 3 




Asparagus. 3 


Sodium Acetate. 3 


Copaiba. 3 




Uva Ursi. 3 


Calomel. 1 


Cubebs. 3 




Buchu. 3 


Digitalis. x 


Pepper. 3 




Sarsaparilla. 3 


Erythrophloeum. x 


Matico. 3 




Pareira. 3 


Caffeine. 3 


Kava. 3 




Chimaphila. 3 


Theobromine. 3 


Guaiac. 3 




Santonica. 3 


Broom. 3 Squill. 1 , 2 


Parsley. 3 




Lobelia. 3 


Nitrites. 2 


Taraxacum. 3 




Aconite. 3 


Colchicum. 3 


Jaborandi. 3 




Tobacco. 1 » 3 


Strj'Chnine. 1 


Dulcamara. 3 




Volatile Oils. 


Stigmata Maidis. 1 , 2 


Bryonia. 3 




Oleo-resins. 3 


huretics are employed 


for the following 


purposes, 


, namely, (1) t 



move the excess of fluid in dropsies, — (2) to hasten the elimination of 
waste products and other poisonous substances from the blood, — (3) to 
dilute the urine. In — 

Cardiac Dropsy, — or other dropsies due to venous congestion, the best diuretics are 
those which act on the general vascular system, as Digitalis, Squill, etc. Calomel is very 
efficient here, so also is Theobromine Sodio-salicylate (Diuretin). 

Dropsy from Renal Disease, — Diuretin, Broom, Nitrous Ether, Oil of Juniper, Digi- 
talis and Squill are the most reliable diuretics, in the order named. 

Hepatic Dropsy, — Copaiba is considered especially suitable. In this and the previous 
form a little Pil. Hydrargyri occasionally often aids the diuretic action of other agents. 

To Eliminate Solids, — Potassium Nitrate and Bitartrate, Turpentine, Juniper, Caffeine, 
etc., are the most efficient. [Compare Antilithics.] 

To Dilute the Urine, — Water is the best diuretic, and its most efficient form is Dis- 
tilled Water acidified with Carbonic Acid Gas. 



Renal Depressants, — are such agents as directly diminish the 
activity of the renal cells, and lessen or suspend the secretion of urine. 
Morphine, Quinine and Ergot act in this way through the circulation, 
and Digitalis, instead of acting as a diuretic, may arrest the renal circu- 
lation by stimulating the vaso-motor centre, and thus by contracting the 



AGENTS ACTING UPON EXCRETION. 53 

vessels may stop the secretion altogether (Brunton). The same is true of 
Caffeine and Strychnine, hence it is well to combine these with other 
diuretics (Nitrous Ether, Alcohol), which dilate the renal arteries. 

Alkalinizers of the Urine, — are agents which produce an alkaline 
reaction of the urine when taken internally. They include the alkalies, 
particularly Potassium and Lithium salts, but excepting Ammonia which 
is broken up in the organism. Sodium salts, being partly excreted by 
the bile and the bronchial mucus, and partly locked up in the system as 
the neutral chloride, while Sodium Urate is insoluble, are not as efficient 
in this regard as are other alkalies. Fruits, milk and fish also act in 
the same manner by means of the salts which they convey into the 
economy. 

Acidifiers of the Urine, — are Benzoic and Salicylic Acids and 
several of their salts, Vegetable Acids in excess, also excess of proteids, 
sugar and starch in the food, and certain wines and spirits. The Mineral 
Acids have little or no influence on the acidity of the urine, being ex- 
creted as neutral sulphates, chlorides, phosphates, etc. 

Salol is much quicker in its action upon the urine than is Ammonium Benzoate ; as or- 
dinarily in a day or so, under its administration, the urine in chronic cystitis loses its al- 
kalinity and foul odor, and becomes clear (Dr. Mansel Sympson). 

Vesical Sedatives, — are substances which lessen irritability of the 
bladder, relieving pain and increasing the desire to micturate. Opium, 
Belladonna, Hyoscyamus, Stigmata Maidis, Cannabis, etc., lessen the 
irritability of the nerves, Calcium Carbonate relieves that due to the 
presence of calculi; mucilaginous drinks, such as Barley-water or Lin- 
seed tea, also astringents like Buchu, Uva Ursi, Pareira, etc., diminish 
the irritation due to chronic cystitis, and antiseptics, as Copaiba, and 
Cubebs, also act in like manner, being carried by the urine to the bladder. 

Vesical Tonics, — increase the contractile power of the muscular 
fibres in the wall of the bladder. Cantharides, Potassium Bromide, 
Strychnine and Belladonna are the most prominent members of this class. 

Urinary Sedatives and Astringents, — act sedatively upon the 
whole extent of the urinary tract through the medium of the urine charged 
with them when administered internally. Some of the members of this 
class may be administered locally, but only to the urethral and vesical 
mucous membranes, which are accessible to direct local medication. 

Instances of the application of these agents are in the use of Potassium and Lithium 
Salts to diminish the acidity of the secretion, — Cubebs, Copaiba and Sandal-wood Oil as 
antiseptics and astringents, — and urethral injections of Alum, Zinc and Lead Acetates, 
Boracic Acid, Chloral and Zinc Chloride, etc., for a similar purpose. Copaiba is one of 
the most efficient agents for rendering the urine antiseptic, and should be more employed 
in cystitis and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata 



54 AGENTS ACTING UPON EXCRETION. 

Maidis (Corn Silk), in tincture, is beginning to be well thought of for a general alterative 
influence on the urinary tract. 

Antilithics or Lithontriptics {A nil, against, Leethos, a stone, 
Treebo, I wear down), — are agents supposed to prevent the formation of 
concretions in the excretory passages (antilithics) or to dissolve them 
when formed (lithontriptics). The terms are generally restricted to 
remedies affecting the urinary calculi, but those directed against the bili- 
ary form are included in this arrangement for the sake of consistent clas- 
sification. The chief agents coming under this title are — 

Biliary Calculi. Uric Acid Calculi or Urates. 

Ether and Turpentine. Distilled Water. 

(Durande's Solvent.) Potassium Salts. 

Sodium Bicarbonate. Lithium Salts. 

Sodium Salicylate. Potassium Tartraborate. 

Sodium Phosphate. Magnesium Citroborate. 

Castile Soap. Piperazin. 

Alkaline Waters, especially Vichy. Tetraethyl-ammonium. 

Calcium Oxalate Calculi. Phosphatic Calculi. 

Dilute Nitro-Hydrochloric Acid. Ammonium Benzoate. 

Carbonated Water. Benzoic Acid. 

Lactic Acid (for digestion). Dilute Nitric Acid. 

There is probably little or no solvent value to the agents recommended for biliary cal- 
culi. In the case of Uric Acid the administration of Potash or Lithia is based on their 
combining with the acid forming the calculus, and forming Urate of Potassium or Lithium, 
which salts are more soluble than the Uric Acid itself. Piperazin is, however, still 
more efficient in this respect, forming a piperazin urate which is seven times more solu- 
ble than lithium urate. 

Diluents {Diluo, I dilute), — are agents which, after their absorption, 
dilute the excretory fluids and enable the latter to hold more solid ma- 
terial in suspension. Water is the one true diluent, whatever form it may 
be disguised in, as teas, weak fluid foods, acid drinks, etc. 

Diaphoretics and Sudorifics {Deeaphorheeo, I carry through ; 
Sudor, sweat ; Facio, I make), — are remedies which increase the action 
of the skin and promote the secretion of sweat. When they act energetic- 
ally, so that the perspiration stands in beads upon the surface, they are 
known as Sudorifics. They may be subdivided into the following groups, 
viz. : — 

1. Simple Diaphoretics, which enter the circulation and are eliminated by the sudor- 
iferous glands, which they stimulate to increased action. 

2. Nauseating Diaphoretics, which produce relaxation and the dilatation of the super- 
ficial capillaries. 

3. Refrigerant Diaphoretics, which reduce the circulation, at the same time acting 
directly on the sweat centres in the spinal cord and medulla. 

The principal diaphoretics are enumerated as follows, the figures refer- 
ring to their respective supposed modes of action as indicated above, viz.: — 



AGENTS ACTING ON THE GENERATIVE APPARATUS. 



55 



Jaborandi. 1 , 3 
Pilocarpine. 1 , 3 
Salicylic Acid. 1 
Salicylates. 1 
Ipecacuanha. 2 
Tartar Emetic. 2 
Sulphur. 1 

Opium 2 , 3 (large doses). 
Camphor. 1 
Tobacco. 2 , 3 
Cocaine. 3 



Ether. 2 , 3 
Alcohol. 2 , 3 
Nitrous Ether. 2 , 3 
Ammonium Acetate. 1 
Ammonium Citrate. x 
Dover's Powder. 2 
Aconite. 3 
Veratrum Viride. 3 
Potassium Salts. 3 
Mezereon. 1 



Lobelia. 2 - 3 
Sarsaparilla. x 
Guaiacum. l 
Serpentaria. 1 
Sassafras. 1 
Senega. 1 
Vapor Bath. 2 
Turkish Bath. 2 
Wet Pack. 2 
Warm Drinks. 2 



•are agents which check 



Anhidrotics (An, without, Heedroce, sweat), - 
perspiration. They may act — 

1. By depressing the action of the sweat-glands. 

2. By depressing the excitability of the sweat-centres. 

3. By reducing the circulation in the skin. 

The most important agents of this class are the following-named, the 
figures indicating their mode of action as above arranged, viz. : — 



Belladonna. 1 

Atropine. 1 
Hyoscyamus. l 
Stramonium. x 
Muscarine. 2 
Agaricus Albus. 
Salvia (Sage). 



Acids, locally. 3 
Jaborandi. 
Pilocarpine. 
Nux Vomica. 

Strychnine. 
Ergot. 3 
Sulphuric Acid. 



Chloralamid. 
Quinine ? 
Picrotoxin. 
Dover's Powder. 
Opium 2 (small doses). 
Zinc Salts. 3 
Local Cold. 3 



Strychnine, Atropine, Dover's Powder, Jaborandi, Picrotoxin and Zinc Salts are all 
respiratory stimulants, and very efficient against the sweating of phthisis, though most of 
them are classed as diaphoretics. This is explained on the theory of accumulation of 
Carbonic Acid in the blood by depressed respiration caused by severe coughing, this 
stimulating the sweat centres, and being opposed by agents which stimulate the respira- 
tory centre. 

Agents Acting on the Generative Apparatus. 

Aphrodisiacs (Aphrohdeetay, Venus), — are medicines which stimulate 
the sexual appetite and power. They act by reflex or central action upon 
either the cerebral or the spinal genital centre. Tonics are indirectly 
aphrodisiac, as are all measures which promote the general bodily nutri- 
tion. The chief agents used as direct aphrodisiacs may be enumerated 
as follows, viz. : — 



Nux Vomica. 

Strychnine. 
Cannabis. 
Cantharis. 
Phosphorus. 
Aurum. 



Cimicifuga. 
Serpentaria. 
Sanguinaria. 
Opium (at first). 
Camphor (at first). 
Damiana (?). 



Ergot. 
Iron. 
Alcohol. 
Bitter Tonics. 
Flagellation. 
Meat Diet. 



Strychnine acts by increasing general nutrition and exalting the reflex excitability of 
the genital centres. Hemp probably only causes a mild delirium which may or may not 
take a sexual direction. Cantharides acts by direct irritation of the mucous lining of the 
urethra, and is dangerous in aphrodisiac doses. Alcohol in small doses excites the genital 
centre in the brain ; so, also Opium and Camphor, the latter being decidedly anaphro- 
disiac after a time. The power of Damiana is doubtful. Urtication and Flagellation of 



56 AGENTS ACTING ON THE GENERATIVE APPARATUS. 

the nates produce priapism by irritation of the genital centre in the cord through the sen- 
sory nerves of the part. Ergot is considered useful by contracting the dorsal vein of the 
penis, preventing its emptying too rapidly. 

Anaphrodisiacs (An, without, Aphrohdeetay, Venus), — are medicines 
and measures which lower the sexual function and diminish the sexual 
appetite. They act by lessening the excitability of the nerves of the 
genital organs, by depressing the genital centres in the brain and cord, 
or by decreasing the local circulation. The principal anaphrodisiacs are 
enumerated as follows, viz. : — 

Bromides. Tobacco. Nauseants. 

Potassium Iodide. Digitalis. Purgation. 

Camphor (at last). Conium. Venesection. 

Opium (at last). Belladonna. Ice, locally. 

Lupulin. Stramonium. Cold Baths. 

Cocaine. Gelsemium. Vegetable Diet. 

Emmenagogues (Emmayneeah, the menses ; Ago, I move), — are 
remedies which restore the menstrual function, either directly by stimu- 
lation of the uterine muscular fibre, or indirectly by improving the blood 
and toning up the nervous system. The direct emmenagogues are ecbolic 
in large doses. The principal members of this class are enumerated in 
the following list, viz. : — 

Direct Emmenagogues. Indirect Emmenagogues. 

Ergot. Quinine. Rue. Apiol. Iron. 

Savine. Tansy. Borax. Myrrh. Manganese. 

Digitalis. Guaiacum. Cinnamon. 

Canthatis. Polygonum Hydropip. Strychnine. 

Pulsatilla. Potass. Permanganate. Aloetic Purgatives. 

Asafetida. Cimicifuga. Cod-liver Oil. 

Alcohol. Oxalic Acid. Hot Hip-baths. 

Indigo. Hedeoma. • Leeching the genitals. 

Hydrargyrum Biniod. Origanum. Rubefacients to thighs. 

Caulophyllum. Viscum Flavescens. Tonic Remedies. 

Oxytocics or Ecbolics (Ockseus, quick, Tokos, childbirth ; Ekbolay, 
abortion), — are agents which stimulate the muscular fibres of the gravid 
uterus to contraction, and may produce abortion. In small doses the 
same remedies are emmenagogue as a rule. Their mode of action has not 
been clearly made known, but it is generally believed to be due in some 
cases to direct stimulation of the uterine centre in the cord, in others to 
congestion of the uterus producing reflex stimulation. The principal 
oxytocics are those enumerated in the following list, viz. : — 

Ergot. Hydrastis. Oil of Rue. 

Ustilago. Quinine. Pilocarpine. 

Savine. Borax. Viscum Flavescens. 

Potassium Permang. Cotton-root bark. Strong Purgatives. 

Any drastic purgative, or gastro-intestinal irritant, may produce abortion by reflex 
action. The Volatile Oils act in this manner, also Colocynth and many other agents used 
by women to produce abortion, as Tansy, Pennyroyal, etc., all of which are dangerous 
to life in doses sufficient to excite the action of the gravid uterus. 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 57 

Uterine Depressants lower the activity of the nervo-muscular appa- 
ratus which controls the uterine contractions. The most important of 
these agents are : — 

Opium. Chloral. Tobacco. 

Bromides. Chloroform. Copper Sulphate. 

Cannabis. Tartar Emetic. Emetics. 

Viburnum Prunifolium. Piscidia erythrina. 

Uterine Tonics and Alteratives, — are medicines which are con- 
sidered to have such specific influence over the uterus. Authorities differ 
very much regarding the value of these agents, but those enumerated in 
the following list are generally considered to have considerable value in 
uterine therapeutics, viz. : — 

Uterine Tonics. Uterine Alteratives . 

Potassium Bromide. Iodine. 

Potassium Chlorate. Iodoform. 

Pulsatilla. Iodized Phenol. 

Helonias Dioica. Glycerin. 

Cimicifuga. Hydrastis. 

Savine. Silver Nitrate. 

Astringents (locally). Galvanism. 

Those in the first list, except Astringents, are used internally ; those in the second 
column as topical applications to the uterine cavity or cervix. 

Galactagogues (Galla, milk, Ago, I bring away), — are medicines 
which increase the lacteal secretion, as Ricinus, Tea, Anise, Fennel, Potas- 
sium Chlorate, etc. The value of many so-called galactagogues is ex- 
tremely doubtful, the best being the local application of the leaves of the 
Castor-oil plant (Ricinus communis), and a good black Tea internally, 
with Milk, Beer or Porter as a beverage. Pilocarpus comes the nearest 
to being a true galactagogue, but its influence is very transient. (Com- 
pare the article entitled Lactation in Part III.) 

Antigalactagogues decrease the secretion of milk. Belladomia is 
the typical and most potent agent for this purpose, and acts when given 
internally or applied locally. Antipyrin has given evidence of similar 
power, also Camphor locally, and Potassium Iodide internally. 



Agents Acting on the Cutaneous Surface. 
Irritants are substances which, when applied to the skin, produce a 
greater or less degree of vascular excitement. When used to produce a 
reflex influence on a part remote from their site, they are termed Coun- 
ter-irritants, and may be subdivided into the following groups, viz. : — 

Rubefacients (Rubefacio, I make red), — produce temporary redness 
and congestion of the skin, unless left too long in contact with the sur- 
face, when they may cause exudation between the cuticle and the true skin 



58 



AGENTS ACTING ON THE CUTANEOUS SURFACE. 



(vesicants), or may destroy the tissue and form a slough (escharotics). 
They may induce muscular atrophy. 

Vesicants, Epispastics or Blisters, — produce decided inflammation 
of the skin, and outpouring of serum between the epidermis and derma. 
Cantharides is the agent generally used for this purpose. 

Pustulants, — affect isolated parts of the skin, as the orifices of the 
sudoriferous glands, giving rise to pustules. 

The following list embraces the principal agents and measures belong- 
ing to these groups, viz. : — 



Rubefacients. 


Rubefacients. 


Vesicants. 


Mustard. 


Oil of Cajuput. 


Cantharides. 


Capsicum. 


Oil of Turpentine. 


Euphorbium. 


Camphor. 


Volatile Oils. 


Mezereon. 


Ammonia. 


Pitch. 


Iodine. 


Mezereon. 


Friction. 


Rhus Toxicodendron. 


Arnica. 


Hot Water. 


Ammonia ( the con fined vapor) 


Alcohol. 




Glacial Acetic Acid. 


Ether. 


Pustulants. 


Volatile Oil of Mustard. 


Chloroform. 


Croton Oil. 


Heat - f 2° iling Y^ter. 


Iodine. 


Tartar Emetic. 


( Corngans Hammer. 


Menthol. 


Ipecacuanha. 
Silver Nitrate. 





Escharotics or Caustics (Eskahrah, a slough or scab ; Katoh, I 
burn), — are agents which destroy a tissue to which they are applied, and 
produce a slough. They act usually in one of three modes, viz. : — 



1. By abstracting the water of the tissue. 

2. By combining with the albumen of the part. 

3. By corrosive oxidation. 



The principal escharotics are enumerated in the following list, the 
numbers affixed to each pointin 
above. 



g out its mode of action as stated 



Mineral Acids. 1 
Glacial Acetic Acid. l 
Carbolic Acid. 1 
Chromic Acid. 3 
Arsenous Acid. 1 
Antimony Chloride. 1 



Caustic Potash. 1 
Caustic Soda. 1 
Lime. l 

Dried Alum. 2 
Silver Nitrate. 2 
Copper Sulphate. 3 



Mercuric Chloride. 2 
Mercuric Oxide. 2 
Mercuric Nitrate. 2 
Zinc Sulphate. 2 
Zinc Chloride. 2 
Bromine. 3 



Astringents {Ad, to, Stringo, I bind), — are agents which produce 
contraction of muscular fibre and condensation of other tissues, the first 
probably by direct irritation, the second by precipitating its albumen 
and gelatin. They also lessen secretion from mucous membranes. The 
principal astringents may be enumerated as follows,, viz. : — 



Acids. 


Tannic Acid. 


Bismuth Subnitrate, etc. 


Alcohol. 


Gallic Acid. 


Cadmium Sulphate. 


Alum. 


Catechu. 


Copper Sulphate. 


Chalk. 


Galls. 


Ferric Chloride. 


Lime. 


Kino. 


Lead Acetate. 


Creosote. 


Oak-bark. 


Silver Nitrate. 


Carbolic Acid. 


Uva-Ursi. 


Zinc Sulphate. 



AGENTS ACTING ON MICROBES, GASES, FERMENTS. 59 

Sulphuric Acid, Gallic Acid and Lead Acetate are examples of Remote Astringents, 
acting on internal organs through the blood. Those which affect the part to which they 
are applied are Local Astringents, and include most of those enumerated above. 

Styptics and Hemostatics {Stuphoh, I contract ; Haimah, blood ; 
Sta/isis, a standing), — are agents which arrest hemorrhage, Styptics being 
those which are applied locally, and Hemostatics those which are admin- 
istered internally. Some of the former act mechanically, by promoting 
the formation of a clot in the mouths of the bleeding vessels ; others cause 
the vessels themselves to contract, checking the flow of blood. The prin- 
cipal members of this class are the following-named : — 

Styptics. Hemostatics. 

Acids. Cold. Ergot. 

Alum. Matico. Digitalis. 

Antipyrin. Spider' s-web. Gallic Acid. 

Cautery. Tannic Acid. Lead Acetate. 

Collodion. Lead Acetate. Dilute Sulphuric Acid. 

Ferric Chloride. Zinc Sulphate. Ipecacuanha. 

Ferric Sulphate. Vegetable Astringents. Hamamelis. 

Silver Nitrate. Oil of Turpentine. 

Emollients (Emollio, I soften), — are substances which soften and 
relax the tissues to which they are applied. They relieve tension, dilate 
vessels, diminish pressure on the nerves, and protect inflamed surfaces 
from the air and from friction. The principal articles which may be 
classed under this heading are the following : — 

Hot Fomentations. Linseed Oil. Petroleum. 

Poultices. Olive Oil. Soap Liniment. 

Glycerin. Spermaceti. Starch. 

Lard. Almond Oil. Cacao Butter. 

Demulcents (JDemulceo, I soothe), — are substances, generally of a 
mucilaginous nature, which soothe and protect the parts to which they 
are applied. This term is generally used for substances employed for 
mucous membranes, and the term Emollients for similar agents used on 
the skin. The chief agents belonging to this class are : — 



Acacia. 


Starch. 


Honey. 


Olive Oil. 


Cetraria. 


Glycerin. 


Marsh-mallow. 


Isinglass. 


Barley. 


Flaxseed. 


White of Egg. 


Tragacanth. 


Liquorice. 


Gelatin. 


Almond. 


Bland Oils. 



Protectives, — are agents of a mechanical nature employed to cover 
and protect an injured part from the air, water, etc. Collodion and Gutta- 
percha are those in general use, but certain plasters, as the Adhesive, the 
Lead or the Soap Plaster, may be employed for this purpose, also Cotton 
Wool. 

Agents Acting on Microbes, Gases, Ferments, etc. 
Antizymotics (Anli, against, Zeumohsis, fermentation), — are agents 
which arrest the fermentative processes, which depend upon the action of 



6o 



AGENTS ACTING ON MICROBES, GASES, FERMENTS. 



unorganized ferments (enzymes), as diastase, ptyalin, pepsin, etc., or upon 
that of organized ferments, as the yeast-plant, bacteria, etc. The Anti- 
zymotics are usually subdivided into two groups, respectively entitled 
Antiseptics and Disinfectants. 

Antiseptics (Anti, against, Sayptekos, putrefaction), — prevent or retard 
septic decomposition, by destroying the bacteria which produce it, or by 
arresting their development. The chief antiseptics are named in the 
following list, the first column containing the most powerful ones, the 
middle column those which are moderately antiseptic, and the third col- 
umn the weakest members of the group. 



Strong. 


Moderate. 


Feeble. 


Corrosive Sublimate. 


Boric Acid. 


Benzoic Acid. 


Formalin. 


Chloral Hydrate. 


Sodium Borate. 


Oxygenated Water. 


Ferrous Sulphate. 


Calcium Chloride. 


Silver Nitrate. 


Zinc Sulphate. 


Sodium Chloride. 


Gold Chloride. 


Arsenic. 


Barium Chloride. 


Zinc Chloride. 


Salicin. 


Strontium Chloride. 


Copper Sulphate. 


Quinine. 


Ammonium Chloride. 


Iodine. Bromine. 


Sodium Salicylate. 


Ammonium Sulphate 


Chlorine. 


Salol. 


Alcohol (pure). 


Potassium Permanganate. 


Mercuric Iodide. 


Sodium Hyposulphite 


Carbolic Acid. Creosote. 


Eucalyptol. 


Potassium Chlorate. 


Chloroform. 


Sulphurous Acid. 


Potassium Arsenate. 


Thymol. Menthol. 


Sulpho-carbolates. 


Potassium Iodide. 


Hydronaphtol. 


Bismuth Subgallate. 


Manganese Chloride. 


Alum. Tannin. 


Resorcin. 


Glycerin. 


Acetanilid. Antipyrin. 


Coffee. 





The first four named are the most powerful. Corrosive Sublimate is probably the most 
powerful of all, but it is very poisonous. The best are those which act sufficiently on the 
microbes without injuring the tissues. Chlorine, Bromine and Iodine are too irritant for 
general use. Salol is the best intestinal antiseptic, though Naphtol will destroy micro- 
organisms in the stomach and intestines. 

We do not know any drugs which, taken internally or inhaled, will certainly destroy 
micro-organisms in the body, unless sufficiently concentrated to be fatal to the patient. 

Disinfectants destroy the specific germs of communicable diseases, 
and as most of these germs belong to the microbe class, many antiseptics 
are also disinfectants. They act in several modes, some as oxidizants, 
others by combining with albumen, others by chemical combination form- 
ing substitution-compounds, others by arresting molecular changes, and 
still others by altering the reaction of the media containing the germs. 
The principal disinfectants are those named in the following list : — 



Corrosive Sublimate. 

Formalin. 

Heat (230°-25o° F.). 

Potassium Permang. 

Zinc Sulphate. 

Hydrogen Dioxide. 

Creolin. 



Carbolic Acid. 
Zinc Chloride. 
Potassium Bichromate. 
Ferrous Sulphate. 
Calcium Chloride. 
Chlorinated Soda. 
Lysol. 



Chlorine. 

Iodine. Bromine. 

Lime (fresh). 

Sulphurous Acid. 

Nitrous Acid. 

Thymol. 

Camphor. 



Condys Fluid is an aqueous solution of Potassium Permanganate, 2 parts in ioo, or 
, 176 in 3 xx. Burnett's Fluid is a solution of Zinc Chloride, containing about 50 per 



AGENTS ACTING UPON EACH OTHER. 6 1 

cent, of the salt, and equivalent to the official Liquor Zinci Chloridi. Labarrague's 
Solution is the official Liquor Sodae Chlorate. Sauitas is an aqueous solution of oxidized 
turpentine, containing Hydrogen Dioxide, Thymol, Camphor, etc. 

The popular idea of disinfecting the air of a room by burning sulphur, etc., is an ab- 
surdity, for the foul air is easily removed by simple ventilation. In disinfecting a room 
in which a case of contagious or infectious disease has been, the true aim is to kill the 
germs contained in the dust on ledges, or in the crevices between the boards, or adher- 
ing to the walls, and a dry gas is powerless for this purpose, which is best accomplished 
by using a Sublimate Solution of the strength of I in iooo, or by Lime washing, pro- 
vided that the lime be freshly burnt, and caustic, or by spraying with Formalin, or by 
dropping the latter on hot plates or sheets of metal. 

Deodorants, — are agents which destroy foul odors. The Volatile De- 
odorants are chiefly oxidizing and deoxidizing substances, acting chemic- 
ally on the obnoxious gases; while the Non-volatile ones are mainly 
absorbents, which condense and decompose the effluvia. The deodorants 
in general use are the following named : — 

Formalin. Hydrogen Dioxide. Charcoal. 

Chlorine Gas. Potassium Permanganate. Earth. Lime. 

Sulphurous Acid Gas. Coffee, freshly roasted. Ferrous Sulphate. 

For removing the fetid exhalations emitted by the foeces, the following powder is a 
very efficient and cheap deodorizing and disinfecting agent. Zinc Sulphate, lbs. ij, Sul- 
phuric Acid, 3Jss to ,^ijss, Essence of Mirbane, ^j, Indigo Blue, gr. ij. About a des- 
sertspoonful of this salt is placed in the bed-pan or chamber utensil before it is used. 
Contact with urine or a liquid stool causes its prompt solution, deodorization is instanta- 
neous, the liquid excreta are at once sterilized, and the fetor is changed to a rather agree- 
able odor. 

Parasiticides (Tarra/iseetos, a parasite, Cado, I kill), — are agents 
which destroy the animal and vegetable parasites found upon the human 
body. They are generally applied in the form of lotions, ointments or 
oleates, and include the following substances, viz. : — 

Sulphur. Mercury. Carbolic Acid. 

Sulphides. Ammoniated Mercury. Petroleum. 

Sulphurous Acid. Mercuric Chloride. Storax. 

Sulphur Iodide.. Mercuric Nitrate. Staphisagria. 

Iodine. Mercuric Oxide. Balsam of Peru. 



Agents Acting upon Each Other. 
Antidotes are agents which affect a poison either physically or chem- 
ically, or both, so as to remove it from the body or alter its character by 
forming with it an insoluble or inert compound before its absorption, 
with the object of preventing its toxic action upon the organism. Anti- 
dotes do their work in the alimentary canal or in the respiratory passages, 
and are applicable to vegetable as well as mineral poisons, but are not 
available against poisons administered hypodermicallv. They include 
sundry chemical substances, also measures of various kinds, and may be 
divided into two classes : (i) Chemical or True Antidotes, which unite 
chemically with the poison, converting a soluble and absorbable substance 
into a compound which is more or less insoluble and non-absorbable, or 



62 AGENTS ACTING UPON EACH OTHER. 

harmless though soluble ; (2) Mechanical, or Antidotal Measures, which 

include such agents or measures as may remove the poison as such from 

the system or mechanically prevent its absorption. 

Thus, Tannic Acid is the antidote for poisoning by Digitalis, as it forms with the 
active toxic principles of the drug chemical compounds (tannates) which are almost insol- 
uble and therefore comparatively harmless. But as these tannates are not entirely inert, 
an antidotal measure, evacuation of the stomach, must be employed, by the administration 
of Zinc Sulphate or any other emetic, or by the use of a stomach-pump. 

Antagonists are agents which directly oppose each other in some or 
all of their physiological actions, and may be used against each other to 
counteract their effects upon the organism. Antagonistic action takes 
place in the blood and tissues, after the absorption of both the poison 
and the antagonist ; it is available against poisons administered hypoder- 
mically as well as by other channels, and so far as drugs are concerned it 
is applicable chiefly to vegetable poisons or to those which produce their 
toxic effects after absorption. In most cases of poisoning by vegetable 
principles absorption has proceeded so far before professional assistance 
is obtained that the time for antidotes has passed, and reliance can be 
placed only upon the physiological antagonists and such antagonistic 
measures as may support vitality until the poison can be eliminated by 
the excretory organs of the body. There may be an exception to this 
rule in the case of Morphine, which, after making the round of the circu- 
lation, constantly returns in part to the stomach until finally eliminated, 
so that repeated washing of that organ with a solution of potassium per- 
manganate, or the ingestion thereof from time to time, may have a con- 
tinuous antidotal action on such portion of the poison as may have been 
absorbed. 

Antagonistic Measures include all such procedures as may tend to 
antagonize any remote effects of poisons, as artificial respiration, fara- 
dization of the respiratory muscles, constant motion or absolute repose, 
application of heat or cold, douching, etc. 

Thus, to refer again to the case of poisoning by Digitalis, the antagonists which will 
counteract the effects of such portion of the drug as may have been absorbed are the 
following : Aconite or Morphine against the cardiac action, the former for the effects of 
large doses, the latter for those of the long-continued use of the drug. Saponin and 
Senegin are the most complete antagonists against Digitalis, their counteraction extend- 
ing throughout nearly its entire range of action. Alcohol is also indicated, as a cardiac 
stimulant, and absolute Rest in the recumbent posture is an antagonistic measure of prime 
importance, by reason of the liability to sudden cessation of the lowered cardiac action 
on the assumption of the erect posture. 

In Part I of this book, under the several titles of the poisonous drugs, 
their most efficient Antidotes and Antagonists are mentioned ; but these 
are more fully described, and are arranged in a form suitable for reference, 
under the caption The Treatment of Poisoning, in the Appendix. 

Physiological Antagonism means a balance of opposed actions on 
particular organs or tissues, excited by medicinal agents and measures or 



AGENTS ACTING UPON EACH OTHER. 63 

by disease. It may extend throughout the whole or the greater part of 
the range of action of the opposing agents, or, as is usually the case, may 
be limited to a few points thereof. There is no instance in which the 
antagonism of two drugs is absolutely complete along their whole line of 
action. In a few cases it is nearly so, as with Morphine and Atropine 
(except as to narcotism), Digitalis and Saponin, and Atropine and Mus- 
carine, the latter being considered the most complete instance known. 
In most cases the antagonism extends only to certain definite spheres of 
action, and the antagonists therein may be synergists to each other in 
other spheres, as in the narcosis produced by both Morphine and Atro- 
pine. It may be local, affecting a single organ or function, or it may 
extend to a group of organs, to several associated functions, or over the 
distribution of the nerves proceeding from a single nerve-trunk (as the 
vagus) or controlled by a single nerve-centre. Antagonism implies a 
balance of functional disturbance, not an alteration of structure. 

Drugs are rarely antagonistic to each other in the same degree, but, by 
reason of differences in their mode and time of action, the action of 
one preponderates over that of the other, so that the latter will not 
counteract the former to the extent of averting a fatal result, though in 
the reverse order their counteraction may be most satisfactory. For ex- 
ample, while Chloral is the antagonist to Strychnine, opposing as it does 
the spinal action of the latter drug, the reverse is true to a very limited 
extent ; and, while Atropine may prevent death from a lethal dose of 
Aconitine, Morphine or Bromal Hydrate, no one of these three will do 
so in atropine poisoning. 

Two mutually antagonistic principles may exist in the same plant, as 
the alkaloids Pilocarpine and Jaborine in pilocarpus, and the glucoside 
constituents of digitalis, one of which, Digitonin, antagonizes the actions 
of the other three, Digitalin, Digitoxin and Digitalein. 

Toxicological Antagonism is a very ancient idea in medicine. Mithridates of 
Pontus (B. C 164-124) and other monarchs of the heathen world occupied themselves 
with the study of poisons and their antidotes and antagonists, established botanical gardens 
for the purpose of their investigation, and gave their names to what were supposed to be 
universal preventives against the results of poisoning. In the 1 6th century Prosper held 
that Theriaca (opium) was an antagonist to all poisons. From 1570 to 1677 many ob- 
servations were made and published on the treatment of belladonna poisoning by opium, 
and in 1810 the same matter was made the subject of an inaugural thesis by Lipp. The 
scientific investigation of drug action and antagonism was not possible until the discovery 
and isolation of the alkaloids, but followed immediately thereafter, and was begun in 1809 
by Magendie upon the upas poison (nux vomica) and its newly discovered alkaloid, 
strychnine. In 1869 Schmeideberg and Koppe made their researches on muscarine and 
atropine, and Liebrich discovered chloral and proved the antagonism of strychnine 
against its action, the converse of which was shown by Bennett in 1875. l n 1870 
Frazer published his investigations upon atropine and physostigma, and Preyer his on the 
antagonistic influence of atropine and hydrocyanic acid on respiration. In 1875 a com- 
mittee of the British Medical Association made an extended investigation and report on 
the antagonisms of several drugs, which was supplemented by the work of Vulpian on 
atropine and pilocarpine in the same year, that of Fothergill in 1877 on aconite, atropine 
and digitalis, and that of Huseman on the antagonisms of chloral. Much good work 



6 4 



AGENTS ACTING UPON EACH OTHER. 



has also been done in England by Brunton and Ringer, and in the United States by 
Wood and Bartholow, on the same lines. The name of Brunton is unalterably associated 
with the antagonism between amyl nitrite and the spasmodic paroxysm of angina pectoris, 
a discovery in therapeutic antagonism which was made by him through the exercise of 
purely scientific reasoning, and which has since been applied to the similar paroxysm 
induced in poisoning by certain drugs, as cocaine. Bartholow has collected a list of 120 
cases of poisoning by opium and belladonna, in which each poison was treated with the 
other as an antagonist, and in which only 15 proved fatal, a mortality of 12^ per cent. 

The following table, modified from Brunton, gives the antagonistic poisons, also their 
mutual antagonistic and lethal doses in each case in which they have been determined. 
The doses are expressed in grains or fractions of a grain per pound weight of the animal. 



ANTAGONISTS. 



ANTAGONIS- 
TIC DOSE. 



LETHAL 
DOSE. 



Aconitine and Atropine, . . . 

" " Digitalin, . . . 

" " Strychnine, . . . 

Alcohol and Strychnine, . . . 

Atropine and Aconitine, . . . 

" Chloral, .... 

" " Hydrocyanic Acid, 

" " Jaborandi, . . . 

" " Muscarine, . . . 

" " Morphine, . . . 

" " Pilocarpine, . . . 

" Phytolaccine, . . 

" " Physostigmine, 

" " Quinine, .... 

Bromal Hydrate and Atropine, . 
Chloral and Atropine, .... 

" " Picrotoxin, .... 

" " Physostigmine, . . 

" " Strychnine, .... 
Chloroform and Amyl Nitrite, . 
Digitalin and Aconitine, . . . 

" " Muscarine, . . . 

" " Saponin, .... 

Gelsemium and Opium, . . 

" " Atropine, . . 

Morphine and Caffeine 

" " Chloroform, . . 

Muscarine and Atropine, . . 
Opium and Atropine, .... 

" " Gelsemium, .... 

" " Veratrum Viride, 



1 

750 

6iJO 

1 



¥^0 

9(70 



7 
7 
7 
7 
7 
7 
7 
7 
7 
7 

900 

7 
7 
7 
7 
7 



7 
1 

28F 

288 

900 

7 



PART I. 



MATERIA MEDICA AND THERAPEUTICS. 



ABRUS, Jequirity (Unofficial), — is the seed of Abrus precatorius, 
or Wild Liquorice, a plant of the nat. ord. Leguminosae, indigenous in 
India, but growing wild in most tropical countries. The seeds are small, 
hard, of a bright scarlet color, and contain some fixed oil, sugar, a prin- 
ciple resembling glycyrrhizin, Abric Acid, C 12 H 24 N 3 0, and two proteid 
poisons, a paraglobulin and an albumose, the latter of which is named 
Abrin. 

Preparation. 

Infusum Abri, Infusion of Jequirity (Unofficial), — prepared by macerating three 
powdered seeds in ^ ss of cold water for twelve hours, adding ^ ss of boiling water, and 
filtering when cold. It should be used while fresh, as after two or three days it is worth- 
less, and is found in a short time swarming with bacteria. Another formula contains gr. 
ix to the % , with gr. iv of Boric Acid to prevent decomposition. 



Physiological Action and Therapeutics. 

Jequirity seeds, when moistened with water, become highly poisonous. 
If applied to the conjunctiva, a severe inflammation is set up, with cedema 
and false membrane, ulceration of the cornea, and extension to the lids, 
face, neck and submaxillary glands. Inserted into a wound in cattle, 
they cause death in a few hours. Sidney Martin has shown that the pro- 
teid poisons contained in Jequirity seeds are almost identical in their 
physiological and toxic properties with the similar principles found in 
snake venom, although less powerful. 

Jequirity is used for the purpose of producing a purulent or croupous 
conjunctivitis, by which to destroy old granulations (trachoma) and pan- 
nus. A mild infusion is applied to the eye two or three times a day for 
two days, and followed by weak solutions of Alum or Borax. This should 
be repeated after three weeks if necessary. An emulsion of the seeds in 
water is a useful application to unhealthy ulcers and lupus. 
5 6 5 



66 ABSINTHIUM ACETANILIDUM. 

ABSINTHIUM, Wormwood, — the leaves and tops of Artemisia Absinthium, a 
perennial garden herb of the nat. ord. Compositae, indigenous in Europe, but cultivated 
in the United States. It contains a volatile oil and a bitter principle, Absinthin. Dose, 
gr. xx— xl, in infusion. There are no official preparations, but of the formerly official 
Vinum Aromaticum, Absinthium constituted one per cent. 

Absinthe, the French liqueur, is an alcoholic solution of the oil, containing also extracts 
of Anise, Majoram and Angelica. Its continued use produces various nervous symptoms, 
morning nausea and vomiting, also a tendency to epileptiform convulsions. 

The bitter constituent of Absinthium is stimulant to the digestive organs, but the oil is 
a narcotic poison, increases the cardiac action, and produces tremor, stupor, epileptiform 
convulsions, involuntary evacuations, and stertorous breathing. It is but little used in 
medicine, only as a stomachic tonic in dyspepsia. 



ACACIA, Gum Arabic, — is a gummy exudation from Acacia Sene- 
gal, a small tree of the nat. ord. Leguminosae, indigenous in Africa. It 
occurs in spheroidal tears of various sizes, breaking with a glassy, some- 
times iridescent fracture ; insoluble in alcohol, but soluble in water, 
forming a thick and mucilaginous liquid. It consists of Arabin or Arabic 
Acid, C^HL^On, combined with calcium, potassium, and magnesium. 

Mucilago Acaciae, Mucilage of Acacia, — has of Acacia 35, Water to 100 parts. It 
should not be prescribed with tinctures or spirits except in very small quantity. Dose, 
indefinite. 

Syrupus Acacise, Syrup of Acacia, — has of the Mucilage 25, Syrup 75. Should be 
freshly made. Dose, indefinite. 

Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyrrhizae Com- 
posita, Pulvis Cretae Compositus, Trochisci Cretae, Troschisci Cubebae, and Trochisci 
Glycyrrhizae et Opii. 

Gum Arabic has no activity except the negative one of a demulcent, 
and is chiefly used in coughs, sore throats, catarrhal inflammation of the 
stomach and intestines, and irritant poisoning. It is much employed in 
pharmacy to suspend insoluble powders in mixtures, for which purpose the 
mucilage is generally used. 



ACETANILIDUM, Acetanilid, (A nlifebrin).— Like the major 
number of the newest antipyretics, which are related either to Chinolm 
or to Phenol, Acetanilid is a derivative of Anilin, from which it is ob- 
tained by the action thereon of glacial acetic acid, substituting the organic 
radical Acetyle for an atom of hydrogen. Chemically, it has the name 
Acetanilid or Phenyl-acetamide, and the formula C 6 H 5 NHC 2 H 3 0. 

The name Antifebrin is copyrighted by its original promoters for trade purposes, and 
therefore should be dropped from professional usage. 

Acetanilid is a white crystalline powder, of neutral reaction, and odor- 
less, but of slightly burning taste. It melts at 235 F., and distils at 55 7 
F., is freely soluble in alcohol, wine, etc., but very sparingly (1 in 200) 
in cold water, more readily in hot water. It is a neutral substance, being 
unaffected by hydrochloric or sulphuric acids, and ordinarily unaltered 
by alkalies. 



ACETANILIDUM. 6*] 

The dose ranges from gr. ij to gr. x, repeated twice, and not exceeding gr. xxx in the 
24 hours. As much as 3J has been swallowed without ill effects supervening. It may 
be administered in the very convenient form of compressed tablets ; — also in powders, or 
in dilute alcoholic solution. ^j may be dissolved in 5 ivss of brandy, to which, if we 
add gvj each of simple syrup and water, we get a six-ounce mixture, of which a table- 
spoonful (Jfss) contains 5 grains of Acetanilid, a fair adult dose. As an antipyretic, 
gr. iij may be administered every %. to ]/ z hour, until 12 or 15 grains have been given, 
which will usually be a sufficient quantity, especially if given at the acme of the febrile 
movement. 

Unofficial Derivatives and Allied Compounds. 

Acetanilid Compound (Aulde), — is a mixture containing Acetanilid 70, Caffeine 10, 
and Sodium Bicarbonate 20 per cent. , and is put up in the form of compressed tablet 
triturates, each containing l / z grain of the mixture. It is intended to replace the numer- 
ous proprietary preparations sold under fancy names and having acetanilid and caffeine 
as the active constituents. Dose, from 10 to 30 tablets. 

Agathin, Salicyl-aldeJiyde-a-metliyl-phenyl-hydrazone, — is a synthetic compound, 
which has been used extensively in Europe as an anti-neuralgic and anti-rheumatic rem- 
edy. Dose, gr. v-x, two or three times a day, but from 55s to ^jss must be given be- 
fore any effect is produced. 

Ammonol, Ammoniated Phenylacetamide, — a new antipyretic and analgesic, claimed 
to possess unusual stimulating and expectorant properties due to the loosely combined 
Ammonia in its composition. Its introduction has been confined to the distribution of 
circulars and samples to physicians by its proprietors. Dose, gr. v-xx. 

Analgen, Ortho-oxy-ethyl-ana-mono-acetyl-amido-chinolin, — a Chinolin derivative ; 
was reformed by inserting benzoyl instead of the acetyl radicle, and re-christened Quinal- 
gen. (See below.) 

Analgesine, — a proprietary preparation, consisting of Acetanilid 60, Ammonium 
Chloride 20, Citrated Caffeine 10, Sodium Bicarbonate 10. Dose, gr. v-xv. 

Antikamnia, — is a proprietary preparation widely advertised as an antipyretic and 
analgesic. Analyses of several samples have been made by different chemists, all of 
which agree in finding the chief ingredients to be Acetanilid and Sodium Bicarbonate in 
varying proportions. By some observers Caffeine was detected, also Tartaric Acid, etc. 
The preparation is formulated by the latest analysis as a mixture of Acetanilid 70, Sodium 
Bicarbonate 20, and Caffeine 10 per cent. Dose, gr. v-xv, in powder or tablets. 

Antikol, — contains Acetanilid 75, Sodium Bicarbonate 17^, Tartaric Acid 7^ per 
cent. (Squibb). Dose, gr. v-xv. Another " Antikol" is advertised by its manufacturer to 
consist of Acetanilid, Quinine Bisulphate, Sodium Bicarbonate, and Caffeine Citrate, the 
latter in the proportion of 10 per cent. 

Antinervin, Salbromalide {Salicylbromalide), — is a mixture of Acetanilid 2, with I 
part each of Salicylic Acid and Ammonium Bromide (Ritsert). Dose, gr. v-xv. 

Antipyrinum, Antipyrin (Pkenazone), — is described under its own title. 

Caffenol, — is a mixture of similar character to the above, and contains Acetanilid and 
Caffeine. Dose, gr. v-xv. 

Exalgin, Methyl-acetanilid, — is a crystalline compound allied to Acetanilid, occur- 
ring in acicular needles, readily soluble in dilute alcohol, less so in warm water, and 
with difficulty in cold water. Dose, gr. j-v, in wine, or other dilute alcoholic mixture. 
Alcohol 3 ss, and Water £ j form a permanent solution with gr. xvj of Exalgin. Its 
name, derived from ef , out of, a/.yoq, pain, denotes its principal therapeutic action. 

Exodyne is a mixture of Acetanilid 90, Sodium Salicylate 5, and Sodium Bicarbonate 
5. The name (from 'ef, out of, odvvij, pain) sufficiently states its claims to medicinal 
virtue. Dose, gr. iij-x. 

Febrinol, Methyl-ara-acet-phenetidin, — so called by its proprietors, is a mixture of 
Acetanilid and other inert substances, advertised at one half the price of similar coal-tar 
preparations. 

Malakin, Salicyl-para-phenetidin, — is a combination of Phenacetin and Salicylic 
Acid, and is described under Salicinum. 

Migranin, — is a double Citrate of Antipyrin and Caffeine, and is described under 
Antipyrinum. 



68 ACETANILIDUM. 

Neurodin, Acetyl- para-oxy-phenyl-iaethane, — an analgesic, antineuralgic and anti- 
rheumatic remedy. Its antipyretic action is too sudden for it to be used as a general anti- 
pyretic. Its action is uncertain and much inferior to that of phenacetin or antipyrin 
(Lippi). Dose, gr. v-xxv. As much as 3JSS has been taken in 24 hours without ill 
effects. 

Phenacetin, Methacetin and Phenocoll, — are closely allied to Acetanilid, both 
chemically and medicinally, and are described under the title Phenacetin um, et seq. 

Phenatol, — contains Acetanilid, Sodium Carbonate, Bicarbonate, Chloride and Sul- 
phate, also Caffeine. Dose, gr. v-x. 

Phenolid, — is a mixture of Acetanilid 58, and Sodium Salicylate 43, and competes 
with the above as a panacea. Dose, gr. v-xv. 

Pyretine, — contains Acetanilid, Caffeine, Sodium Bicarbonate and Chalk, in varying 
proportions. Dose, gr. v-x. 

Quinalgen, Ortho-ethoxy-ana-mono-benzoyl-amido-quinoline, — is a derivative of Quin- 
oline (Chinolin), and is a reformation and renaming of the preparation named Analgen 
(see above). It is described under Chinolinum. Dose, gr. vij-xv, up to gr. xlv daily. 

Salfene and Kaputin are Acetanilid mixtures, the latter being simply colored acetan- 
ilid. 

Thermodin, Acetyl-para-ethoxy-phenyl-methane, — is closely allied to Neurodin (see 
above), which it resembles in all respects except that it has a smaller dose, which is 
gr. v-x. 

Physiological Action. 

Acetanilid is strongly analgesic, somewhat hypnotic and antispasmodic, 
a moderately efficient antipyretic, also a decided antiseptic and local 
anaesthetic. It lessens the reflex action of the spinal cord, and inhibits 
the sensibility of the sensory nerves. It raises arterial tension somewhat, 
and slows the heart in a corresponding degree, quiet sleep often following. 

Compared with the action of Antipyrin, the effect of Acetanilid on 
the body-temperature is manifested more slowly (1 hour against ^ hour), 
but lasts a longer time (6 against 2 hours). It is markedly diuretic, and 
somewhat diaphoretic ; is a cerebral, muscular and vaso-motor stimulant, 
and leaves no ill after-effects ; — while Antipyrin is powerfully diaphoretic, 
a cerebral sedative, and produces great depression. Furthermore, Ace- 
tanilid frequently produces nearly the same degree of reduction of body- 
temperature as Antipyrin, with the ingestion of but ^th the dose; and, 
like the latter agent, it has little or no effect on the normal temperature, 
and its continued use begets tolerance of its action. Its antipyretic 
action is, however, less reliable than that of Antipyrin, and corresponds, 
in degree and in duration, to the size of the dose. There is neither 
vomiting nor diarrhoea afterwards, but there is a tendency, in some cases, 
to collapse, with chills and cyanosis, especially the latter, during the 
period of depressed temperature. 

A toxic dose destroys the ozonizing function of the blood, decolorizing 
it, and forming methyl-haemoglobin. The heart, liver and kidneys of 
animals poisoned thereby are found in a state of acute fatty degeneration. 
Its continued use in large doses is highly injurious to the blood, especially 
in diseases (as typhoid fever) which are themselves destructive to the 
blood-elements. 



acidum aceticum. 69 

Therapeutics. 

Besides being a fairly efficient antipyretic, Acetanilid has marked anal- 
gesic and antispasmodic powers; and these, together with its great ad- 
vantages of a small dose, comparative efficiency and safety, and the absence 
of the severe rigors and cardiac depression which mark the chinolin de- 
rivatives, combine to make it an agent of wider therapeutical range than 
most of its analogues. It is especially useful in phthisis and typhoid fever, 
for the hyperpyrexia, thereby relieving wakefulness, lessening delirium, 
and upholding a failing heart ; but if long used in large doses in the 
latter disease it may increase the liability to serious sequelae, especially 
periostitis of the ribs, gangrene of tissues, etc. For the pains of loco- 
motor ataxia, and in those of rheumatic origin, sciatica, lumbago, etc., 
it is a most efficient remedy. In acute rheumatism, influenza and scarlet 
fever it is highly praised ; and in acute bronchitis doses of four grains 
every two hours have often arrested the attacks within twenty-four hours. 
In epilepsy, it is being tried, with the view of moderating reflex excita- 
bility. Added in minute proportion to aqueous solutions for hypodermic 
use, it is said to preserve them from decomposition more efficiently than 
any other agent hitherto employed for that purpose. It acts very well 
with children, when used in proper doses ; but in all cases, overdosing 
must be avoided, both as to quantity and repetition. 

Acetanilid is now extensively employed in surgical practice as a dry 
dressing for wounds, burns, scalds, and other injuries involving breach 
of the tissues. Dusted in fine powder over the surface of a wound it 
promotes healing, prevents suppuration, relieves pain, and is odorless, 
unirritant and non-toxic, though a few cases of very young children are 
reported in which its topical application to wounds caused cyanosis and 
symptoms of collapse. It has also been used with much benefit as an 
application to mucous patches and rectal ulcers. 

Antinervin attracted much attention, during the epidemic of influenza in Scotland, 
as an analgesic and antipyretic. It relieved the pains in the back and head, reduced the 
fever and produced copious perspiration, without being followed by unfavorable sequelae. 
It has proven to be of great benefit in acute rheumatism, and may be used with advan- 
tage in all abnormal excitement of the nervous system, either against neuralgia or as a 
general nerve sedative. The best way to prescribe it, is as an extemporaneous mixture, 
containing the proper proportions of its ingredients, viz. : — Acetanilid 50, Salicylic Acid 
25, and Ammonium Bromide 25 per cent., mixed secundum artem, and administered in 
doses of gr. v-xv every two hours until relief is obtained. 

Exalgin resembles Acetanilid and Antipyrin in its antipyretic and analgesic powers. 
Compared with the latter it is less efficiently antipyretic, but more powerful as an anal- 
gesic and antiseptic. In overdose it is highly dangerous, having produced symptoms 
resembling those of angina pectoris, also toxic effects resembling those of carbolic acid, 
with delirium, dyspnoea, cyanosis, and renal disturbances. It has been used with most 
excellent results in neuralgias ; also in chorea. In the latter affection daily doses of 3 
grains were sufficient. 

ACIDUM ACETICUM, Acetic Acid,— is a liquid composed of 
36 per cent, of absolute Acetic Acid, HC 2 H 3 2 , and 64 per cent, of water. 



/O ACIDUM BORICUM. 

It is a clear, colorless liquid, of a distinctly vinegar odor, a purely acid 
taste, and a strongly acid reaction ; miscible in all proportions with water 
and alcohol, and wholly volatilized by heat. It is prepared from wood 
by destructive distillation and purification. Acetic Acid is also official 
in two other degrees of concentration, viz. : — 

Acidum Aceticum Glaciale, Glacial Acetic Acid, HC. 2 H 3 2 , — is nearly or quite 
absolute Acetic Acid, solid below 59 F., above that temperature a colorless liquid. Is 
strongly escharotic and only used locally. 

Acidum Aceticum Dilutum, Diluted Acetic Acid, — consists of Acetic Acid 10, Dis- 
tilled Water 50 parts, contains 6 per cent, of absolute Acetic Acid, and has a sp. gr. of 
I.008. Dose, 3J-ij. 

Acetum, Vinegar (Unofficial), — is an impure diluted Acetic Acid, produced by the 
acetous fermentation of any liquid susceptible of the vinous fermentation. 

Diluted Acetic Acid is used in the preparation of the two official Aceta (Vinegars). 

Physiological Action and Therapeutics. 

Acetic Acid, like the other vegetable acids, in concentrated form is 
escharotic and produces gastro-enteritis if swallowed. In dilute form it 
acts as a refrigerant, diminishing thirst and allaying restlessness. It forms 
salts in the stomach, thus enters the blood, and is there oxidized, produc- 
ing carbonic acid, and thereby increasing the acidity of the urine. It is 
also diuretic. Long used, it causes emaciation and poverty of the blood, 
producing a general scorbutic condition. It is hemostatic and anthel- 
mintic, and the vapor inhaled causes reflex contraction of the vessels and 
raises the blood-pressure. Lately, investigations into its germicidal powers 
have given it high rank among germ-destroyers, a solution containing 7 
per cent, of this acid proving as efficient as mercuric chloride. 

The glacial acid is used as a caustic in many skin affections, as warts, 
condylomata, etc., and to destroy the parasite in ringworm and pityriasis. 
It has been employed locally in carcinoma, with the view of dissolving 
the supposed cancer-cells. The dilute acid is used locally in superficial 
inflammations of the skin, and may be sponged over the body to check 
perspiration and reduce the surface temperature in fevers. It is often 
administered internally to reduce obesity, which it does by impairing 
digestion. Locally, it may be employed to arrest slight hemorrhages, 
as epistaxis ; and is occasionally used by enema for the destruction of 
ascarides. 



ACIDUM BORICUM, Boric (Boracic) Acid, H 3 B0 3 ,— is a 
weak acid occurring in transparent, colorless, six-sided plates, of unctuous 
touch, odorless, of a cooling and slightly bitter taste, soluble in 25 of 
water, in 15 of alcohol and in 10 of glycerin. Its aqueous solubility is 
increased by the addition of hydrochloric acid or borax. It is produced 
from Borax by the action of sulphuric acid ; also by the purification of 
the native acid. Dose, gr. v-xv. There are 2 official Borates, viz. : — 



ACIDUM BORICUM. J\ 

Sodii Boras, Sodium Borate [Borax) , Na 2 B 4 0- -\- loH 2 0, — colorless, transparent 
prisms, of cooling and sweetish, afterwards alkaline taste and alkaline reaction, soluble 
in 16 of water at 59 F. , and in 0.5 of boiling water ; insoluble in alcohol. Occurs 
native in ancient lake beds in the Death Valley region, California, and various other parts 
of the world. Dose, gr. v-xxx. 

Glyceryl Borate, Boroglycerin, — official in the following preparation, — 
Glyceritum Boroglycerini, Glycerite of Boroglycerin (Glycei'ite of Glyceryl Borate, 
Solution of Boroglyceride), — prepared by heating together Boric Acid 310 and Glycerin 
460, until reduced to 500 grammes, then adding an equal weight of Glycerin. 

Unofficial Preparations. 

Boroglyceridum, Boroglyceride, — is a solid chemical compound, prepared by heating 
together Boric Acid and Glycerin. It is soluble in water, but is generally used in solu- 
tion with glycerin, as the above official glycerite. It combines readily with Chrysarobin, 
Carbolic Acid, Atropine and Morphine, and is used as a local application in eye diseases 
and skin affections. 

Boracic Ointment, — has of Boracic Acid 1, White Wax 1, Paraffin 2, Almond Oil 2, 
thoroughly mixed together. 

Boracic Lotion, — is a saturated solution of the acid in water. 

Boracic Lint, — prepared by steeping lint in a boiling saturated solution and drying. 
It contains nearly one-half its weight of the acid. 

Magnesii Boro-citras, Magnesium Borocitrate, — prepared extemporaneously thus ; 
R . Magnesii Carbonatis J^j, Acidi Citrici gij, Sodii Biborat. 5jij, Aquae Bullientis 
^viij. A tablespoonful three or four times daily as a solvent of uric acid calculi. 

Potassii Tartra-boras, Potassium Tartraborate, — is a better solvent of uric acid 
calculi than the Magnesium salt, and is soluble in 2 parts of cold water. Prepared by 
heating together Boracic Acid I, Potassii Bitartras 4, Water 10 parts. Dose, gr. xx, 
largely diluted with water, three or four times a day. 

Sodium Tetraborate is a new preparation (or salt ?) obtained by heating together 
equal parts of Boric Acid, Borax and Water. The resulting compound is neutral, and is 
supposed to be an entirely new salt. It was introduced to furnish a more soluble form 
of Boric Acid, and may be used wherever the latter is indicated, but it has the disadvan- 
tage of forming hard crusts upon dressings, which irritate abraded surfaces. 

It has long been known that the addition of Borax to Boric Acid in aqueous solution 
greatly increases the solubility of the acid, — and the above may explain the observed fact. 

Borine, — is a proprietary antiseptic preparation, advertised to be " composed of the 
active constituents of Benzoin, Wintergreen, Meadowsweet, Golden Rod, Witch Hazel, 
combined with the stearoptenes of Wild Thyme, Eucalyptus, Peppermint and Boracic 
Acid." What the stearopten of Boracic Acid is the advertisers do not say. It is in- 
tended chiefly for external use, diluted, I part to 1-4 of water ; but may be used inter- 
nally in doses of _ 5f j— ij. 

Listerine, — is a proprietary preparation, advertised to be "the essential antiseptic 
constituent of Thyme, Eucalyptus, Baptisia, Gaultheria, and Mentha Arvensis, in com- 
bination. Each fluid-drachm also contains two grains of refined and purified Benzo- 
boracic Acid," — whatever the latter may be. It is chiefly intended for external use, but 
may be given internally, in doses of 3 j three or more times a day (as indicated), either 
full strength, or diluted with water, or in combination with other drugs. 

Physiological Action and Therapeutics. 
Boric Acid is an efficient antiseptic, disinfectant and deodorant, arrest- 
ing fermentation and putrefaction, and very destructive to all low organ- 
isms. A solution of 1 in 133 arrests the activity of bacteria. It is feebly 
acid and but slightly irritant, and is used in the form of a dusting powder 
as a surgical dressing for its antiseptic and unirritating qualities. Its 
lotion and ointment have been successfully employed in ulcers, eczema, 



72 ACIDUM CARBOLICUM. 

burns and scalds, pruritus ani, fetid perspiration, wounds, tinea tonsurans, 
and tinea circinata. 

Sodium Borate is a powerful antiseptic and disinfectant, as it also de- 
stroys low vegetable organisms. It removes the epidermis when locally 
applied, has power to increase uterine contraction, and aids the solution 
of Benzoic and Boric Acids. It is employed as a wash to remove the 
epidermis from the skin, and as a sedative lotion in acne, freckles, chlo- 
asma, leucorrhcea, aphthae, etc., also to allay itching in urticaria, psoriasis, 
impetigo, and in pruritus pudendi, scroti et ani. It has been used inter- 
nally in amenorrhcea, dysmenorrhcea, puerperal fever, and puerperal 
convulsions, for its supposed specific action on the uterus ; and has been 
found beneficial in epilepsy, though far inferior to potassium bromide in 
efficacy and far more dangerous in toxic effects. It is apparently of 
most service in cases where the bromides fail and in those in which the 
epilepsy is associated with gross organic disease. 

When administered in large doses Borax produces certain toxic symp- 
toms to which the term Borism is applied. These include intestinal dis- 
turbance, nausea, vomiting and anorexia, also dryness of the skin, with 
redness and even inflammation of the mucous membranes. There is 
great general weakness, the hair is dry and falls out, and there is an erup- 
tion on the skin, which may assume the forms of seborrhceic eczema, 
reddish patches which desquamate like psoriasis, or papules attended 
with much itching. In severe cases albumen may appear in the urine, 
and oedema of the face and extremities may occur, so that whenever this 
drug is given in full doses a careful watch should be kept upon the state 
of the urine (Fere). 

Boro-glyceride in aqueous solution (I to 40), or as the official Glycerite, is also a 
powerful antiseptic, and is used as a lotion in purulent ophthalmia and in the treatment 
of wounds, also as a local application to diphtheritic membranes. It is an efficient pre- 
servative of milk and food against putrefactive changes, and is entirely harmless. 

An elegant cosmetic cream may be made by dissolving Boric Acid in Glycerin, and 
then incorporating it with White Wax and Almond Oil. 



ACIDUM CARBOLICUM, Carbolic Acid, Phenol {Phenic 
Acid, Phenyl Alcohol), C 6 H 5 OH, — occurs in Castoreum, in the urine of 
man and of herbivorous animals, and in the products of the dry distillation 
of various organic substances, such as resin, bones, wood and coal. It 
is obtained by the fractional distillation of coal-tar, and subsequently 
purified ; occurring in colorless, interlaced, needle-shaped crystals, of 
characteristic, aromatic odor, deliquescent on exposure to damp air, and 
acquiring a reddish tint with age and light. When copiously diluted 
with water it has a sweetish taste, and a slightly burning after-taste. It 
is soluble in about 15 of water, very soluble in alcohol, ether, chloroform, 
benzol, glycerin, oils and carbon disulphide ; almost insoluble in benzin. 



ACIDUM CARBOLICUM. 73 

Is melted by gentle heating, and liquefied by the addition of about 8 per 
cent, of water. Dose, gr. J^— ij, well diluted. 

Acidum Carbolicum Crudum, Crude Carbolic Acid, — is obtained 
as above stated, but by a lower degree of heat ; and contains various 
other constituents of coal-tar besides Phenol, chiefly Cresol (Cresylic 
Acid) and Xylic Acid, in varying proportions. Is used as a disinfectant. 

Peculiarities about Carbolic Acid are that the addition of about 8 per cent, of water 
liquefies it, while a further addition of water produces a turbid mixture, until about 15 
parts of water to I of the acid is reached, when a stable and clear solution is formed. 
One volume of the liquefied acid, containing 8 per cent, of water, forms with one volume 
of Glycerin a clear mixture, which is not rendered turbid by the addition of 3 volumes 
of water (absence of Creosote and Creosol). 

Hitherto described as neutral to litmus paper, it is now officially given a faintly acid 
reaction. Its claims to be considered an acid are, however, very feeble, as, though it com- 
bines with salifiable bases, it is incapable of neutralizing the alkalies, and its combinations 
are decomposed by the feeblest acids (carbonic, etc.), sometimes, it is asserted, even by 
water. Chemically, it is considered to be the Hydroxyl (HO) derivative of Benzene 
(C 6 H B ), which would ally it to the alcohols ; but as it does not yield the same products 
on oxidation (yielding finally oxalic instead of acetic acid), it is taken as the type of a class 
called phenols, which are simple HO derivatives of the aromatic hydrocarbons. [For the 
chemical theory of the Benzene derivatives see the sub-title SUBSTITUTES FOR Quinine, 
under the title Cinchona.] 

Carbolic acid is converted by concentrated sulphuric acid into Sulpho-carbolic Acid, 
C 6 H 5 HSO + ; by nitric acid into several substitution-products, the most important of which 
is Picric Acid. The reddish tint which it acquires with age and light, does not impair 
its pro erties ; but is unaccounted for satisfactorily, though supposed to be due to the 
presence of Aurin and Rosolic Acid, impurities which form a red compound by the ab- 
sorption of C0 2 and oxygen. 

Carbolic Acid coagulates albumen and collodion, Creosote does not. 

Official Preparations. 

Unguentum Acidi Carbolici, Ointment of Carbolic Acid, — strength 5 per cent. 
Carbolic Acid 5, Unguentum 95. For external use. 

Glyceritum Acidi Carbolici, Glycerite of Carbolic Acid, — has of Carbolic Acid I, in 
Glycerin 4. Dose, rr\v-x in water. Should be diluted with an equal quantity of water 
for external use. 

Sodii Sulpho-carbolas, Sodium Snlpho-carbolate, NaS0 3 C 6 H 4 (OH) -f-2H 2 0, — is pre- 
pared by dissolving Carbolic Acid in an equal part of strong Sulphuric Acid, thus form- 
ing sulpho-carbolic acid, which is neutralized with barium carbonate, and then treated 
with water and sodium carbonate, forming a solution of Sodium Sulpho-carbolate, which 
is evaporated to crystallization. It occurs in transparent, rhombic prisms, soluble in 5 of 
water, less freely in alcohol and in glycerin. Dose, gr. x-xxx. 

Sulpho-carbolates of Ammonium, Magnesium, Potassium and Sodium crystallize in 
tufts of acicular crystals, more or less white ; Sulpho-carbolate of Copper, in transparent, 
light blue, interlacing prisms; of Iron, in small brown, micaceous crystals ; of Zinc, in 
transparent, rectangular, colorless plates. That of Sodium is the only one official. 

Unofficial Preparations. 

Aqua Acidi Carbolici, Carbolic Acid Water, — has of the Glycerite 3 x to Aquae 
Oj. Dose gj-iv. 

Carbolic Acid Solutions, — for antiseptic surgery, are : — 

5 per cent, in Water, as a spray or wash. Is decidedly irritant. 
2.y z per cent, in Water, for sponges, hands, or as a lotion. 
5 per cent, or less in Olive Oil, as a special dressing. 
Carbolic Acid Gauze, is Gauze medicated with Carbolic Acid I, Resin 5, Paraffin 7, 
and is used as a surgical dressing. 



74 ACIDUM CARBOLICUM. 

Carbolic Acid Plaster,— an unofficial plaster composed of Carbolic Acid 25, Shellac 
75, coated with Gutta-percha dissolved in Carbon Disulphide. 

Phenol Sodique, — is composed of Carbolic Acid, gr. 188, Caustic Soda, gr. 31, 
Distilled Water, 3 iv. 

Phenol-camphor, — has of Carbolic Acid and Camphor, equal parts. A colorless, 
refractive liquid ; soluble in alcohol, ether, chloroform and oils ; insoluble in water or 
glycerin. Used as a local anaesthetic, chiefly for toothache. In the proportion of Carbolic 
Acid I, Camphor 3, an application to false membrane in diphtheria, and as subcutaneous 
and intrapulmonary injections in phthisis. 

Phenol Iodatum, Iodized Phenol, — a mixture of Iodine and crystallized Carbolic 
Acid. (See under Iodum.) 

Pheno-resorcin, — is a mixture of Carbolic Acid 67 with Resorcin 33 and Water 10, 
forming a liquid which mixes readily with water. It is supposed to combine the virtues 
of both its ingredients. 

Phenosalyl, — is a clear, syrupy liquid, consisting of a mixture of Carbolic, Salicylic 
and Benzoic Acids, melted together and dissolved in Lactic Acid. It is very soluble in 
water, has a pleasant and non-persistent odor, and is used in a I per cent, solution as an 
antiseptic application. 

Aseptol, — is the trade name of a S3- 3 P er cent, solution of Sozolic or Ortho-phenol- 
sulphojiic Acid, which is formed when Carbolic Acid is dissolved in concentrated Sul- 
phuric Acid. Aseptol occurs as a syrupy liquid which crystallizes in small deliquescent 
needles, decomposes when distilled and is very soluble in water, also in alcohol and 
in glycerin. It has a faint odor of carbolic acid, and is asserted to be antiseptic but not 
poisonous nor irritant, and hence of especial value in abdominal and ophthalmological 
surgery. In spite of these allegations it is probably toxic, and at any rate has been shown, 
by a careful series of comparative experiments, to have not more than one-third the anti- 
septic power of carbolic acid. It has been recommended for internal use as a substitute for 
Salicylic Acid, on account of its greater solubility. It has been employed in concentrated 
solution for the treatment of pharyngitis and diphtheritic laryngitis. Externally it is used 
so diluted as to contain from 3 to 10 per cent, of the active principle. 

Aseptolin, — is a solution containing about 23^" per cent, of absolute Carbolic Acid 
and 0.02 per cent, of a new pilocarpine salt named Pilocarpine-phenyl-liydroxide. It is 
intended for hypodermic use only, in one daily dose of Tr^l-ccl for adults, injected into 
the abdominal parieties or into the muscles of the back. 

Allied Products and Derivatives. 

Creosotum, Creosote, — is a similar product, obtained from wood-tar. It consists of 
a mixture of phenols, chiefly Guaiacol (C 7 H 8 2 ), and Creasol (C 8 H ]0 O 2 ) ; and by the 
action of nitric acid is converted into oxalic acid principally, while Carbolic Acid is con- 
verted into picric acid by that reagent. Creosote does not coagulate albumen or collodion, 
Carbolic Acid does. Creosote is described under its own title. 

Resorcinum, Resorcin, C 6 H 6 2 , — is also a phenol, obtained from certain resins by 
the action of fusing alkalies, and is described under its own title. 

Creolin (Unofficial), — was the first form in which the cresols were presented in a 
liquid condition for use in medicine. It is a coal-tar product, occurring as a dark-brown, 
alkaline, semi-fluid substance, of the consistence of honey. It forms a white cloud when 
added to water, with which, however, it is miscible, as an emulsion, up to about 10 or 12 
per cent, strength. The Solutions in general use vary from y z to 2 per cent. ; the Oint- 
ments to 5 per cent., and Creolin Gauze is prepared of 10 per cent, strength of the drug. 
Dose, Tr^iij-v, in capsules. 

Lysol (Unofficial), — one of the latest disinfectants and antiseptics, is a saponified 
product of coal-tar, chiefly composed of the cresols ; and occurs as a clear, brown, oily 
liquid, mixible readily with water, and forming clear solutions with glycerin, alcohol, 
chloroform and various other fluids. It is employed as a local application only, gener- 
ally in a I per cent, solution. 

Trikresol (Unofficial), — is a mixture of the three isomeric cresols, respectively named 
the ortho-, meta- and para-methyl phenols, and also contains the hydroxyl group, which 
seems to be a characteristic constituent of antiseptics and germicides. It occurs as a 
white liquid, of creosote-like odor, sp. gr. 1,042 to 1,049, and is soluble in water to the 



ACIDUM CARBOLICUM. 75 

extent of 2.55 per cent. Its solutions are clear and do not impart any sensation of numb- 
ness to the fingers. It is a powerful germicide in solutions of I per cent, strength, which 
are said to be as efficient as a 5 per cent, solution of carbolic acid. Trikresol Water 
(1 part to 1000) is used as a menstruum for the ordinary collyria employed in ophthal- 
mological practice. 

Saprol, Disinfection Oil (Unofficial), — is a dark brown, oily mixture, highly inflam- 
mable, and composed of the crude cresols in a great excess of the liquid hydrocarbons 
obtained from the refining of petroleum. It floats on water and yet gives up its soluble 
constituents as disinfectants to the offending fluid, leaving the remainder as an oily film on 
the surface to hinder the escape of disagreeable odors, and the spread of infecting spores. 
It is a cheap disinfectant, and can be employed on a large scale in barracks, prisons, 
schools, etc., if no light or fire is brought into proximity with it. Sewage treated with it 
still retains its value as a manure ; and so small a quantity as one per cent, of it will effect- 
ually sterilize urine and fecal matter impregnated with micro-organisms like the bacilli of 
cholera and typhoid fever (Laser). 

Solutol and Solveol (Unofficial), — are disinfectants of the same class as the preced- 
ing, both being soluble forms of the insoluble Cresol (Cresylic Acid). Solutol is an alka- 
line solution of Sodium Cresylate in an excess of Cresol, and is not suited for surgical 
use, by reason of its caustic alkalinity ; but is of marked utility in the preservation of the 
cadaver, and for general and copious use in disinfecting water-closets, sinks, infected 
bed-clothing, sputa and deleterious discharges of all kinds. 

Solveol differs from Solutol in containing Sodium Cresotate instead of sodium cresylate, 
is devoid of the causticity so characteristic of the latter substance, and is also free from 
the greasiness of Creolin and Lysol. It is a dark-colored, nearly odorless liquid, of 
neutral reaction, soluble in water in all proportions. It is especially applicable to surgical 
uses, a y^ per cent, solution being employed for dressings, being more active (it is claimed ) 
antiseptically, than a 2 per cent, solution of carbolic acid. 

Physiological Action. 

Carbolic Acid is a powerful antizymotic and antiseptic, a good disin- 
fectant, somewhat antipyretic, also a local anaesthetic, and a depressant 
of the cardiac, respiratory, cerebral and spinal functions. It is destructive 
to all low forms of life, rapidly destroying all organized ferments, both 
animal and vegetable. On unorganized ferments (enzymes), such as 
pepsin and ptyalin, it does not act so readily, but in large doses it like- 
wise destroys their activity ; and is an efficient parasiticide against certain 
vegetable parasites which infest the skin. The foregoing is true of the 
liquefied acid and its aqueous and glycerin solutions, but not of its solu- 
tions in oils, which have no antizymotic properties. 

Applied to the skin in weak or moderately strong solutions, it produces 
local anaesthesia, with a sensation of numbness, which lasts for several 
hours. Applied in concentrated form, it is irritant and superficially 
escharotic, with burning pain of brief duration, and produces at the point 
of application a white spot, changing to red if the acid is soon removed. 
It does not vesicate, but if the application be prolonged, a white eschar or 
slough results, from the coagulation of the albumen of the tissue, and this 
is bordered by a red zone of inflammation. 

Taken internally, the concentrated acid has the same effect on the 
mucous membranes as on the skin, producing white, superficial eschars, 
after burning pain of short duration, in the mouth, gullet and stomach. 
To the latter viscus it is a powerful irritant, and causes a violent gastritis. 



j6 ACIDUM CARBOLICUM. 

In medicinal doses, when acted upon by the gastric secretions, it is con- 
verted into a sulpho-carbolate, and is so diluted by the contents of the 
stomach that it loses its antizymotic power, and hence is of no value 
as an internal antiseptic remedy. In the blood it probably circulates as 
an alkaline carbolate, in medicinal doses having no effect upon the circu- 
lation or respiration. Its antipyretic power is incapable of being utilized, 
requiring a dosage which would be dangerous. 

A toxic dose paralyzes the vaso-motor centre in the medulla before 
markedly affecting the heart. The blood-pressure and body-temperature 
fall ; the respiration, at first accelerated by stimulation of the vagi, is 
quickly depressed and ultimately paralyzed ; cardiac inhibition is stimu- 
lated, the heart being first slowed and then depressed. The anterior 
cornua of the spinal cord are first stimulated, producing convulsions; and 
subsequently depressed, causing suspension of reflexes, impaired motility 
and sensibility, and finally paralysis of both motion and sensation. The 
cerebrum is profoundly depressed, producing stupor deepening into coma, 
with minutely contracted pupils. Death occurs, in most cases, by par- 
alysis of respiration ; in a few, by paralysis of the heart. 

Carbolic Acid is readily absorbed, and rapidly diffused ; many fatal 
cases having resulted from its external use in undiluted form. A single 
vaginal injection of a moderately weak solution has produced very severe 
constitutional results. It is partly oxidized in the blood, and partly 
eliminated by the lungs and kidneys. It imparts to the urine a peculiar 
smoky or olive-green color, which is not due to blood, and may be seen 
after moderate doses, or even as a result of its absorption from dressings. 
When ingested in a large dose, the acid itself may appear in the urine ; 
but the smoky color is due to the presence of its intermediate oxidation 
products, viz., pyrocatechin (only in alkaline urine), and hydrochinon, 
also salts of sulpho-carbolic acid and glycuronic acid. In poisoning 
thereby the sulphates are absent from the urine. 

A case of poisoning by Carbolic Acid shows white, corrugated eschars in 
the mouth and fauces, if the drug has been swallowed in concentrated 
form. These eschars are also found on the mucous lining of the oesopha- 
gus and stomach, at the autopsy. The patient has complained of an 
intense, burning sensation along the same tract, immediately after the 
ingestion of the poison, and soon passes into a state of collapse ; the 
skin being cold and clammy, the pupils contracted, respiration becomes 
more and more feeble and shallow; the urine, if not entirely suppressed, 
is of a dark-green color; reflexes are then abolished, stupor and coma 
supervene, and finally the breathing ceases. The blood, after death, is 
dark in color, and coagulates imperfectly; and fatty degeneration of the 
liver and kidneys may be found. When poisoning occurs by absorption, 
an early symptom is the peculiar, smoky color of the urine. There may 



ACIDUM CARBOLICUM. JJ 

be pain in the lumbar region, indicating renal irritation, and slight rest- 
lessness or cerebral disturbance ; after which come the impairment of 
respiration and stupor. 

A toxic dose of Carbolic Acid, taken internally, is one of the most 
rapidly acting poisons known, sometimes equalling Prussic Acid in this 
respect. The symptoms develop almost immediately, and death may 
occur in a very few minutes ; but usually the patient lives from one to ten 
hours; rarely over two days. In some cases, a great amendment has 
occurred, with restoration of consciousness, but after some hours sudden 
and fatal collapse has supervened. The minimum fatal dose is not deter- 
mined, but ^ss has frequently caused death ; and doses as small as n^vj 
have given rise to dangerous symptoms. Cases of suicidal and accidental 
poisoning by this drug are very frequent, by reason of the facility with 
which it may be obtained for use as a disinfectant. 

Treatment of Poisoning by Carbolic Acid. 
If the case is seen shortly after ingestion, Apomorphine may be administered hypoder- 
mically, as a rapidly acting emetic; but, in any case, the stomach should be washed out 
freely. The chemical antidote is any soluble sulphate to form the harmless sulpho-car- 
bolates ; as Magnesium Sulphate i|j, or Sodium Sulphate j|ss, dissolved in y 2 pint of 
water. Even if several hours have elapsed since the ingestion of the poison, the sulphates 
should be used, as their antidotal action proceeds in the blood current. In one case 
where % ss of the 95 per cent, acid had been taken, nearly ^ iij of Magnesium Sulphate 
(Epsom salts) were used, resulting in complete recovery from an apparently hopeless con- 
dition. Stimulants, as ether or brandy hypodermically, should also be used freely; also 
hot water bottles and hot blankets if signs of collapse appear. Vegetable demulcents 
may be given (but no oils or glycerin), to protect the mucous surfaces. Liquor Calcis 
Saccharatus, or Syrupus Calcis, is also antidotal to the poison in the stomach, but is much 
less efficient than the sulphates. Atropine, hypodermically, is a very complete physio- 
logical antagonist to the systemic symptoms, maintaining the heart and respiration until 
elimination occurs (Post). Cider Vinegar may prove antidotal, as it removes the effects 
of the local application of the strong acid. Soap, in strong, watery mixture (suds), is 
said to have acted as a perfect antidote ; but its action would be confined to the poison in 
the stomach. Oils should not be used, as they increase the absorption of the poison. 

Therapeutics. 

Carbolic Acid owes its prominence to its having been the principal 
agent used in the antiseptic method of treating wounds ; but its employ- 
ment in that connection has become much restricted, and many of the 
most prominent surgeons have abandoned it altogether in favor of other 
germicides. In the estimation of many, however, it still retains high 
favor as a surgical antiseptic lotion ; and it is in general use as a disin- 
fectant for surgical instruments, hospital apparatus, soiled linen, etc. 
The carbolic spray, formerly so commonly used during operations, has 
been entirely discarded. For disinfectant purposes about drains, privies, 
on floors, walls, etc., the crude acid is to be preferred, not only on account 
of its less cost, but also for the reason that its principal impurity, Cresol 
(Cresylic Acid), has very high power as a disinfectant. 

As a local application, Carbolic Acid has extensive and varied uses. 



70 ACIDUM CARBOLICUM. 

Unna calls it the opium of the skin, as it relieves pruritus of almost any 
form, if applied in 5 per cent, aqueous solution over the itching surface ; 
and a lotion, composed of gr. xx to gss each of water and glycerin, 
makes a very efficient application for the itching of jaundice. The gly- 
cerite, diluted, effectively destroys the fungus of tinea tonsurans or tinea 
versicolor, and may be applied as a stimulant to indolent ulcers, or to the 
patches of aphthous stomatitis. A one per cent, solution in water and gly- 
cerin (rr^v to ^j) makes an excellent anaesthetic and cleansing gargle for the 
painful sore throat of diphtheria, tonsillitis, etc. Cotton soaked in the 
strong acid will stop the pain of a decayed tooth, but care must be taken, 
by covering it with dry cotton, to prevent its access to the gums, or slough- 
ing thereof may result. For burns, one of the best dressings is carbolized 
sweet oil (gj to gvj) to relieve the pain. For local anaesthesia in minor 
surgical operations, such as that for ingrowing toe-nail or opening a felon, 
the part may be soaked for ten minutes in a 30 per cent, solution, or the 
pure acid may be brushed over the line of incision. 

As a parenchymatous injection, which should be not over gss of a 2 
per cent, solution, Carbolic Acid has been employed with much success 
in combating deep-seated inflammations. The skin being first anaesthet- 
ized by the local application of the acid, a hypodermic needle is intro- 
duced obliquely, to the centre of the inflamed tissue, and should not be 
connected with the syringe if any blood escapes through it, lest the in- 
jection be introduced into a vein. This method has been successfully 
used in glandular swellings, 5 to 10 minims of the solution for each gland 
being sufficient in phlegmons of every grade and character, erysipelas, 
poisoned wounds, inflamed bursas, hydrocele, acute and subacute rheu- 
matism, chronic synovitis, buboes, and in some severe cases of tetanus. 
Under the trade-name Aseptolin (see ante, page 74) Dr. Edson has re- 
cently put forth a solution, containing 2^ per cent, of carbolic acid and 
a minute quantity of a pilocarpine salt, for hypodermic use in curable 
cases of tuberculosis, malaria, and other diseases due to germ infection. 
There is nothing original in this treatment, it being a repetition of the 
phenic acid injection of Declat combined with the pilocarpine treatment 
of phthisis announced about two years ago as the " discovery " of Dr. 
Waldstein. It is now going through the usual puffing methods of trade 
promotion, and the few independent reports upon its use show no evi- 
dence of any special merit for it in these diseases. 

Internally, Carbolic Acid is not much employed. It has been given to 
relieve flatulence and dyspepsia, and is often an efficient remedy against 
vomiting. It has proven of considerable temporary benefit in diabetes of 
hepatic origin ; and has been used against intermittents, typhoid fever, 
and various zymotic diseases ; but is probably of no efficacy in constitu- 
tional affections. A mixture, containing carbolic acid and spirit of chloro- 



ACIDUM CARBOLICUM. 79 

form has been lately used as an internal remedy for typhoid fever by Dr. 
Quill, of the Indian army, without the loss of a single case, and in a 
country where enteric fever has a very high rate of mortality. 

In phthisis and other chronic pulmonary diseases, it has been much 
employed as a spray by inhalation, and certainly does do good therein by 
relieving cough and irritation of the throat. In these affections, Creosote 
is preferred to it for both internal and local use. An acute conjunctivitis 
is greatly relieved by holding the open eye in the spray of a steam atom- 
izer, the cup of which contains a 5 per cent, solution of carbolic acid. 
This measure maybe also used for acute coryza with beneficial results; or 
a mixture of Carbolic Acid and Tincture of Iodine may be dropped on to 
a sponge in a wide-mouthed bottle and volatilized for inhalation by being 
wrapped in a cloth wrung out of hot water, or even by being held in the 
hand. 

The Sulpho-carbolates of Sodium, Potassium, etc., have been em- 
ployed internally with advantage in the septic diseases, as the exanthe- 
mata, diphtheria, puerperal fever, etc., with the object of obtaining the 
antiseptic action of carbolic acid without the dangers attending its use in 
efficient doses. They may be used locally with good results in aphthae, 
tonsillitis, otorrhcea, gonorrhoea, and for inflamed mucous membranes 
generally. 

Creolin was highly vaunted, by Professor von Esmarch and other authorities, as the 
ideal antiseptic for external use, being possessed of great germicidal power, and a most 
efficient deodorant and disinfectant, while its absorption caused no toxic results whatever. 
Experience has justified these claims in the main, but the drug has, however, given rise 
to serious symptoms, when used to excess. As a vaginal wash, in puerperal cases, the 2 
per cent, solution is reported as fully equal to sublimate solutions, while better as a de- 
odorant, and free from danger by absorption. The weaker solutions have given satisfac- 
tion as local applications in the treatment of otorrhcea, nasal ulcers, rhinitis (i to ioooi, 
blepharitis, keratitis, etc. ; and in female cystitis a I per cent, solution as a vesical wash, 
gradually increased to 2 per cent., is highly praised by Parvin. The Ointments and 
Gauze are used for wounds and other solutions of continuity, in the same manner as car- 
bolized preparations, and with better satisfaction, Creolin being less volatile than Carbolic 
Acid, and of a more agreeable, though powerful, odor. Internally it has been employed 
in gastric fermentation, dysentery, and typhoid fever. 

Lysol is said to be superior to carbolic acid, creolin and the other analogous coal-tar 
products as a germicide, but it has no advantage over the antiseptics of established repu- 
tation ; and is only really efficient in solutions of such strength as to be irritating or 
caustic. Although not destined to play any great part in surgery, it may be useful in the 
prophylaxis and arrest of epidemics ; and is likely to be particularly serviceable in the 
disinfection of premises, privies, ships and stables, being readily soluble, reasonably active, 
and very cheap (Squibb). Dr. Pee, who has had very favorable results from Lysol, 
recommends a one per cent, solution in obstetrics and gynecology, and says that a solu- 
tion of one part in 200 destroys streptococci in fifteen minutes. 

Trikresol possesses very high germicidal power, and is said to be practically non-toxic 
and less irritating to wounds than either carbolic or sublimate solutions. A I in 1000 
solution dropped into the eye produced not the slightest irritation, and the I to 500 
solution dropped into my own eyes produced no burning sensation whatever (De 
Schweinitz). These solutions may therefore be advantageously employed as menstrua for 
the stock collyria, especially for those of cocaine, physostigmine and atropine, which arc 
most liable to contamination. Trikresol is particularly fatal to pyogenic cocci, a I per 
cent, solution invariably killing them in half a minute in watery solutions, and in a minute 
and a half in rich albuminous fluids (Grtiber). 



80 ACIDUM CARBONICUM. 

Phenosalyl possesses an antiseptic power which is considerably superior to that of 
carbolic acid, a I per cent, solution immediately killing the staphylococcus pyogenes aureus, 
which is the most resistant microbe known. In order to attain the same result with car- 
bolic acid it is necessary to expose the staphylococcus to the action of a 2^ per cent, 
solution for at least one minute. Phenosalyl does not irritate the skin, has no corrosive 
action on instruments, is very soluble in water, is non-toxic, and leaves a pleasant and 
non-persistent odor which does not cling about the hands or the clothes. Its solutions 
have no corrosive action on the skin, and the mucous surfaces treated with it remain 
smooth and slippery and do not become dried up, as is the case after washing with car- 
bolic acid or corrosive sublimate solutions (Frankel). 



ACIDUM CARBONICUM, Carbonic Acid, C0 2 (Unofficial), 
— is a colorless and odorless gas, of sp. gr. 1.526, slightly sharp taste, solu- 
ble in its own volume of pure water at the ordinary temperature and pres- 
sure, much more soluble under increased pressure and lowered temperature 
of the water, also more soluble in water containing phosphates. In water 
it promotes the solution of phosphates and carbonates. Its aqueous solu- 
tion gives an acid reaction, and is " sparkling" from rapid escape of the 
gas, especially when agitated. It is prepared by treating any carbonate 
(usually calcium carbonate in the form of marble-dust) with dilute Hy- 
drochloric Acid ; the resulting gas is passed into water under pressure, 
and the solution is thus obtained. 

Carbonic Acid gas occurs in the atmosphere in the proportion of 2 to 6 parts in 10,000, 
also in all water in varying quantity. Certain sparkling waters contain it in the propor- 
tion of more than one-half their volume, Johannis having more than 90 per cent. It 
occurs also in all the liquids of the body, especially in the blood, originating in the oxida- 
tion processes which are constantly taking place in the tissues, and readily passing by 
osmosis through animal membranes. It is continuously produced by the action of the 
yeast-plant, and by all other fermentation processes, and accumulates in brewer's vats, 
old wells, some caves, grottoes and deep valleys, also in mines, forming the well-known 
" choke-damp" of miners. It is constantly evolved during respiration and in the burning 
of gas, fires, etc. When the air of a room contains o. I per cent, of this gas it is unfit for 
continued respiration. 

Preparation. 

Aqua Carbonata, Carbonated Water, Soda-water (Unofficial), — is water highly 
charged with carbonic acid gas, the excess of gas being dissolved in the water by 
pressure, and escaping in bubbles when the pressure is taken off. It was official in the 
U. S. P., 1870, under the title Aqua Acidi Carbonici, the formula requiring that the water 
be charged with five times its volume of gas, for which a pressure of five atmospheres is 
required. 

Carbonated Mineral Waters. 

Selters, Nassau, Germany, 30 cubic inches "] 

Apollinaris, Nuenahr, Prussia, 47 " [ of C0 2 

Old Sweet Spring, West Virginia, 1 1 " f to the pint. 

Sweet Chalybeate Spring, Virginia, 13 " J 

There are 10 official Carbonates and 2 official Bicarbonates, which are severally de- 
scribed under their basylous titles. 

Physiological Action. 
Carbonic Acid gas is highly antiseptic and preservative. D'Arsonval 
employs it, under 30 atmospheres' pressure, for the sterilizing of orchitic 
extract. Beef will remain perfectly fresh and its taste unchanged for 



ACIDUM CARBONICUM. 8 1 

eight days if hung in a chamber filled with the gas. Externally, applied 
to the skin, mucous membranes or wounded tissues, the undiluted gas pro- 
duces slight hypersemia, with prickling and a sense of heat, followed by 
a certain degree of local anaesthesia. Internally, given by the stomach in 
aqueous solution, it is refreshing and quenches thirst, slightly stimulates 
the heart's action, quickens respiration and causes a brief sense of exhila- 
ration. It increases somewhat the gastro-intestinal secretions and excites 
peristalsis, but diminishes the sensibility of the mucous lining of the ali- 
mentary canal. Inspired, the gas is highly toxic, a proportion of 10 per 
cent, thereof in the air being irrespirable and fatal. Even o. i per cent, 
produces unpleasant symptoms, as headache, sleeplessness and depression; 
0.3 per cent, causes a throbbing headache, fulness and tightness across 
the temples and giddiness ; and a large quantity profoundly affects the 
nervous system, inducing fainting, muscular weakness, somnolence or in- 
sensibility, and coma or convulsions. The inhalation of the undiluted 
gas at first excites irritation and sometimes spasmodic closure of the glottis 
with consequent asphyxia, but in any case it soon arrests the respiration. 
It hinders the exhalation of the carbonic acid normally existing in the 
blood, and is itself absorbed in small quantity, inducing dyspnoea, cyano- 
sis, slow and labored pulse, and ultimately arrest of the heart's action. 
In toxic quantity it abolishes at once the functions of nerve and muscle 
by stopping the process of oxidation in the tissues. 

The symptoms of Carbonic Acid poisoning may be divided into three 
stages, which are the stages of Asphyxia. They are : (1) that of dyspnoea, 
in which the blood pressure rises from excitation of the centres in the 
medulla by the venous blood, the vessels of the surface become dilated, 
and insensibility comes on ; (2) that of convulsions, in which the respira- 
tory movements become more violent and spread to all the muscles of the 
body ; (3) that of paralysis, in which the convulsions cease, the blood 
pressure falls, the respiration gradually fails, and finally the heart stops. 
The autopsy shows great venous congestion everywhere, the right side of 
the heart distended with blood, the brain much congested, with exudation 
and even extravasation therein, and the blood exceedingly dark in color. 

Treatment of Carbonic Acid Poisoning. 
The antagonists are Oxygen and stimulants of the peripheral circulation. The prime 
object of treatment is to get the blood oxygenated as quickly as possible. The patient 
should be brought at once into the open air, and if the respiratory movements have 
ceased, cold water should be dashed on the face and chest, in order to awaken them by 
reflex action. If no effect is thereby produced, recourse must be had to ai-tifuial respir- 
ation, which should be maintained for at least an hour. [Compare the article entitled 
Asphyxia and Apncea in Part III.] If the heart does not begin to beat shortly after 
artificial respiration has been begun, the jugular vein should be opened, with care to 
prevent the entrance of air, in order to relieve the distention of the right ventricle and 
prevent the consequent paralysis of the heart. This vein is selected because there are 
no valves of any importance between it and the heart. A series of sharp, quick blows 
upon the chest in the cardiac region will sometimes start the heart into action after it 
has stopped. 
6 



82 ACIDUM CHROMICUM. 

Therapeutics. 

Carbonic Acid has been locally employed as a local stimulant in ulcers 
and as an anaesthetic in cancers, either by directing a stream of the gas 
upon the part or by the application of a yeast poultice. The gas has 
been applied in streams to the eyes, ears, nose, vagina and rectum, in 
catarrhal inflammation of these parts, also to the bladder, for irritability of 
that viscus, and its application is beneficial when there is no acute inflam- 
mation present. It is injected into the vagina with good results in 
dysmenorrhcea and in many other painful affections of the pelvic viscera, 
whether neuralgic in character or arising from organic disease. Diluted 
with 90 to 95 per cent, of air, its inhalation is serviceable in chronic 
laryngitis and pharyngitis, also in asthma, chronic bronchitis and chronic 
cough. 

Carbonated water, or "soda-water" as it is popularly named, is a 
grateful beverage in warm weather, especially when flavored with certain 
syrups and fruit-juices. It is a useful drink in febrile affections, as it 
relieves thirst, allays nausea and gastric irritability, and is both diaphoretic 
and diuretic in slight degree. It is an efficient remedy for vomiting, 
and in the form of iced champagne is one of the numerous agents which 
have proven efficacious in the vomiting of pregnancy. It forms an 
excellent vehicle for the administration of saline cathartics, the vari- 
ous carbonates and piperazin. The free use of carbonated mineral 
waters is of service in gout, especially when they contain the salts of 
lithium in solution. At many European spas the course of treatment is 
largely based on the use of carbonic acid, administered in the forms of 
baths and inhalations as well as by the ingestion of the waters containing 
it. Bathing in the natural carbonated waters is sometimes beneficial in 
catarrh, gout, rheumatism, anaemic amenorrhcea and leucorrhoea, the gas 
acting as a gentle stimulant of the cutaneous circulation and promoting 
slight diaphoresis. [Compare the article entitled Aqua.] 



ACIDUM CHROMICUM, Chromic Acid {Chromic Trioxide, 
Chromic Anhydride), Cr0 3 , — is obtained by the action of Sulphuric Acid 
upon Potassium Bichromate, and occurs in small, crimson, needle-shaped 
crystals, which are deliquescent and very soluble in water. This sub- 
stance is not Chromic Acid, which does not occur in the free state, and 
the formula of which would be H 2 Cr0 4 . It should be known by one of 
its chemical synonyms mentioned above. It should be kept in glass- 
stoppered bottles, and great caution should be observed to avoid bringing 
it in contact with organic substances, such as cork, tannic acid, sugar, 
alcohol, glycerin, etc., as dangerous accidents are liable to result. It is 
not used internally. 



ACIDUM FLUORICUM. 83 

Potassii Bichromas, Potassium Bichromate, K 2 Cr 2 7 , — large, orange-red prisms of 
disagreeable, metallic taste and acid reaction, soluble in 10 of water at 59 F. , and in 1 J 2 
of boiling water, insoluble in alcohol. Used locally in aqueous solution (gr. v-£j to the 
^), and internally in doses of gr. jQ-gr. ij in trituration. 

Physiological Action and Therapeutics. 

Chromic Acid is a powerful escharotic, penetrating deeply, but slow 
of action and not very painful. It coagulates albumen and parts readily 
with its oxygen, oxidizing organic matter and decomposing ammonia and 
sulphuretted hydrogen \ and is therefore an energetic disinfectant and 
deodorizer. When used as a caustic it is mixed with sufficient water to 
make a paste, which may be employed for the destruction of warts, hem- 
orrhoids and other superficial growths ; the neighboring parts being pro- 
tected by cotton soaked in a strong alkaline solution. For syphilitic warts 
and condylomata, lupus, tinea tonsurans, etc., a solution of 100 grains to 
the % of distilled water is generally used. A solution of 1 in 40 is an 
excellent and inexpensive antiseptic lotion for putrid sores and wounds, 
syphilitic affections of the tongue, mouth and throat, ozaena, leucorrhcea, 
and gonorrhoea. In uterine catarrh and hemorrhages a solution of 120 
grains to the g has been injected into the uterine cavity with good results. 

Potassium Bichromate is a good antiseptic and an escharotic of milder 
action than the acid. In doses of gij-iv it has proved fatal to life in 
adults, with symptoms of gastro-enteritis, suppression of urine, and cardiac 
paralysis. It is chiefly employed as a local application in saturated solu- 
tion to warts and venereal condylomata ; and in dilute solution (gr. j-x 
to the 3) for catarrhal conditions of the nasal, buccal or vaginal mucous 
membrane. Internally it has been employed with benefit in locomotor 
ataxia and in dyspepsia simulating gastric cancer; also in chronic gastric 
catarrh, the tongue having a thick yellow coat, in chronic diarrhoea from 
intestinal ulceration, and in chronic ulcers of the pharynx and mouth. It 
is a good remedy in syphilitic sore throat, local rheumatism of the fibrous 
tissues, periosteal and syphilitic rheumatism, and acute catarrh and influ- 
enza, chronic nasal catarrh, chronic laryngitis, and chronic catarrhal 
affections of the bronchial mucous membrane, especially when the expecto- 
ration is tough and stringy. It has also been used with some success in 
membranous croup and diphtheria. In pharmacy it is employed in the 
preparation of Chromic Acid and Valerianic Acid, and as a test solution. 
Most of the medical galvanic and faradic batteries are run by a mixture 
of this salt with Sulphuric Acid. Poisoning by it should be treated as 
directed for mineral acids. 

ACIDUM FLUORICUM, Fluoric Acid, HF (Unofficial),— is a strong escharotic, 
acting deeply and leaving a dry and painful slough. The dilute acid (1 in 200) is pre- 
pared by acting on fiuor spar by Sulphuric Acid, the resulting gas being dissolved in 
water. Its dose is TT\xx-xxx, well diluted. 

Dilute Fluoric Acid has been successfully used as an internal remedy in goitre, and the 
gas has been inhaled with benefit in diphtheria and membranous croup. 



84 ACIDUM GALLICUM. 

ACIDUM GALLICUM, Gallic Acid, HC 7 H 5 5 .H 2 — is a 

nearly colorless solid in long needles and triclinic prisms, having a slightly 
acid and astringent taste, soluble in 100 of water and in 5 of alcohol at 59 
F. , and in 3 of boiling water. It is prepared from a paste of powdered 
galls (see Galla), by fermenting for six weeks, boiling and reboiling in 
water, filtering and crystallizing. According to some authorities the 
Tannic Acid of the galls is split up into Gallic Acid and glucose by fer- 
mentation ; but according to others the glucose is an impurity and the 
Tannic Acid is simply converted into two parts of Gallic Acid, C u H 10 O 9 
-f- H 2 = (HC 7 H 5 5 ) 2 . Dose, gr. v-xv, in solution, pill or powder. 

Pyrogallol, Pyrogallic Acid, Tri-hydroxy-benzene, C 6 H 3 (OH) 3 , — is a 
triatomic phenol, obtained chiefly by the dry distillation of Gallic Acid. 
Light white, shining laminae, or fine needles, of bitter taste ; soluble in 
water, alcohol and ether. Dose, gr. j-ij. 

Vegetable Astringents depend for their medicinal value upon the Gallic and Tannic 
Acids contained in them. Such are — 

Alnus, Alder Bark. Heuchera, Alum Root. 

Castanea, Chestnut Leaves. Kino, Kino. 

Catechu, Catechu. Krameria, Rhatany. 

Diospyros, Persimmon. Myrica, Wax Myrtle. 

Galla, Nut Galls. Nymphaea, Pond Lily. 

Geranium, Cranesbill. Quercus Alba, Oak Bark. 

Granatum, Pomegranate. Rosa Gallica, Red Rose. 

Hamamelis, Witch Hazel. Rubus, Blackberry. 

Hsematoxylon, Logwood. Statice, Marsh Rosemary. 



Physiological Action. 

Gallic Acid, and its congener Tannic Acid, are astringents, the former 
being the more feeble of the two. They differ in that Tannic Acid coagu- 
lates albumen and gelatin, while Gallic does not. Tannic Acid is con- 
verted by the organism into Gallic and Pyrogallic Acids, in which forms 
it is absorbed and excreted. According to some authorities the difference 
between Gallic and Tannic Acids is one of oxidation, according toothers 
of hydration ; the latter assuming Tannic Acid to be simply Gallic Acid 
Anhydride. They constringe the muscular tissue in the walls of the 
minute vessels, thus checking secretion and hemorrhages and cutting 
short local inflammations. Except in enormous doses they are harmless. 
[Compare Acidum Tannicum.] 

Pyrogallol may act as an intense poison. It has been absorbed from 
the surface with fatal results, preceded by vomiting and diarrhoea, rigors 
and fever, black urine full of globulin, and disorganization of the blood- 
corpuscles. It has great affinity for oxygen and may be used as an anti- 
septic and disinfectant in 1 to 2^ per cent, solutions. 

Mineral Acids, Alkalies, per-salts of Iron, and salts of Antimony, Lead, and Silver 
are chemically incompatible with preparations containing Tannic or Gallic Acid. 



ACIDUM HYDROCHLORICUM. 85 

Therapeutics. 

Gallic Acid is preferred to Tannic Acid when an astringent action 
is desired upon remote parts, as the lungs, kidneys, etc., which can only 
be reached through the circulation. In hematuria, distant passive hem- 
orrhages, albuminuria, diabetes insipidus, bronchorrhcea, night-sweats, 
chronic diarrhoea, and chronic cystitis, it is a most useful remedy. 

Pyrogallol has been used internally in two-grain doses for internal 
hemorrhages. As an ointment (3J-^j) it ranks next to Chrysarobin as 
an efficient palliative in psoriasis, and has been used with good results in 
lupus and epithelioma, being supposed to attack the diseased nodules 
only, leaving the adjacent skin uninjured. 

ACIDUM HYDROBROMICUM DILUTUM, Diluted Hydrobromic Acid, 
— is composed of 10 per cent, of absolute Hydrobromic Acid (HBr), and 90 per cent, of 
water. It is a clear, colorless, and odorless liquid, of a pungent acid taste, produced by 
decomposing Potassium Bromide by Sulphuric Acid and distilling. Dose, TTVxx- 3 ij , 
every three hours. 

The action of Hydrobromic Acid on the nervous system and circulation is identical 
with that of the Bromides. Added to a mixture of Quinine and water (tt\,ij to each 
grain of Quinine) it will produce a clear solution. 

In hysteria, congestive headaches, neuralgia, and nervous exhaustion, Hydrobromic 
Acid has been found useful. Used as a solvent of Quinine it retards cinchonism, and 
prevents the headache resulting from the full action of Quinine and Iron. As a substi- 
tute for the Bromides of Sodium and Potassium it is highly recommended, being much 
less depressant. It has been especially recommended in tinnitus aurium. Fothergill 
uses it for coughs of reflex or spasmodic nature, also for simple continued fever where 
there is cerebral disturbance. 

ACIDUM HYDROCHLORICUM, Hydrochloric Acid 

(Muriatic Acid), — is a liquid composed of about 32 per cent, of absolute 
Hydrochloric Acid Gas, HC1, and 68 per cent, of water. It is colorless 
and fuming, of specific gravity 1.163, pungent odor, intensely acid reac- 
tion and taste, and is obtained by the action of Sulphuric Acid upon 
Sodium Chloride, the resulting gas being carried through water, which 
dissolves it. It is sometimes used as a caustic. Its union with basic sub- 
stances forms salts, called Hydrochlorates (Muriates), of which four are 
official, viz. — Apomorphine, Morphine, Pilocarpine, and Quinine Hydro- 
chlorates, described under the titles of their respective bases. 

Acidum Hydrochloricum Dilutum, Diluted Hydrochloric Acid, — is a 10 per cent, 
solution of the absolute acid in water. Dose, TTLiij-x. 

Acidum Nitro-hydrochloricum, Nitro-hydrochloric Acid, — is described under 

ACIDUM NlTRICUM. 

Physiological Action of the Mineral Acids. 

The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro-hydro- 
chloric, and Phosphoric) resemble each other in general action so closely 
that they may all be described in this place. 

The strong acids are escharotic, abstracting the water of the tissues, 
combining with the albumen and other bases, and destroying the proto- 



86 ACIDUM HYDROCHLORICUM. 

plasm. They are very diffusible, redissolving the albumen after precipi- 
tating it (except Nitric Acid). Sulphuric and Phosphoric have a strong 
affinity for water, completely decomposing tissues to which they are 
applied, and are therefore the most powerfully escharotic. Nitric Acid 
does not readily redissolve the albumen precipitated by it, which thus 
forms a barrier against the deep action of the acid. Sulphuric Acid 
chars or carbonizes the tissues black, while Nitric and Hydrochloric tan 
them yellow. 

The dilute acids produce a peculiar taste in the mouth and a sensation 
of roughness on the teeth. They stimulate the flow of saliva from the 
parotid and submaxillary glands, but have no action on the sympathetic 
saliva. They promote the alkaline intestinal secretions and excite the 
flow from glands having an alkaline secretion (bile, etc.), when applied to 
the mouths of their ducts, but check that from those whose secretion is 
acid (gastric, etc.). Secretion generally is promoted by Nitric Acid, 
and lessened by Sulphuric, Hydrochloric acting between the other two. 
Given before meals, in small doses, they relieve acidity of the stomach by 
checking the production of the acid gastric juice. At first they aid diges- 
tion, being synergistic to the action of pepsin, but if continued they im- 
pair digestion by lessening the production of the gastric juice. They check 
fermentation and constipate the bowels, except Nitric Acid, which relaxes 
them. They render the urine slightly more acid than its normal reaction, 
but do not acidify alkaline urine as the vegetable acids do. They are all 
astringent to the tissues, Hydrochloric being weakest and Sulphuric the 
strongest in this respect. 

Antidotes and Antagonists . 

Alkalies to neutralize the acid ; Oil, Albumen, or Milk, to protect the mucous mem- 
brane ; Stimulants, Opium, Ammonia (intravenously), to combat the resulting depression 
of the vital powers. 

Therapeutics of the Mineral Acids. 
All the members of this group are useful in fevers, if well diluted, 
Hydrochloric being usually preferred, especially in typhoid. In atonic 
dyspepsia, acidity of the stomach, and locally in ulcerations of the throat, 
Hydrochloric Acid is best used. Nitric is the acid generally preferred as 
a caustic, its action being effectual and superficial. As such it is applied 
undiluted to phagedenic ulcers and sloughs, warty growths, and to the 
cavity of the womb in chronic inflammation thereof. Dilute Nitric Acid 
is used internally in oxaluria and lithsemia, intermittent and remittent 
fevers, and aphonia of singers. Dilute Nitro-hydrochloric is more suitable 
in chronic hepatic disorders due to malaria; Sulphuric in hemorrhages, 
diarrhoeas, colliquative sweating, and as a prophylactic against lead-poison- 
ing. Dilute Sulphuric Acid is used as an acid drink in fevers, and before 



ACIDUM HYDROCYANICUM DILUTUM. 8? 

meals in acidity of the stomach. It is very doubtful whether the latter 
has any special influence on the nervous or osseous systems. 

All these acids act injuriously on the teeth, by attacking the enamel. 
They should always be administered largely diluted, taken through a straw 
or glass tube, and the mouth should be thoroughly rinsed at once with an 
alkaline solution. 



ACIDUM HYDROCYANICUM DILUTUM, Diluted Hy- 
drocyanic (Prussic) Acid, — is a liquid composed of 2 per cent, of 
absolute Hydrocyanic Acid, HCN, and 98 per cent, of water. It is 
colorless, faintly acid, of peculiar odor, and is prepared by distilling solu- 
tions of Potassium Ferrocyanide and Sulphuric Acid together, or extem- 
poraneously by adding 6 grammes of Silver Cyanide to a solution of 5 Cc. 
of Hydrochloric Acid in 55 of distilled water, shaking together and pour- 
ing off the supernatant liquid, n^xl have proved fatal. Dose, tnj-v, of 
a recent preparation ; as, even under the most favorable conditions, it 
will decompose within a year. 

Preparations containing Hydrocyanic Acid. 

Aqua Laurocerasi, Cherry-laurel Water (Unofficial), — is a water distilled from the 
fresh leaves of Primus laurocerasus, the common Laurel or Cherry Laurel, a small tree 
of the nat. ord. Rosacea, sub-order Amygdaleae. The leaves contain a variable amount 
of Hydrocyanic Acid and a volatile oil. Dose, TT\v-xxx, cautiously. 

Scheele's Dilute Hydrocyanic Acid (Unofficial), — is a 4 or 5 per cent, solution, 
and is highly dangerous even by inhalation. 

Amygdala Amara, Bitter Almond (see its title) and its essential oil; also, various 
other members of the sub-order Amygdalese, including the official Primus Virginiana, 
perhaps the unofficial Primus laurocerasus, and the leaves and kernels of the peach and 
cherry trees, contain a proximate principle Amygdalin, and a ferment Emulsin, which 
in the presence of water react on each other, forming Hydrocyanic Acid, a volatile oil, 
and glucose. C 20 H 2 .NO U (Amygdalin) + 2H 2 = C 7 H 6 (Oil of Bitter Almond) + 
HCN (Hydrocyanic Acid) + 2C 6 H ]2 6 (Glucose). 

Other Cyanogen Compounds. 

Potassii Cyanidum, Potassium Cyanide, KCN, — a white, opaque salt, of alkaline 
reaction, bitter- almond taste, and a peculiar odor when moist ; soluble in 2 of water, 
sparingly soluble in alcohol. Dose, gr. ^V - !* Locally, a solution of gr. j-v to the 5 
is as strong as should be employed. 

Potassii Ferrocyanidum, Potassium Ferrocyanide, K 4 Fe(CN) 6 3H 2 0, — large, 
lemon-yellow prisms or tablets, efflorescent, odorless, of sweetish taste and neutral reac- 
tion, soluble in 4 of water, insoluble in alcohol. Employed in pharmacy as a test solu- 
tion, and in the preparation of Iron Ferrocyanide, Diluted Hydrocyanic Acid and Potas- 
sium and Silver Cyanides. Rarely used medicinally. Dose, gr. v-xv. 

Physiological Action. 
Hydrocyanic Acid is one of the most powerful and rapid poisons known, 
half a grain having proved fatal almost immediately. Its action on the 
organism is one peculiar to itself, the inhalation of a strong preparation 
producing rapid insensibility and almost immediate exhaustion ; — death 
from a full dose occurring by sudden paralysis of the heart, from a less 



53 ACIDUM HYDROCYANICUM DILUTUM. 

but still a fatal dose, by paralysis of respiration. The symptoms are those 
of sudden and complete asphyxia, but some volitional movements may be 
made before death, unless the dose be very large. In cases in which the 
dose, though fatal, permitted of the observance of its effects, they were 
usually divisible into two marked stages, viz. : (i) Dyspnoea, slow and 
full pulse, giddiness, loss of muscular power ; — (2) Vomiting, dilated 
pupils, unconsciousness, spasms, muscular rigidity, and cessation of the 
heart's action. In poisonous, but not fatal doses, the following effects 
have been observed : feeble pulse, dilated pupils, turgid and dusky face, 
insensibility, convulsions or rigidity, but no paralysis. Large medicinal 
doses may produce salivation, irritation of the throat, dizziness, buzzing 
in the ears, headache, numbness, dusky countenance, staggering gait, 
sense of constriction of the chest, palpitation of the heart, a frequent or 
an abnormally slow pulse, a sense of great weariness and drowsiness. 
Post-mortem examination usually shows dilated pupils, the eyes having a 
marked glassy lustre, the cadaveric rigidity very great. The blood, in 
cases which have been rapidly fatal, may show the arterial color in both 
the arterial and the venous systems ; but in slower cases it is dark and fluid, 
engorging both sides of the heart, the venous trunks, and the cerebral 
sinuses. The paralyzant action of the drug is chiefly exercised on the 
nerve-centres in the medulla ; next on the peripheral afferent nerves, the 
spinal cord, the motor nerves, and finally on the muscular tissue. It stops 
the heart by irritation of the vagus-roots in the medulla, as well as by 
paralyzing the cardiac motor ganglia. It is said to form with haemoglobin 
a compound (cyan-haemoglobin), which does not readily give up oxygen. 
The odor of the acid is fragrant, resembling that of bitter almonds or 
peaches, and may be detected in the lungs shortly after death. The effects 
of a medicinal dose pass off in an hour at the farthest. 

Locally applied to the skin, Hydrocyanic Acid penetrates the epidermis 
and paralyzes the end-organs of the sensory nerves in the derma. It is 
rapidly absorbed from mucous surfaces. 

Potassium Cyanide has similar action, but in addition has some few 
peculiar to itself. Locally used it produces dermatitis, with an eczema- 
tous eruption, and if applied to an abraded surface freely may cause fatal 
effects. Internally it has proved fatal in doses of 3 to 5 grains, with all 
the symptoms of Hydrocyanic Acid poisoning, but its action is less rapid. 
It is much used in photography, and many cases of poisoning by it have 
occurred in persons employed in that art. 

Antagonists and Antidotes. 

Atropine has antagonistic action, but is too slowly diffused to be of any value. Am- 
monia by inhalation, by the stomach, and by intra-venous injection, with cold affusion to 
the spine, and artificial respiration, are the measures most likely to avail in cases of poi- 
soning where there is time to do anything. In poisoning by Potassium Cyanide give 
Ferrous Sulphate, producing Ferrocyanide of Iron (Prussian Blue). Then evacuation of 



ACIDUM LACTICUM. 89 

the stomach, artificial respiration, and Ammonia by intra-venous injection. Cobalt Nitrate 
is announced as an efficient antidote to Hydrocyanic Acid or Potassium Cyanide, by M. 
Antal, a Hungarian toxicologist and chemist. 

Therapeutics. 

Hydrocyanic Acid is used for its anti-spasmodic and sedative effects. 
In vomiting, whooping-cough, and coughs of spasmodic character, in 
asthma and other neuroses of the respiratory organs, in affections involv- 
ing the pneumogastric nerve, vertigo and headache from stomachal de- 
rangements, gastralgia, painful dyspepsia, vomiting, etc., it is very efficient 
as a palliative. In acute mania and melancholia it has been used with 
advantage; and in various skin diseases, accompanied by itching, tingling, 
etc., its use as a lotion (n^xxx-^j ad gj Aquae Rosae) to the unbroken sur- 
face is prompt in relieving the pruritus and other distressing sensations. 
Only when recently prepared is it of any service ; as, even under the most 
favorable conditions, it will undergo decomposition within a year. 

Potassium Cyanide in ointment (gr. v ad gj) is used to allay pruritus, 
and in solution (gr. iij-v ad ^j) is applied locally with benefit in reflex 
headaches, and is used as a wash to remove nitrate of silver stains. It 
has been used internally in doses of gr. j for acute articular rheumatism, 
but such employment of it is highly dangerous. In smaller doses (gr. 
j4-/{), it is a useful ingredient of cough mixtures, where Opium or its 
alkaloids are not admissible. 

Potassium Ferrocyanide has been used in doses of 8 to 15 grains as 
an astringent and anodyne, but it is seldom employed in medicine. 

Cherry-laurel Water has been extensively used as a flavoring agent, 
having a very agreeable taste. It is official in the British Pharmacopoeia, 
and is supposed to be a rather elegant mode of administering Prussic Acid ; 
but the uncertainty of its strength is such that it should never be used 
internally, except in very small quantities. It has been employed as an 
anaesthetic injection into the urethra prior to catheterization, and was 
formerly employed by ophthalmologists as an eye-wash in painful affections 
of that organ. 



ACIDUM LACTICUM, Lactic Acid, — is a liquid composed of 75 per cent, of 
absolute Lactic Acid (HC 3 H 5 3 ) and 25 per cent, of water ; nearly colorless, syrupy, 
odorless, of acid taste and reaction, freely miscible with water, alcohol and ether, but 
nearly insoluble in chloroform. It is produced by the lactic fermentation of sugar of 
milk or grape-sugar, has a sp. gr. of 1. 213, and is difficult to obtain pure. It enters into 
Syrupus Calcii Lactophosphatis. Dose, ^ss-^ss, well diluted. 

Lactic Acid is found in the stomach as a product of the food, and combines with bases 
in the blood, forming lactates, which, being oxidized, are converted into carbonates. It 
aids digestion and promotes the appetite, but, in large doses, causes flatulence and much 
epigastric pain. Injected into the peritoneal cavity of animals, it excites endocarditis, and 
given in diabetes it has produced acute rheumatism and rheumatic endocarditis. Hence 
its supposed causation of acute rheumatism when in excess and free in the blood. It dis- 
solves false membranes and also calcium phosphate. Hypnotic properties have been 
ascribed to it. 



90 ACIDUM NITRICUM. 

It is used with benefit in diabetes, atonic dyspepsia, oxaluria, and in the lithic and 
phosphatic diatheses when due to imperfect digestion and assimilation. As a solvent of 
false membrane in croup and diphtheria it is unquestionably of great service but painful. 
In chronic cystitis it arrests the ammoniacal decomposition of the urine. As the acid found 
in the shops is generally of poor quality, disappointment in its use may be expected. 



ACIDUM NITRICUM, Nitric Acid,— is a liquid composed of 
68 per cent, of absolute Nitric Acid, HN0 3 , and 32 per cent, of water. 
It is colorless, fuming, very caustic and corrosive, of sp. gr. 1.414, strongly 
acid in reaction, and is obtained by the action of Sulphuric Acid on 
Potassium Nitrate. Is only used externally as a caustic. 

Preparations. 

Acidum Nitricum Dilutum, Diluted Nitric Acid, — has of the above 10 parts in 58 
of Distilled Water, and contains 10 per cent, of absolute Nitric Acid. Dose, fl\iij-xv, 
well diluted. 

Acidum Nitrohydrochloricum, Nitrohydrochloric Acid, Nitromuriatic Acid, Aqua 
Regia, — a golden-yellow, fuming, corrosive liquid, composed of Nitric Acid 18 vols., 
Hydrochloric Acid 82 vols. Is wholly volatilized by heat, readily dissolves gold-leaf, 
and a drop added to test-solution of Potassium Iodide liberates Iodine in abundance. 
Dose, TTy-viij, well diluted. 

Acidum Nitrohydrochloricum Dilutum, Diluted Nitrohydrochloric Acid, — con- 
sists of Nitric Acid 4, Hydrochloric Acid 18, Water 78 vols. Dose, Tr^v-xx, well diluted. 

Physiological Action and Therapeutics. 

The action and uses of these agents are described with those of the 
other mineral acids, under the title Acidum Hydrochloricum. Some 
special properties are as follows : — 

Nitric Acid is an exceedingly powerful escharotic, but, as it coagulates 
and does not redissolve the albumen of the tissues, it forms a barrier to 
its own excessive action. The vapor may cause oedema of the glottis, 
intense bronchitis, etc., and death from suffocation. It is used for the 
destruction of chancres, warts, hemorrhoids, phagedenic ulcers, etc. ; and 
internally in dilute form for bilious affections, as it is supposed to have a 
selective action on the liver. It also lessens phosphatic deposits in the 
urine, and acts as an astringent in the system, diminishing profuse secre- 
tion in bronchorrhoea and phthisis. 

Nitrohydrochloric Acid is also supposed to specially affect the liver. 
It is usefully employed in jaundice, dyspepsia, and the so-called bilious 
condition ; also in frontal headache, situated just above the eyebrows, 
when unaccompanied by constipation, and in acidity of the stomach. In 
hepatic disorders it may be used in dilute form as baths, or applied to the 
hepatic region on compresses. The official dilute acid is of little use 
therapeutically, as it rapidly deteriorates, and the same may be said of 
the strong acid when standing long enough for the color to change to a 
lemon-yellow. The most efficient preparation is the strong acid freshly 
prepared, when it is of an orange-red color. This should be properly 



ACIDUM OLEICUM ACIDUM PHOSPHORICUM. 9 I 

diluted when required for use, and should be constantly protected from 
light. 

ACIDUM OLEICUM, Oleic Acid, HC 18 H 33 2 ,— is one of the 

constituent acids of oils and fats, obtained commercially as a secondary 
product in the manufacture of stearin candles. It is a yellowish oily 
liquid, semi-solid at 57 F., odorless, tasteless, and of neutral reaction, 
insoluble in water but soluble in alcohol, chloroform, benzol, benzin, 
turpentine, and the fixed oils. It dissolves most of the metallic oxides 
and the uncombined alkaloids, forming the so-called Oleates, which, 
however, are not pure chemical compounds, but merely compounds of 
the oxides or alkaloids, as the case may be, with oleic acid, dissolved in 
a great excess of the latter. Three of these are official, viz. : — 

Oleatum Hydrargyri, Oleate of Mercury, — has 20 of the Yellow Oxide of Mercury, 
with 80 of Oleic Acid. 

Oleatum Veratrinse, Oleate of Veratrine, — has 2 of Veratrine in 98 of Oleic Acid. 
Oleatum Zinci, Oleate of Zinc, — has 5 of Zinc Oxide in 95 of Oleic Acid. 

Unofficial Preparations. 
Oleates (Oleata) of Aconitine (2 per cent.), Atropine (2 percent.), Morphine (10 per 
cent.), Morphine atid Mercury (2 per cent, morphine and 20 per cent, mercuric oxide), 
Quinine (25 per cent.), Strychnine (2 per cent.), Arsenic (gr. xx of oleate of arsenic to 
the ^), Alujninum, Bismuth, Copper, Iron, Lead, Silver, etc. , are prepared by the manu- 
facturing pharmacists, and are to be obtained in the shops. Most of them answer to the 
description given above, but several are Oleo-palmitates, or double salts of Oleic and Pal- 
mitic Acids, being prepared from oils which yield the latter acid in considerable quan- 
tity. Drs. Shoemaker and Wolff, of Philadelphia, have introduced, under the above 
names, several solid or semi-solid preparations, which they claim to be chemically true 
oleates, salts having no excess of either their acid or basic radicals. They are produced 
by the double decomposition of sodium oleate with solutions of neutral salts, the precipi- 
tates, washed and dried, being the oleates required. These oleates are claimed to be 
more stable than the official oleic solutions, and using less oleic acid are much less 
costly. Many of them may be used as dusting powders, or mixed with oil or lard to 
form ointments. 

Oleic Acid is only used in making the Oleates, which were introduced 
by Marshall, as substitutes for ointments, being cleaner, more elegant, and 
more penetrating, but decidedly more irritating if applied with friction. 
Their medicinal properties depend upon the bases employed, hence their 
actions and uses will be described under the corresponding basic heads. 
They should usually be diluted with an equal bulk of vaseline or olive oil 
before being rubbed into the skin, as they may produce a cutaneous erup- 
tion or even pustulation. As a rule, they should be lightly spread over 
the surface with the finger or a brush. As parasiticides, the Oleates of 
Copper and Mercury are most efficient, and in skin diseases generally 
these preparations are rapidly gaining favor. 



ACIDUM PHOSPHORICUM, Phosphoric Acid,— is a liquid 
composed of 85 per cent, of Orthophosphoric Acid, H 3 P0 4 , and 15 per 



92 ACIDUM PICRICUM ACIDUM SULPHURICUM. 

cent, of water, and is obtained by oxidizing Phosphorus by Nitric Acid. 
It is strongly acid, odorless, colorless, and of sp. gr. 1.710 at 59 F. 

Acidum Phosphoricum Dilutum, Diluted Phosphoric Acid,— has of Phosphoric 
Acid 10 parts in 75 of Distilled Water, sp. gr. 1. 05 7, and contains 10 per cent, of Ortho- 
phosphoric Acid. Dose, mw-xxx, in sufficient water. 

Phosphates of Ammonium, Ferrum, and Sodium, Syrupus Ferri, Quininae et Strych- 
ninae Phosphatum, and Acidum Hypophosphorosum Dilutum, are described under PHOS- 
PHORUS. 

The action and uses of Phosphoric Acid are described with those of 
the other Mineral Acids under Acidum Hydrochloricum. It may be 
given in larger doses than the other acids without deranging digestion, 
and is therefore preferred in cases requiring acid treatment for a long 
period, as in diabetes, etc. It is considered of especial value in strumous 
affections, and it is thought to diminish the growth of osseous tumors, 
and to dissolve phosphatic deposits. As it contains no free phosphorus, 
it cannot be used to obtain the effects of that drug. 



ACIDUM PICRICUM, Picric Acid (Carbazotic Acid, Trinitrophenol), C 6 H 3 - 
(N0 2 ) 3 (Unofficial), — is obtained by the action of Nitric Acid on Carbolic Acid, or 
many other substances. It has recently been introduced as a test for albumen and sugar 
in the urine. A saturated aqueous solution has been used locally in erysipelas with some 
advantage. Some of its salts (Picrates of Ammonium, Iron, etc.) have been tried thera- 
peutically, without any particular results. Powers as an antiperiodic and anthelmintic 
and against trichinae have been urged for it, but experience has not supported these 
claims. Dose, gr. v-xv per diem. 

Ammonium Picrate, in doses of gr. y% to gr. jss, in pill, four times daily, has been 
used in the malarial fevers of India, in over 10,000 cases with most effective results. 



ACIDUM SULPHURICUM, Sulphuric Acid,— is a strongly 
caustic and corrosive liquid, oily, inodorous, of a strong acid reaction, 
composed of not less than 92^ per cent, of absolute Sulphuric Acid 
(H 2 S0 4 ) and 7^ per cent, of water. It is obtained by the combustion 
of Sulphur and its oxidation by nitrous fumes. Its specific gravity should 
not be below 1.835, anc ^ it is miscible in all proportions with water and 
alcohol, with evolution of heat. Occasionally used as a caustic. 

Acidum Sulphuricum Dilutum, Diluted Sulphuric Acid, — has of the strong acid I 
part to %~% of distilled water, and contains 10 per cent., by weight, of absolute sulphuric 
acid. Dose, rr^v-xv, well diluted. 

Acidum Sulphuricum Aromaticum, Aromatic Sulphuric Acid, Elixir of Vitriol, 
— is Sulphuric Acid 10 per cent, by volume, 20 per cent, by weight, diluted with Alcohol 
and flavored with Cinnamon and Ginger. It is not an acid, but rather an ether formed 
by reaction between the acid and the alcohol. Dose, TT\v-xv, well diluted. 

The action and uses of Sulphuric Acid generally are described with 
those of the other Mineral Acids under Acidum Hydrochloricum. Its 
chief use internally is in lead-poisoning, to form the insoluble sulphate, 
and as a remote astringent in diarrhoea, hemorrhoids, hemorrhages, 
night-sweats, and mucous discharges. In choleraic diarrhoea and lead 



ACIDUM SULPHUROSUM. 93 

poisoning it is generally administered in combination with Opium. The 
only hemorrhages in which it is efficient are those from mucous surfaces. 
It is excreted chiefly by the kidneys, part escaping by the bowels as 
sulphates, part also by the skin. Like the other mineral acids, it does not 
increase the acidity of the urine to any considerable extent. Its princi- 
pal actions are those of an astringent, an anhydrotic and a hemostatic. 

ACIDUM SULPHUROSUM, Sulphurous Acid,— is a color- 
less liquid, of sulphurous taste and very acid reaction, composed of not 
less than 6.4 per cent., by weight, of Sulphurous Acid Gas (S0 2 ) and 93.6 
per cent, of water. It is prepared by heating Sulphuric Acid with char- 
coal and dissolving the gas produced in distilled water. Dose, n^v-^j, 
largely diluted with water. 

Sodii Sulphis, Sodium Sulphite, Na 2 S0 3 .7H 2 0, — colorless, transparent, monoclinic 
prisms, efflorescent in dry air, of cooling, saline, and sulphurous taste, and neutral or 
feebly alkaline reaction; soluble in 4 of water at 59 F., and in 0.9 of boiling water, 
very slightly soluble in alcohol. Dose, gr. v-xx. 

Sodii Bisulphis, Sodium Bisulphite, NaHS0 3 , — opaque prismatic crystals, or a 
crystalline or granular powder, slowly oxidized in the air ; of faint, sulphurous odor, a 
disagreeable taste, and an acid reaction ; soluble in 4 of water and in 72 of alcohol at 
59 F., in 2 of boiling water, and in 49 of boiling alcohol. By strong heat it is con- 
verted into sulphur and sulphate of sodium. Dose, gr. iij-x. 

Sodii Hyposulphis, Sodium Hyposulphite. Na 2 S 2 3 .5H 2 0, — large, colorless, mono- 
clinic prisms or plates, efflorescent in dry air, of cooling and bitter taste, and neutral or 
faintly alkaline reaction ; soluble in 1.5 of water at 59 F., and in 0.5 of boiling water, 
which partly decomposes it ; insoluble in alcohol. Dose, gr. v-xx. 

Incompatibles. 
All oxidizing substances change the sulphites into sulphates, and the Mineral Acids 
decompose them. 

Physiological Action and Therapeutics. 

Sulphurous Acid has great affinity for oxygen, and is a powerful dis- 
infectant and deodorizer, and very destructive to all plant life. The gas 
inhaled is irritant to the glottis, and may produce dangerous inflamma- 
tion of the respiratory passages. 

Sulphurous Acid Gas (Sulphurous Anhydride) is extensively used as a 
disinfectant, being the most powerful and convenient agent for this pur- 
pose. Sulphur is burned on a shovel or plate in the room to be fumi- 
gated, all outlets having been carefully closed. It is injurious to many 
fabrics. Sulphurous Acid is used locally in many throat affections as a 
spray or by a mop. In diphtheria, stomatitis, aphthae, ulcers of the 
tonsils, syphilitic and tuberculous laryngitis, chronic bronchitis, etc., it 
may be thus applied with great benefit. Morbid fermentation in the 
stomach with growth of penicillium and sarcinse is quickly stopped by 5 
to 60-minim doses in water, or by the sulphites in 20-grain doses. In 
parasitic skin diseases and foul wounds these agents are extremely useful 
as local applications. 



94 ACIDUM TANNICUM. 

The Sulphites and Hyposulphites are partly decomposed by the acid 
of the stomach, sulphurous acid being given off, and the balance being 
converted into sulphates act as purgatives, and are absorbed, undergoing 
elimination as sulphates by the kidneys and bowels. They were formerly 
supposed to enter the blood and tissues as sulphites, and to arrest morbid 
processes of the zymotic character, but both these assumptions have 
proven erroneous. The Sulphites were used in zymotic and septic fevers 
as internal antiseptics on theoretical grounds, but their supposed value 
has not been realized. 



ACIDUM TANNICUM, Tannic Acid (Gallotannic Acid, 
Digallic Acid, Tannin), HC 14 H 9 9 , — is a solid body in light-yellowish 
scales, of strongly astringent taste and acid reaction, obtained from pow- 
dered galls (see Galla), by exposure for three days in a damp atmos- 
phere, then macerating with ether, pressing, and drying the liquid 
portion. It is soluble in i of water, in 0.6 of alcohol, at 59 F., and in 
about 1 of glycerin with moderate heat ; very soluble in boiling water 
and in boiling alcohol, almost insoluble in ether, chloroform, benzol or 
benzin. Dose, gr. j-xx, in wafer, pill or capsule. 

Preparations. 

Unguentum Acidi Tannici, Ointment of Tannic Acid, — is a 20 per cent, ointment, 
made with Benzoinated Lard. 

Trochisci Acidi Tannici, Troches of Tannic Acid, — each troche contains nearly 
one grain of Tannic Acid. 

Glyceritum Acidi Tannici, Glycerite of Tannic Acid, — strength I part in 4 of 
Glycerin. 

Suppositoria Acidi Tannici, Suppositories of Tannic Acid (Unofficial), — have 1 
part in 5 of Cacao Butter. 

Collodium Stypticum, Styptic Collodion, — has of Tannic Acid 20, Alcohol 5, Ether 
25, Collodion to make 100 parts. 

Vegetable Astringents contain some form of tannic acid, as Quercitannic Acid from 
Oak-bark, Rhatania-tannic Acid m Rhatany, etc. (For list, see page 84.) The offi- 
cial acid is Gallo-tannic Acid, being that produced from Galls. 

Mineral Acids, Alkalies, persalts of Iron, and salts of Antimony, Lead and Silver, are 
chemically incompatible. Vegetable alkaloids and Gelatin form insoluble precipitates 
with Tannic Acid. 

Physiological Action and Therapeutics. 
Tannic Acid is a powerful astringent. It precipitates pepsin and co- 
agulates albumen, impairs digestion, stops peristalsis, and causes constipa- 
tion. A part of that taken into the stomach unites with the pepsin and 
albumen, while a part is converted into Gallic and Pyrogallic Acids, 
and in this form is both absorbed and excreted. It is a crystalloidal 
body, but combines with colloids, and is a valuable antidote in poisoning 
by the alkaloids and tartar emetic, with which it forms tannates which 
are nearly insoluble. Its continued use disorders digestion, irritates the 



ACIDUM TARTARICUM — ACONITUM. 95 

mucous membranes, and produces emaciation. Injected into the veins it 
forms emboli and thus may cause death, but by the stomach it is non- 
toxic. Some authorities hold that Tannic Acid is merely Gallic Acid 
Anhydride ; others believe that the difference between them is one of 
oxidation. Gallic Acid does not coagulate albumen or gelatin, while 
Tannic Acid does. Tannic Acid is a more powerful astringent than 
Gallic Acid, and hence is preferred for local use and for astringent effect 
on the intestinal canal. It is well employed in hemorrhoids and hemor- 
rhages from the lower bowel, in hematemesis, epistaxis, rectal ulcers or 
fissures, catarrhs and chronic affections of the mucous membranes, endo- 
cervicitis, conjunctivitis, dysentery and diarrhoeas, eczema, impetigo and 
other forms of skin-disease, otorrhcea, bed-sores, prolapsus ani, and many 
other affections. 

Styptic Collodion is used to stanch the bleeding from an open wound, 
to unite and protect incised or lacerated wounds, and to cover and change 
the character of foul ulcers. 

Tannigen, Diacetyl-tannin (Unofficial), — is an acetic acid ester of tannin, prepared 
by the action of glacial acetic acid on tannic acid. It occurs as an odorless and tasteless 
powder, insoluble in cold water and dilute acids, but soluble in cold alcohol and in dilute 
solutions of soda, sodium phosphate and borax. It is said to pass through the stomach 
unchanged and to be gradually decomposed in the intestines, thus exerting an astringent 
effect upon the entire intestinal canal. Its uses have been as an intestinal astringent. It 
appears to be absolutely innocuous. Dose, gr. iij-viij, up to gij daily. 



ACIDUM TARTARICUM, Tartaric Acid, H 2 C 4 H 4 6 ,— is a crystalline acid, 
prepared from Potassium Bitartrate (Acid Tartrate of Potassium, Cream of Tartar), by 
neutralizing a solution thereof with chalk and calcium chloride, then decomposing the 
calcium tartrate thus formed by sulphuric acid, evaporating and purifying. It occurs in 
colorless, transparent prisms, which are odorless, of acid taste and reaction, and soluble 
in 0.8 of water and in 2]/ 2 of alcohol at 59 F. Twenty grains exactly neutralize 27 of 
Potassium Bicarbonate, 22 of Sodium Bicarbonate, or 15^2 of Ammonium Carbonate. 
Dose, gr. x-xxx. 

Tartaric Acid is an ingredient of the Effervescing Powders (see under Potassium). 
Five Tartrates and one Bitartrate (see Index) are official, and are described, with their 
actions and uses, under the titles of their respective bases. For Potassium Bitartrate see 
under Potassium. The Alkaline Cupric Tartrate Volumetric (Fehling's) Solution is 
described in the Appendix. 

The actions and uses of Tartaric Acid are similar to those of the other Vegetable 
Acids, as described under Acidum Aceticum. It is chiefly employed in the preparation 
of effervescing refrigerant drinks and effervescing granulated salts. 



ACONITUM, Aconite, — is the tuber of Aconitum Napellus, a 
perennial plant of the nat. ord. Ranunculaceae (Monkshood), found in 
mountainous regions of Europe, Asia and N. America. This plant has 
deep-blue, helmet-shaped flowers, and leaves which have deeply-cut, 
wedge-shaped segments, exciting slowly when chewed a sensation of 
tingling in the tongue and lips. The root is conical and tapering, with a 
thick bark enclosing a seven-rayed, star-shaped pith, odorless, taste 



96 ACONITUM. 

sweetish at first, soon becoming acrid. A minute portion, cautiously 
chewed, causes prolonged tingling and numbness. Its active principle 
is the alkaloid Aconitine (see below), which it contains in the proportion 
of .03 per cent. It also contains gum, sugar, Aconitic Acid, and several 
other principles, viz. — Aconine, Napelline, Pseudaconitine, Lyctonine, etc., 
concerning which there is much diversity of opinion. Dose, gr. ^j-ij. 

Other aconite-roots are those of A. Camniarum, A. ferox, and the Chinese or Japan- 
ese Aconite, A. Chinense vel Japonicum. From the latter an alkaloid is obtained, 
named Japaconitine, which is even more poisonous than pseud-aconitine. The Indian 
variety (A. ferox) contains pseud-aconitine but does not yield aconitine. The former is 
considered to be more active than the latter, and Japaconitine more so than either of the 
other two. 

Preparations. 

Extractum Aconiti, Extract of Aconite, — is at least four times as strong as the ex- 
tract official in the U. S. P., 1870, which was prepared from the leaves, and is yet to be 
found in the shops. Dose, gr. l /6- l /i- 

Extractum Aconiti Fluidum, Fluid Extract of Aconite, — each drop represents 
nearly one grain of the powdered drug : an alcoholic preparation. Dose, n\ ^-ij. 

Tinctura Aconiti, Tincture of Aconite, — has of Aconite 35, Alcohol and Water to 
100. Is about 25 times stronger than the tincture of the leaf formerly official. Dose, 

Tinctures of Aconite root vary greatly in strength. In Fleming's Tincture 79 parts 
of aconite are used in preparing 100 of the tincture, in that of the Br. P. 16, in the 
French 20, the German 10, while the Linimentum Aconiti (B. P.) is really a very strong 
tincture, of the strength of I to )/ z . Probably the best and safest preparation for ordi- 
nary use is a 10 per cent, tincture, of which the maximum single dose for an adult is 
stated in the P. Ger. at TT^ix, and the maximum daily dose at rr^xxxv. 

The best rule for the administration of aconite preparations is to give the minimum 
dose at intervals of 15 to 20 minutes, until the desired effect is produced. 

Unofficial Preparations. 

Aconitina, Aconitine, C 33 H 43 N0 12 , — a white, and usually amorphous solid, of alkaline 
reaction, soluble in 150 of cold and 50 of hot water; much more soluble in alcohol and 
ether. Is difficult to obtain of constant strength, some samples being all but inert, others 
extremely active. As obtained in the shops it is usually a mixture of several alkaloids. 
The Aconitine Crystalisee of Duquesnel, which, according to Squibb, is a nitrate of 
aconitine, is considered to be the most active of those in the market. Dose, gr. aijoTV 

Oleatum Aconitinse, Oleate of Aconitine, — is a 2 per cent, solution in Oleic Acid, 
for external use. Duquesnel's crystals will not dissolve in Oleic Acid (Squibb). 

Napellina, Napelline, — is weaker than Aconitine, and has been used in doses of gr. 
x /z-\. It has lately been studied by Laborde, who claims for it most valuable hypnotic 
properties, and proposes to use it as a substitute for opium and chloral. 

St. Jacob's Oil (a patent medicine),- is a weak Aconite Liniment, which also con- 
tains Ether, Alcohol, Turpentine, red coloring matter and water (Squibb). See Ap- 
pendix. 

Physiological Action. 
Aconite is a powerful depressant of the sensory nerve ends, the heart, 
the respiration and the spinal system. It is also antipyretic, diaphoretic 
and diuretic. It acts chiefly on the peripheral ends of the sensory nerves, 
but paralyzes both the motor and sensory nerves — the sensory being 
affected first and from the periphery inwards, while the motor nerves are 
affected from the centres outwards. It stimulates at first but soon relaxes 
the inhibitory apparatus of the heart, and paralyzes finally the vagus ends, 



ACONITUM. 97 

the cardiac muscle and its contained ganglia, the respiratory centres, and 
the spinal cord in all its functions — sensory, reflex and motor ; but does 
not affect the cerebrum. 

The primary stimulation which the drug produces upon the vagus centre 
in the medulla slows the heart-rate at first ; but its depressant action upon 
the motor cardiac centres and the vagus end-organs in the heart, is soon 
manifested ; and finally the vagus centre shares in the increasing paralysis, 
which affects the vaso-motor centre as well as the cardiac nervous appa- 
ratus. The heart -rate becomes very rapid near the end, from paralysis of 
the vagus ends in its structure. 

Its taste is bitter, acrid and pungent. Soon after the ingestion of even 
a small quantity, a sensation of numbness and a persistent tingling are 
felt in the tongue and lips. Full medicinal doses cause a sense of con- 
striction in the fauces, irritation of the gastro-intestinal mucous membrane 
with increased secretion ; sometimes nausea and vomiting, and severe 
pains in the joints and muscles ; always more or less salivation, diaphoresis 
and diuresis ; reduced respiratory power, cardiac rate and force ; lowered 
arterial tension and temperature. 

A lethal dose produces great muscular weakness, dim sight, dilated 
(sometimes contracted) pupils ; shallow, irregular, and labored respiration, 
slow and weak pulse, cold surface, clammy sweat, great anxiety, numbness 
and tingling in the extremities, lowered body-temperature (2 to 3 ), 
abolished sensation, impaired reflexes and motility, and finally death from 
paralysis of the heart and respiration, with or without convulsions, con- 
sciousness being preserved until near the end, when C0 2 narcosis sets in. 
In two recorded cases, oedema of the entire body resulted from Aconite- 
poisoning by eating the leaves of the growing plant. 

Aconite is rapidly diffused and slowly excreted, the effects of a full 
medicinal dose continuing for three or four hours. Applied externally, 
it paralyzes the sensory nerves of the part, producing its characteristic 
numbness and tingling. 

Antagonists. 

Caffeine, Atropine, Morphine, Ether, Ammonia and Amyl Nitrite antagonize its effects 
on the heart and respiration. Digitalis counteracts its heart action and the relaxation of 
cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, warmth ap- 
plied to the extremities, stimulants administered, artificial respiration if necessary, and 
the recumbent posture strictly maintained. Caffeine may be administered hypodermically 
and per orem. 

Therapeutics. 
Aconite antagonizes the fever process, and rightly used is therefore one 
of the most valuable drugs we possess. It has well been called the " ther- 
apeutic lancet," and is certainly responsible to a great extent for the dis- 
use of venesection. Its power over the circulation, respiration and trans- 
piration renders it of the greatest value in all affections characterized by 
7 



98 ADEPS. 

high, resisting pulse, dry hot skin, and elevated body-temperature. It is 
especially useful in'acute throat affections, the early stage of acute inflam- 
mations of the respiratory organs, catarrhal croup, acute pleuritis and 
peritonitis before the stage of effusion, simple and eruptive fevers, puer- 
peral and surgical fevers, facial erysipelas, acute rheumatism, cardiac affec- 
tions with overaction or hypertrophy and without valvular lesion, diar- 
rhoea and dysentery from cold or exposure, menstrual suppression from 
chill, and neuralgia of the 5th (externally and internally), it having a 
very positive and selective influence on that nerve. It is also highly 
recommended in otitis, nervous palpitations, restlessness, and sick head- 
ache, also in the acute stage of gonorrhoea. 

Aconite is best administered in small doses frequently repeated ; from 
half a drop to a drop of the tincture every fifteen minutes in a teaspoon- 
ful of water, as a rule gives better results than do proportionately larger 
doses at longer intervals. 

Aconitine has been remarkably efficient in trigeminal neuralgia; — so 
also has Napelline been in the same affection, and as an hypnotic it is 
well mentioned by several observers of authority. 



ADEPS, Lard, — is the prepared internal fat of the abdomen of Sus Scrofa (Pig), 
purified by washing, melting and straining. A soft, white, unctuous solid, of bland taste 
and neutral reaction, entirely soluble in ether, benzin, and bisulphide of carbon ; com- 
posed of 38 per cent, of Stearin and Margarin, and 62 per cent, of Olein. Lard forms 70 
per cent, of Ceratum, and 80 per cent, of Unguentum, and enters into the composition of 
several of the official cerates. 

Fats are formed of the immediate principles, Stearin, Margarin and Olein, which are 
regarded as salts composed of stearic, margaric and oleic acids with a common base, 
glycerin ; also odorous and coloring principles. 

Preparations. 

Adeps Benzoinatus, Benzoinated Lard, — has 2 per cent, of Benzoin in powder, in- 
corporated by stirring. 

Oleum Adipis, Lard Oil, — is a fixed oil expressed from lard at a low temperature. 

The actions of the Oils and Fats are described under Morrhlve Oleum. 

Lard is only used as an ingredient of ointments and cerates. Lard Oil is used in mak- 
ing the Unguentum Hydrargyri Nitratis, but has been proposed as an inferior substitute 
for Cod-liver oil in cases where the taste of the latter is particularly offensive. 

Adeps Lanae Hydrosus, Hydrous Wool-fat (Lanolin), — is the purified fat of the 
wool of sheep, mixed with not more than 30 per cent, of water. A yellowish-white, 
ointment-like mass, having a faint, peculiar odor ; insoluble in water but miscible with 
twice its weight thereof. 

Under the name Lanolin this substance was in use for several years before it became 
official. It is a cholesterin fat, and a very old medicament, having been mentioned by 
Ovid, Herodotus, Pliny and Aristophanes ; yet the process for obtaining it from the suds 
from the washings of sheep's wool is patented in this country by Liebrich. It differs from 
all other fatty substances chiefly in resisting saponification and the action of water, having 
no tendency to become rancid ; and readily passes through the integument, carrying with 
it any medicament with which it is charged. It is a perfectly neutral base, and therefore 
is not liable to decompose any ordinary substance. The difficulty about its use has been 
its very disagreeably sheepy smell, but recent samples seem in great measure to be devoid 
of this objectionable quality. It is particularly useful in chronic skin diseases where 
there is infiltration, and where a penetrative action is desired for medicaments locally 



.ETHER. 99 

applied. In a few cases of acute and subacute eczema it has proved irritating, but as a 
rule it is perfectly bland. Where a simple protective action is alone desired it is inferior 
to Lard, Vaseline or Cold Cream. 

Acidum Stearicum, Stearic Acid, — is an organic acid, usually obtained from the 
more solid fats, chiefly tallow. In its impure, commercial form, it occurs as a hard, white, 
glossy solid, odorless and tasteless, permanent in the air ; insoluble in water, soluble in 
45 of alcohol, also in ether. It is used as a substitute for wax, and is an ingredient of 
the Suppositoria Glycerini. 



iETHER, Ether, Ethyl Oxide (C 2 H 5 ) 2 0,— in its absolute form is 
not official, the strongest preparation containing 4 per cent, of alcohol 
and some water. Considered as a generic term, an ether is analogous to 
a salt, as an alcohol is to a metallic hydrate. The particular ether offi- 
cially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic 
Alcohol) by a dehydrating agent with the aid of heat, and then purified 
by various processes. The agent used is Sulphuric Acid, hence this ether 
is improperly called " Sulphuric Ether," but the acid simply dehydrates 
the alcohol and remains in the retort, becoming constantly more diluted 
by the abstraction of water from the alcohol. Consequently H 2 is the 
difference between Alcohol and Ether. (C 2 H 6 0) 2 — H 2 = (C 2 H 5 ) 2 0. 
The official ethers are the two following, viz. — 

^ther, Ether, — is a volatile and inflammable liquid, composed of 
about 96 per cent, of absolute Ether, Ethyl Oxide, and about 4 per cent, 
of Alcohol containing a little water. Sp. gr. 0.725 to 0.728 at 59 F. 
It is the preparation employed for anaesthetic use, and is generally though 
improperly called " Sulphuric Ether," a term which belongs to Ethyl 
Sulphate (C 4 H 10 SO 4 ). The dose of iEther for internal administration is 
tt^x-^j, in syrup ; hypodermically, for heart failure, n^xv-xxx. It is best 
prescribed as Spirit of Ether, which mixes readily with water. 

Water dissolves a tenth of its volume of Ether, and reciprocally Ether takes up about 
the same proportion of water. It is colorless, of a strong and characteristic odor, hot 
and pungent in taste. It evaporates speedily in the open air, with the production of con- 
siderable cold. When good, it evaporates from the hand, without leaving a disagreeable 
odor. It boils at about the temperature of the body (98. 6° Fah.), and its vapor is very 
heavy and very inflammable. It dissolves Hydrargyrum Bichloride, Hydrargyrum 
Iodidum Rubrum, Iodine and Bromine freely ; Sulphur and Phosphorus sparingly. It 
is also a solvent of the fixed and volatile oils, many resins and balsams, caoutchouc, and 
most of the organic vegetable alkaloids. It does not dissolve Potash or Soda, in which 
respect it differs from Alcohol. 

/Ether Aceticus, Acetic Ether, Ethyl Acetate, C 2 H 5 C 2 H 3 0, — is an 
inflammable liquid, transparent and colorless, of ethereal and acetous 
odor, soluble in alcohol, ether, chloroform, and in 8 of water. It is a 
constituent of Sp. Odoratus and Tr. Ferri Acetatis. Dose, filx-gj. 

Hydrobromic Ether, Ethyl Bromide t C 2 H 5 Br (Unofficial), — is not 
inflammable. Dose, internally and hypodermically, TTLX-3J. 

Hydriodic Ether, Ethyl Iodide, C 2 H 5 I (Unofficial), — is a colorless 
liquid, non-inflammable, and insoluble in water. Dose, inhaled, rr^xv, 



IOO .ETHER. 

For the Chlorinated Ethers see under Chloroform. 

Preparations. 

Oleum .^Ethereum, Ethereal Oil, — is a volatile liquid, consisting of equal volumes 
of heavy Oil of Wine and Ether. Used to prepare the Spt. ^Etheris Comp. As it occurs 
in commerce is usually a worthless preparation. 

Spiritus /Etheris, Spirit of Ether, — has of Ether 325 parts, Alcohol 675. Dose, 

Spiritus ,/Etheris Compositus, Hoffmann' 's Anodyne, — contains Ether 325, Alcohol 
650, Ethereal Oil 25 parts. Dose, V(\y-%). 

Spiritus ^Etheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, — is an 
alcoholic solution of Ethyl Nitrite, B 2 H 5 N0 2 , containing 5 per cent, of the crude ether. 
It turns acid with age, and should not be kept long. It is a constituent of Mist. Glycyr- 
rhizse Co. (3 per cent.). Dose, ^ss-^ss. Its incompatibles are Potassium Iodide, 
Ferric Sulphate, Tr. Guaiaci, Tannic and Gallic Acids, and Antipyrin. 

Anesthetic Mixtures. 

Nussbauvv 's has — Ether 3 parts, Chloroform I, Alcohol I. 

Vienna General Hospital uses — Ether 9, Chloroform 30, Alcohol 9. 

The " Vienna Mixture" — Ether 3, Chloroform I. 

Medico- Chirurgical Society of London (1864) approved a mixture originally introduced 
by Dr. Geo. Harley, and known as the "A. C. E. Mixture." It consists of Alcohol 
I, Chloroform 2 and Ether 3 parts. 

Physiological Action of Ether. 

Ether is anodyne, antispasmodic, diaphoretic and anthelmintic ; a 
cardiac and cerebral stimulant, an anaesthetic, and a narcotic poison. 
Given internally, it is one of the most powerful stimulants of the secre- 
tions, acting especially on the secretions of the stomach, salivary glands 
and pancreas. On the cerebrum and the motor and sensory nerves its 
action is similar to that of alcohol, but more prompt and less protracted. 
It is eliminated rapidly, chiefly by the lungs. Externally it is a powerful 
refrigerant and local anaesthetic ; also rubefacient when rubbed into the 
skin. 

Inhaled Ether produces at first faucial irritation, a sense of strangula- 
tion and cough ; then a stage of excitement (cerebral intoxication), in 
which the face is flushed and the respiration and pulse are accelerated. A 
tetanic convulsive stage generally follows, the face being cyanosed, the 
muscles rigid, and the respiration stertorous. This soon subsides, and 
complete insensibility is established, the muscles being then relaxed, the 
reflexes abolished, and the cerebral functions suspended, the lower centres 
in the medulla carrying on the processes of respiration and circulation. 
If the inhalation be continued, these also become paralyzed, death 
usually resulting from slow paralysis of respiration, the heart pulsating 
long after breathing has ceased. If the inhalation be discontinued before 
the lower centres are affected, the patient gradually emerges from the 
condition of insensibility, and, as the narcosis subsides, vomiting is usually 
experienced. 



.ETHER. IOI 

Dr. Brunton found that in a hot climate Ether will decompose within a few hours, and 
hence, during his investigations for the Hyderabad Chloroform Committee, he found it 
impossible to obtain pure ether. This may account for the preference for Chloroform as 
an anaesthetic which is so universal in the Southern States. 



Ether Compared with Chloroform. 
Ether is less irritant than Chloroform to the mucous membranes when 
swallowed, but its vapor is more irritant to the air-passages. It is more 
of a general stimulant, and less depressant to the heart and circulation. 
It does not clot the blood. Its vapor is very inflammable, less pleasant to 
inhale, slower in action, has a longer stage of excitement, and a less 
profound narcosis, and causes a greater degree of vomiting. It is much 
less dangerous than Chloroform, death from the inhalation of Ether oc- 
curring slowly and usually by paralysis of respiration — from Chloroform, 
it is almost always sudden, and is generally believed to occur by paralysis 
of the heart. Ether has undoubtedly been the direct cause of a number 
of deaths, besides several which occurred some hours after termination 
of its anaesthesia. 

Modes of Dying from Ancesthetics. 

(i.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex 
action proceeding from some peripheral injury before complete anaesthesia is produced. 
Thus, in the extraction of teeth, a small quantity of Chloroform having been administered, 
the heart is enfeebled, and the action of the cerebral hemispheres suspended, but not 
those of the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by 
the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may 
be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete 
anaesthesia is always a dangerous one in which to perform any operation around the dis- 
tribution of the 5th nerve. 

(2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood 
backing up on the venous side, and arresting the heart's action, respiration ceasing before 
the cardiac action is stopped. 

(3.) In the stage of complete relaxation, by paralysis of respiration ; or by paralysis of 
the tongue, causing obstructed respiration. 

(4.) In the same stage, by paralysis of the motor ganglia of the heart. 

(5. ) From depression of the functions by chloroform narcosis, and from shock, — and 
may occur in the anaesthetic state, or afterwards. 

Contraindications for Anaesthesia are — fatty degeneration or dila- 
tation of the heart, renal and pulmonary disease, enlarged tonsils, cere- 
bral tumor, and chronic alcoholism — particularly the first and last named. 

Dangerous Symptoms should be met by withdrawing the vapor and 
inverting the patient head downwards, drawing the tongue forwards, and 
applying a cold douche to the face and chest. Atropine hypodermically 
is an agent of great value in combating the cardiac failure, — artificial 
respiration and faradization of the respiratory muscles if breathing ceases. 
Strychnine, hypodermically, as a cardiac and respiratory stimulant, has 
many advocates, and has done good service, especially in chloroform 
narcosis. Arnyl Nitrite by inhalation, or Ammonia, hypodermically. 
Heat to the body and limbs. 



102 .ETHER. 

Comparative Safety of Ancesthetics. 

A comparison of these agents in respect to their safety has been made by Dr. Richard- 
son, who considers Methylic Ether to be the safest of all, and the others as follows : 

Safe are — Ethyl Bromide, Ethyl Chloride, Ether, Ethene (defiant gas), Ethene Chlo- 
ride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane 
(marsh gas), Nitrous Oxide. 

Of doubtful value are — Amylene, Amyl Chloride, Butyl Chloride, Benzene (benzol), 
Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, 
Spirit of Turpentine. 

Dangerous are — Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. 
Chloroform and Ethene Dichloride are considered useful, but requiring care. 

Pental, Tri-methyl-ethylene, C 5 H ]0 (Unofficial) , — is a colorless liquid, highly inflam- 
mable, insoluble in water, but miscible in all proportions with alcohol, ether and chloro- 
form. Sp. gr. 0.678. It is obtained by heating amylene hydrate in the presence of acids. 

Pental is an efficient anaesthetic, equal to Nitrous Oxide in its rapidity of action and 
safety, but superior thereto in its more prolonged action and its having no unpleasant 
after-effects. Under it there is seldom any stage of exhilaration, and consciousness is 
sufficiently retained to enable response to commands, even when insensibility to pain is 
reached. It does not lose its effect by repeated inhalations. Compared with Chloroform, 
it acts more promptly, and has no evil after-effects ; with Ethyl Bromide, it is somewhat 
slower in action but more lasting in effect, and can be prolonged as may be necessary ; 
with Nitrous Oxide, it can be continued for a longer time, is more safe, and free from 
after-effects of unpleasant character. 

Physiological Action of Other Ethers. 

Hydriodic Ether is an antispasmodic and a general stimulant ; also 
an anaesthetic if inhaled for a sufficiently long time. Its use as a medici- 
nal agent is chiefly to bring the system rapidly under the influence of 
iodine. It increases appetite, stimulates the action of the heart, gives 
vivacity to the general feelings and activity to the intellect. 

Hydrobromic Ether has a not unpleasant odor, produces but little 
irritation of the air-passages, has very brief stages of excitement and 
rigidity, and but a short stage of insensibility, with prompt awakening 
and but little of the mental confusion and excitement consequent on the 
use of the other anaesthetics. It is not inflammable, acts quickly, and is 
a good local anaesthetic. Its actions in other respects correspond with 
those of Ether. 

Nitrous Ether is a mild diaphoretic, a diffusible stimulant, a carmin- 
ative, and an efficient diuretic. On the blood it acts similarly to Amyl 
Nitrite, diminishing oxygenation, relaxing the peripheral vessels, accel- 
erating the heart's action, and thus lowering arterial tension. Relaxing 
the renal and cutaneous vessels, it is diuretic and diaphoretic. 

Acetic Ether has a pleasant odor and taste, forming agreeable combi- 
nations with other carminatives as a stimulant and antispasmodic. 

Therapeutics. 
When diluted with alcohol Ether mixes readily with water, and may be 
administered internally with advantage in indigestion of fats, and to aid 
the digestion of Cod-liver Oil. It is also given in hysteria to relieve the 



iETHER. 103 

paroxysm and flatulence, and in hepatic colic from calculi, Ether with 
Turpentine (Durande's solvent remedy), which acts only as an anodyne 
and antispasmodic, is considered by some as of great value. 

Subcutaneously Ether is used in the algid stage of cholera, sudden car- 
diac depression, neuralgia, and in the adynamia of hemorrhage, pneu- 
monia and the eruptive fevers. 

Local anaesthesia by the Ether-spray affords great relief in neuralgia of 
superficial nerves, lumbago, chorea, and spinal irritation. In minor sur- 
gical operations it is a valuable method. 

As an Ancesthetic the vapor of Ether is less prompt than that of 
Chloroform, but is equally efficient and much safer. It should be inhaled 
in as concentrated a form as possible, and will then produce insensibility 
in from 5 to 10 minutes. If a light be in the room it should be high 
above the patient. A grate-fire or gas-stove in the vicinity is very dan- 
gerous. [Compare the article on Chloroform.] Besides its surgical 
uses ether-anaesthesia is employed in neuralgia, cancer, tetanus, chorea, 
colic, delirium, puerperal mania and convulsions, infantile convulsions, 
hystero-epilepsy, epileptic seizures, laryngismus stridulus, whooping- 
cough, and asthma. The unpleasant after-effects may be greatly modified 
if not entirely prevented by the previous administration of Morphine 
(gr. -|~J) and Atropine (gr. i\-^) subcutaneously. 

Hydrobromic Ether had a short period of popularity as an anaesthetic, 
but fell into disrepute after a few cases of death under its influence, which 
were probably not due to the agent used (Levis' and Sims' cases). Its 
action is less prolonged than that of Ether, but it has many advantages, 
requiring only 3J to §ij, rapidly given, and being uninflammable. Its in- 
halation has been of especial value in hysteria, epilepsy, chorea and other 
spasmodic disorders ; and it has been employed subcutaneously in place 
of Ether in the treatment of such spasmodic affections as whooping- 
cough, chorea, etc. 

The Compound Spirit of Ether (Hoffmann's Anodyne) is an admir- 
able agent in gastralgia, colic, flatulence, syncope, etc., also in the vari- 
ious manifestations of the hysterical paroxysm. In combination with the 
camphorated tincture of Opium it is often remarkably efficient in check- 
ing the diarrhoea of hot weather. 

Spirit of Nitrous Ether is used as a diaphoretic, a diuretic and a 
carminative ; also in expectorant mixtures, as an antipyretic in febrile 
affections, and to relieve pain in angina pectoris, dysmenorrhcea and 
asthma. When its diuretic effect is desired it should be administered in 
iced water, and the patient should be lightly covered: but when its di- 
aphoretic action is required, it should be preceded by a hot drink, and 
the patient should be well covered. 

Hydriodic Ether may be obtained in glass capsules containing five 



104 AGARICUS ALBUS — AGARICUS MUSCARIUS. 

minims each, and is used by inhalation in chronic pulmonary disorders, 
cardiac dyspncea, spasmodic affections of the bronchi and larynx, asthma, 
and in catarrhal laryngitis with dyspncea. It is not employed as an 
anaesthetic. 



AGARICUS ALBUS, White or Purging Agaric (Unofficial),— is the fungus 
Polyportis officinalis, which grows on the European larch. It occurs in large, white, 
spongy pieces ; and contains Agaricic or Laricic Acid, also from 40 to 70 per cent, of 
resins. The term Agaricin was formerly applied to the impure Agaricic Acid containing 
about 3 per cent, of Agaricol, which is physiologically inert. 

The taste of Purging Agaric is first sweetish, then becoming very acrid and bitter. 
The powder inhaled causes violent sneezing, and taken internally in full doses it produces 
watery stools. Small doses check diarrhoea and dysentery, and diminish the secretions 
of the bronchi and mammae. 

Agaricus Albus was formerly employed as a drastic purgative, in doses of gr. xxx to 
gj. It has lately been used, with much success, in 15-grain doses of the powder, or 3 
grains of the alcoholic extract, to check the night-sweats of phthisis. Agaricic Acid has 
proved very valuable in checking persistent sweating from any cause, especially that 
occurring after influenza. The dose is gr. y 1 ^ to ^ : and it should not be given hypoder- 
mically. 



AGARICUS CHIRURGORUM, Surgeon's Agaric (Unofficial),— is the interior 
portion of the fungus Polypoms fomentarius, which grows on the trunks of beeches, 
birches, and oaks in Europe. It is prepared for use by boiling in weak lye and beating 
with mallets, and then occurs in light, thin, yellowish -brown pieces, soft and pliable, 
without odor or taste. It is almost pure cellulose. It was formerly used as a mechanical 
hemostatic, and for the purpose of moxa. When soaked in a strong solution of the 
Nitrate or Chlorate of Potassium and dried, it is very inflammable, and is called Spunk. 



AGARICUS MUSCARIUS, Amanita Muscaria, Fly-Agaric 
(Unofficial), — is a poisonous mushroom, of disagreeable odor and burn- 
ing, acrid taste, used in infusion with milk for poisoning flies, and by the 
Tartars as an intoxicant. It contains an actively toxic alkaloid, Musca- 
rine, C 5 H 13 N0 2 , of syrupy consistence, odorless and tasteless, soluble in 
water and alcohol, and readily dissolved out by water and dilute acetic 
acid, so that a doubtful mushroom may be easily rendered innocuous. 
It may also be produced synthetically, but it is doubtful whether the 
article so prepared is as active as the natural product. It has been made 
from Choline by Schmiedeberg. 

Preparations. 

Muscarina, Muscarine (Unofficial). — Dose, gr. |-gr. ij. It maybe used hypoder- 
mically in watery solution. 

Muscarinae Nitras, Nitrate of Muscarine (Unofficial), — may be used hypodermi- 
cally, in doses of from gr. y 1 ^ to gr. |. 

Physiological Action. 

Muscarine is a powerful respiratory and cardiac depressant, paralyzing 

the respiratory centre and arresting the heart in diastole by paralyzing 

its motor ganglia while stimulating its inhibitory apparatus. It lowers 

the arterial tension, produces profound salivation, lachrymation and 



AILANTHUS. 105 

sweating, contracts the pulmonary vessels, causing intense dyspnoea, and 
increases the intestinal, hepatic and pancreatic secretions, but markedly 
diminishes the renal. It disturbs the gastro-intestinal tract, causing 
tetanic intestinal contractions, severe colic, vomiting and purging. It 
produces spasm of the accommodation, marked myosis and contraction 
of the pupil when given internally, but dilates the pupil widely when 
locally applied. [Gelsemium does so also.] Under its action the body 
temperature is decidedly reduced, and the excretion of waste-products is 
lessened. It is eliminated unchanged by the kidneys. 

Agaricus acts as an intoxicant to the cerebrum, producing more vertigo 
and delirium than Alcohol, followed by profound sopor with lowered re- 
flexes, perhaps coma and death. 

Antagonists. 
Atropine exactly opposes Muscarine, and vice versa; no example of physiological 
antagonism being so complete in all particulars. When a frog's heart is arrested by the 
topical action of a minute quantity of Muscarine, the application of a little Atropine 
will immediately paralyze the inhibition and restore the pulsations. An equally prompt 
antagonism runs through their entire spheres of action. Digitalin is to some extent 
antagonistic ; so also is Physostigmine. 

Therapeutics. 
Muscarine has been as yet little used in medicine, but it will probably 
prove to be a valuable drug. It has been long used, with marked benefit, 
in the night-sweats of phthisis. A tincture of Agaricus has been found 
beneficial in ataxic typhus, chorea, and chilblains. Muscarine promises 
to be of great value in inflammations characterized by copious exudation, 
especially eye-inflammations, catarrhal jaundice, recent hemorrhoids, 
acute bronchitis, pulmonary hemorrhage, incipient pulmonary congestion, 
diabetes of both forms, and in constipation due to intestinal torpor and 
deficient secretion, accompanied by a torpid liver and difficult digestion 
of fats. In the latter affection it should be given in small doses, gr. ^-, 
thrice daily. 



AILANTHUS, Tree of Heaven (Unofficial),— is the bark of Ailanthus glandn- 
losa. a well-known shade tree, of the nat. ord. Simarubacese, indigenous to China, but 
cultivated elsewhere. It contains an oleo-resin and a volatile oil, on which its properties 
probably depend. Dose, gr. x-^j. 

Extractum Ailanthus Fluidum, Fluid Extract of Ailanthus, — Dose, Vi\x-^). 

Tinctura Ailanthus, Tincture of Ailanthus, — Dose, TTLx-^ij. 

Ailanthus is a decided nauseant, and a drastic purgative, causing also vertigo, weak- 
ness, cold sweats, dull headache, pains in the back, numbness and tingling in the limbs. 
It paralyzes the cerebrum and spinal cord of animals, impairment of motility beginning 
in their hind extremities. The cardiac action, at first increased, soon slows, the pulse 
becoming small and weak, and the respiration depressed, death occurring from paralysis 
of respiration. It is a good taeniafuge. 

Ailanthus is used against tapeworm, a decoction of the fresh bark (^j to t ^iv), or the 
oleo-resin in drachm doses, being very efficient. It has also been well employed in 
malignant scarlatina, with dark and partial eruption, insensibility, delirium and other 
cerebral symptoms. 



106 ALCOHOL. 

ALCOHOL, Alcohol {Ethyl Alcohol, Ethyl Hydrate), C 2 H 5 OH. 
The official alcohol is Ethyl Alcohol, which is represented in the pharma- 
copoeia by the several preparations named Brandy, Whiskey, and Wine, 
as also under the following four forms, viz. — 

Alcohol Absolutum, Absolute Alcohol, C 2 H 5 OH, — is Ethyl Alcohol, 
containing not more than i percent, by weight of Water. A transparent, 
inflammable, colorless, mobile and volatile liquid, very hygroscopic, of 
characteristic, agreeable odor, and burning taste. Sp. gr. not higher 
than 0.797 at 59 F. Used in the manufacture of Chloroform. 

Alcohol, — a liquid composed of about 91 per cent, by weight, or 94 
per cent, by volume, of Ethyl Alcohol, C 2 H 5 OH, and about 9 per cent, 
by weight, of Water. A transparent, inflammable, colorless, mobile and 
volatile liquid, of agreeable odor and burning taste. Sp. gr. 0.820 at 59 
F., or 0.812 at 77 F. Miscible with water in all proportions and with- 
out any trace of cloudiness ; also miscible with ether or chloroform. 
Obtained by the distillation of fermented saccharine fluids. Used in pre- 
paring all the tinctures and spirits, also in some of the liniments, liquors 
and mixtures. 

Alcohol Deodoratum, Deodorized Alcohol, — a liquid composed of 
about 92^ per cent., by weight, or 95.1 per cent, by volume, of Ethyl 
Alcohol, and about 7}^ per cent., by weight, of Water. Sp. gr. about 
0.816 at 59 F. 

Alcohol Dilutum, Diluted Alcohol, — a liquid composed of about 41 
per cent., by weight, or about 48.6 per cent., by volume, of absolute 
Ethyl Alcohol, and about 59 per cent, of Water. It is prepared by mix- 
ing together equal volumes of Alcohol and Distilled Water, or 410 parts 
by weight of the former and 500 of the latter. Sp. gr. about 0.936 at 
59° F. 

An Alcohol is a volatile organic compound, which contains no N, has a great affinity 
for water, and reacts with acids, forming therewith H 2 and ethers. Alcohols are there- 
fore analogous to the metallic hydrates, as are Ethers to salts. Methyl Alcohol is 
obtained by the destructive distillation of wood, Phenyl Alcohol (Phenol) by that of 
coal-tar, and the fermented Alcohols (Ethyl, Amyl, etc.) from any vegetable substance 
containing sugar (or starch and the ferment Diastase, which converts the starch into 
sugar) , by fermentation through the agency of the yeast-plant, which splits the sugar into 
Alcohol and C0 2 . The product contains much water, and is then distilled in order to 
separate the alcohol, which passes over first, with a certain amount of water, the greater 
part of the latter being left behind. In this country Alcohol is so produced from grain 
(chiefly barley), and is termed " High Wine," being disposed of by the distillers to cer- 
tain wholesale liquor dealers, many of whom proceed to "rectify" it by mixing and 
blending it with water, essential oils of corn, rye, etc., ethers, burnt sugar, and occasion- 
ally small quantities of genuine whiskey, brandy, etc. The product is then labeled " Old 
Tom Gin," "Old Crow Whiskey," etc., according to the requirements of the retail 
dealers. True Whiskey is distilled from the mash of fermented grain (corn, wheat, and 
rye, or a mixture of all three), and should be not less than two years old, to be official ; 
Brandy from the fermented juice of fresh grapes, and should be not less than four years 
old. Wines are the product of the fermented juice of grapes, without distillation. 

Alcohol may be produced synthetically by shaking Olefiant Gas (C 2 H 4 ) with strong 
Sulphuric Acid, then diluting and distilling. Absolute Ethyl Alcohol, which is only 
used for chemical testing and for the manufacture of Chloroform, is obtained by shaking 



ALCOHOL. IO7 

Rectified Spirit (Alcohol) with Potassium Carbonate, decanting and distilling with slaked 
lime. 

Alcohol very slowly oxidized forms Aldehyde (C 2 H 4 0) ; if less slowly Acetic Acid 
(C 2 H 4 2 ) ; if quickly, as in burning, C0 2 and H 2 0, which are in all cases the ultimate 
products of its continued oxidation. 

An Aldehyde is obtained from an alcohol by removing therefrom two atoms of hydro- 
gen, hence its name — Al (cohol) dehyd (rogenatum). Aldehydes lie in chemical con- 
stitution between the alcohols and the acids, and have the power of reducing silver salts 
in darkness, which is shared also by living protoplasm. The principal aldehydes are — 

Acetic Aldehyde, Aldehyde, Ethyl Aldehyde, Ethylidene Oxide, C 2 H 4 0, — a colorless, 
mobile liquid, antiseptic, locally irritant, anaesthetic when inhaled, and a powerful de- 
pressant of the respiration, too dangerous for use. 

Formic Aldehyde, Formaldehyde, CH 2 0, — is a gaseous body prepared by subjecting 
methyl alcohol to oxidation. It is readily absorbed by water, and is put on the market 
in the form of a 40 per cent, aqueous solution named Formalin, which is a powerful anti- 
septic, disinfectant and deodorant. It is described under its own title. 

Paraldehyde, C 6 H 12 3 , — is a polymeric form of Aldehyde and a valuable hypnotic. It 
is described under its own title. 

A Ketone bears the same relation to an aldehyde that an Ether does to an alcohol, 
being an aldehyde in which the hydrogen has been replaced by a radical. The most im- 
portant Ketone is — 

Hypnone, Phenyl-methyl-acetone, C 6 H 5 (CO) (CH 3 ), — a hypnotic agent of moderate 
energy, described under the title Chloral. 

Principal Unofficial Alcohols. 

Methyl Alcohol, Methyl Hydrate, Wood-spirit, CH 3 OH, — also called 
Carbinol, Methol, Hydroxymethane. A non-fermented alcohol, obtained 
from the destructive distillation of wood. Ordinarily it contains many 
impurities, which give it a very disagreeable odor, and mixed with ethyl 
alcohol it renders the latter so disagreeable as to be unfit for drinking. 
Such a mixture is sold, under the name Methylated Spirit, for use as a 
solvent in the arts, as a combustible in lamps, etc. 

Amyl Alcohol, A?ny I Hydrate, Potato-spirit, Fusel Oil, C 5 H n OH. — 
A fermented alcohol obtained from the potato, also occurring in the crude 
spirit produced by the fermentation of saccharine solutions with yeast, 
and separated by the excessive distillation thereof, passing over after the 
ethyl alcohol. It is oxidized into Valerianic Acid. From it is prepared 
Amyl Nitrite, by distilling with nitric and sulphuric acids and copper 
wire. It is an oily liquid, of penetrating and oppressive odor and burn- 
ing taste : sparingly soluble in water, but soluble in all proportions in 
alcohol, ether and essential oils. 



Preparations. 

Spiritus Frumenti, Whiskey, — obtained from the distillation of the mash of fer- 
mented grain; rye, wheat or corn (U. S.), barley (Scotch), and at least two years old. 
Sp. gr. 0.917 to 0.930. Has an alcoholic strength of 44 to 50 per cent, by weight; also 
Ethers developed by the action of acetic and butyric acids on the alcohol, and traces of 
Amyl Alcohol (fusel-oil) even in the best. Dose, ^ij-^ij- 

Spiritus Vini Gallici, Brandy, — obtained from the distillation of the fermented juice 
of grapes, and at least four years old. Sp. gr. 0.925 to 0.941. Has an alcoholic strength 
of 39 to 47 per cent, by weight, and CEnanthic and other Ethers developed by age. Pale 
Brandy is colored by the cask, the dark has caramel to color it. Is often prepared artifi- 



108 ALCOHOL. 

cially by adding to high wines Acetic or Nitric Ether, Caramel, and Logwood or Catechu 
for astringency. Dose, ^ij-^ij- 

Vinum Album, White Wine, — should contain from 10 to 14 per cent, by weight of 
absolute alcohol, and is made by fermenting the unmodified juice of the grape, freed from 
seeds, stems and skins. California Riesling, Ohio Catawba, etc. Dose, ^j-Jiv. 

Vinum Rubrum, Red Wine, — should contain from 10 to 14 per cent, by weight of 
absolute alcohol, and is made by fermenting the juice of colored grapes in presence of 
their skins. Native Claret, Burgundy, etc. Dose, ^ j— ^ iv. 

Unofficial Alcoholic Preparations. 

Rectified Spirit, sp. gr. 0.835, — has 85 per cent, by weight of absolute alcohol, and 
no fusel oil. Is often spoken of as " 56 over proof," meaning that to reduce 100 volumes 
of it to the strength of proof spirit, requires 56 volumes of water. 

Proof Spirit, sp. gr. 0.920, — contains 49 per cent, by weight of absolute alcohol, with 
a peculiar oil and other foreign matters. 

Rum, — is obtained from the distillation of fermented molasses, and has about 42 per 
cent, by weight of alcohol. 

Gin, — has about the same alcoholic strength as rum, and approaches very nearly to the 
official Spiritus Juniperi Compositus. It is usually distilled from rye or barley, and flavored, 
in Holland, with juniper berries and hops, in England, often with oil of turpentine, 
various cheap aromatics, acetate of lead, sulphate of zinc, cayenne pepper, etc. Pure gin 
is slightly diuretic, from the oil of juniper contained in it. 

Spiritus Odoratus, Perfumed Spirit, Cologne-water, — prepared by adding to 800 parts 
of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of Lemon 8, Oil of 
Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange Flowers 4 parts. A perfume 
and ingredient of lotions. 

Vinum Aromaticum, Aromatic Wine, — consists of Stronger White Wine 94 per 
cent., with Lavender, Origanum, Peppermint, Rosemary, Sage and Wormwood, of each 
I per cent. It was official in the U. S. P. 1880. 

Vinum Portense, Port Wine, — is not a natural wine, spirit being added during the 
process of manufacture, and the alcoholic strength raised to 30 or 40 per cent. 

Vinum Xericum, Sherry Wine, — a dry, spirituous white wine, generally made to 
order by the dealers, and having from 20 to 35 per cent, of alcohol. 

Sparkling Wines, as Champagne, Hock, Catawba, — are more or less sweet, and 
charged with carbonic acid, being bottled before fermentation is completed and the grape 
sugar all converted into alcohol. They contain 8 to 10 per cent, of absolute alcohol. 

Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, etc., — 
are of low alcoholic strength, 6 to 7 per cent, unless fortified. 

Light Red Wines, as Claret, Red Rhine, Concord, — have 5 to 7 per cent, alcohol, 
tannic acid, grape coloring matter, etc. 

Dry Acid Wines, as Rhine and Moselle wines, California Hock, Ohio, and Kelley- 
Island Catawba, — in these fermentation is complete, and the alcoholic strength from 5 to 
7 per cent. 

Beer, Ale and Porter, — are fermented liquors, made from malted grain, with hops 
and other bitters added. Beer is made by slow fermentation, the yeast sinking; Ale by 
rapid fermentation, the yeast floating. Their alcoholic strength is from 2 to 3 per cent, in 
beer, to 4 to 6 per cent, in ale and porter, — and they also contain malt extract, carbonic 
acid, lactic acid, various aromatics, potassium and sodium salts, etc. 

Kumyss, — is obtained by the fermentation of milk, that of the mare being used in 
Tartary, where it is largely employed as a food. It contains from I to 3 per cent, of 
alcohol, sugar, lactic acid, casein, fat, salts, carbonic acid and ethers. It is described 
under its own title. 

Physiological Action of Alcohols. 
The Alcohols of the series to which the above-mentioned belong are 
all narcotic poisons when taken in sufficiently large doses; and have the 



ALCOHOL. IO9 

general effect of paralyzing the nerve-centres in the inverse order of their 
development. Their symptoms may be divided into stages, viz. — (1) 
Stimulant, (2) Narcotic and Anodyne, (3) Anaesthetic, (4) Paralytic ; 
therein closely following the action of the volatile anaesthetics derived 
from them, though wanting in the profound degree of anaesthesia which 
the latter produce. Ethyl Alcohol, the effects of which are detailed 
below, has the most typical action, and in poisoning by it all the stages 
follow each other in regular order. In poisoning by Methyl Alcohol the 
excitement is greater, the subsequent stages succeed each other more 
rapidly, and if the dose be insufficient to cause death, the effects pass off 
more quickly. They all lower the body-temperature. 

The post-mortem appearances, after acute poisoning by the alcohols, show changes in 
the blood, stomach, intestines, liver, lungs and kidneys ; some of which are probably due 
to the asphyxiation resulting from the paralysis of respiration. The Blood is dark and 
clotted in the heart. The Stomach and Intestines are congested and softened, especially 
so if the ingested alcohol has been undiluted. The Liver is very much congested, soft 
and friable. The Spleen is gorged with blood and softened. The Lungs are congested 
and show small extravasations of blood, and in the Kidneys hemorrhages are also found. 

Physiological Action of Ethyl Alcohol. 

Externally applied, Alcohol is a powerful antiseptic and disinfectant, 
also refrigerant, astringent, anhidrotic, rubefacient? and slightly anaes- 
thetic. Applied to the exposed skin it quickly evaporates, cooling the 
surface, temporarily contracting the superficial vessels, and checking the 
secretion of the sweat-glands. If its evaporation is prevented, as by 
covering with a watch-glass or a piece of rubber, or if the alcohol is 
rubbed in, it absorbs water from the tissue, and hardens it. It also 
coagulates the albumen of the part, but the coagulum is soon redissolved 
by the fluids of the tissues. It then dilates the vessels of the derma, pro- 
ducing a sensation of warmth and a rubefacient effect upon the skin. 
Upon the mucous membrane of the mouth and pharynx similar effects 
are produced by the same application. If the alcohol is concentrated, a 
burning sensation is felt immediately ; also an increased flow of saliva 
and quickened pulse, due to reflex action. Then follows a slight local 
anaesthesia of the part, and if the alcohol be held there for some time, 
the mucous membrane becomes whitish and opaque, from coagulation of 
the albumen, abstraction of water from the tissue and congestion of its 
vessels. This soon disappears, as resolution of the albumen occurs. 

Internally, in moderate quantity and single dose, Alcohol acts briefly 
as a cerebral, cardiac and general stimulant ; in large doses as an anaes- 
thetic, an intoxicant and deliriant, and finally as a narcotic poison and 
paralyzant of the nerve-centres. It is somewhat antipyretic, also diuretic 
and antispasmodic, and is hypnotic in many cases. 

A single dose of a strong alcoholic preparation, for example an ounce 
of neat brandy, introduced into the stomach, immediately produces im- 



I 10 ALCOHOL. 

portant and valuable reflex effects. The cardiac rate is quickened, and 
its force is increased ; the vessels of the entire body are dilated, especially 
those of the skin ; the blood -pressure is raised, and a sense of glowing 
heat is produced. These reflex effects are well seen in the prompt resto- 
ration of a fainting person by the administration of a single dram of 
whiskey or brandy. By the same means the nausea, paleness and other 
unpleasant symptoms produced by tobacco are promptly counteracted. 

Internally, in small quantity diluted, Alcohol dilates the gastric vessels, 
reddening the mucous membrane of the stomach, produces a sense of 
warmth and comfort, stimulates the gastric glands to increased produc- 
tion of gastric juice, and increases the activity of the gastric movements. 
Taken moderately, immediately before or during meals, it thus promotes 
the appetite and assists digestion ; lessens the elimination of waste-pro- 
ducts (urea and C0 2 ), causes a subjective sensation of heat, and slightly 
raises the body temperature. It briefly stimulates the heart, prolonging 
its systole and reducing the length of the diastole, and increases the 
functional activity of all the organs. The effects of large doses are very 
injurious ; the vaso-motor nerves are partially paralyzed for a time, caus- 
ing dilatation of the arterioles throughout the body ; the pepsin of the 
gastric juice is precipitated, the gastric and hepatic vessels are congested, 
the walls of the stomach are inflamed, and the gastric glands and hepatic 
cells are over-stimulated to the production of pathological secretions. If 
the ingestion is continued, even in moderate quantities frequently re- 
peated, chronic gastritis ensues, gastric mucus is poured out in large 
amount, the gastric glands soon atrophy, and the permanent dyspepsia of 
drunkards is set up, with morning vomiting of glairy mucus. The fur- 
ther effects of large doses are the total arrest of digestion, the production 
of intoxication, perhaps hallucinations and delirium, also great incoor- 
dination of thought and motion, depressed sensibility, depression of the 
heart and respiration, lowered arterial tension and body-temperature, 
abolished reflexes, stupor, and, if the dose be sufficient, coma and death. 

Upon the Blood Alcohol acts to first increase and then diminish the 
amoeboid movements of the white corpuscles, and so affects the red cor- 
puscles as to prevent the oxyhemoglobin from readily parting with its 
oxygen. It consequently diminishes the oxidation of the tissues, and may 
lead to imperfect combustion of fat, which then accumulates. The result 
is obesity in many persons who habitually consume large quantities of 
alcoholic beverages, especially if these contain much saccharine material. 

Upon the Heart and Circulation the first effects of Alcohol are those 
of slight and brief stimulation by reflex action. After its absorption the 
same effects are exhibited in a more marked degree. The pulse becomes 
fuller, the action of the heart is quickened and its force increased, due 
mainly to direct stimulation of its accelerator nerves. The vaso-motor 



ALCOHOL. I I I 

system is inhibited, causing dilatation of all the vessels of the body, espe- 
cially those of the periphery, and producing a sense of increased body-heat. 
The blood-pressure is raised, the great increase of cardiac action over- 
coming the results of the vascular dilatation. The mental and bodily 
functions are all stimulated for a time, the person feels better for the dram, 
his muscular power'seems to be increased, more urine is passed, and per- 
spiration is freer. But these effects are very transitory, and after a brief 
period of stimulation reaction sets in, and the entire organism is depressed 
to a lower point than where it was before the ingestion of the alcoholic 
stimulant. Large doses do not stimulate the heart at all, but immediately 
depress it, both by reflex action and by direct paralysis after their absorp- 
tion. A toxic dose may paralyze the heart almost immediately by direct 
depressant action, but usually, after a very brief period of excitement, it 
produces insensibility, stertorous breathing, dilated or contracted pupils, 
complete muscular resolution, and death by paralysis of the heart and res- 
piration. The action of alcohol upon the heart clearly exemplifies two 
therapeutic laws : (i) That excessive stimulation is necessarily followed 
by depression, and (2) that drugs which in moderate doses excite a func- 
tion are very apt in large doses to paralyze it. 

The extremists, who find no good whatever in alcohol, hold that it is a fallacy to 
apply the term " stimulant " thereto, — that alcohol is a paralyzant from first to last, — 
that its apparent cardiac stimulation is in reality the result of its narcotism of cardiac in- 
hibition, — and that every special sense is blunted by even small doses of this poison. 
They calmly ignore the fact that their premises apply to every stimulant in its special 
field of action as well as to alcohol in its sphere, and forget that their conclusion (that 
alcohol has no place in medicine except as a poison) applies by the same reasoning to 
every other stimulant. Hence, to be consistent, they should advocate the banishment 
of all stimulant drugs from the materia medica. 

On the Skin and Kidneys Alcohol is mildly diaphoretic and diuretic, 
acting partly by its vascular dilatation, partly by stimulation of glandu- 
lar activity. On the Intestines it has a slightly astringent effect at first, 
but in those who use it habitually to excess the bowels are always very 
loose, and the evacuations watery. 

Upon the Nervous System Alcohol has specific and selective action. By 
a moderate dose this entire system is briefly stimulated, chiefly as a result 
of increased blood supply due to the vascular dilatation and cardiac ele- 
vation. Reaction, however, soon occurs, and if the dose be very large, 
the period of exaltation quickly passes into one of profound cerebral de- 
pression, but this is usually preceded by marked incoordination of thought 
and of muscular movement, shown by incoherency of language, difficult 
speech, and staggering gait. The reflex activity of the spinal centres is 
abolished next, the urine and faeces are discharged involuntarily ; the de- 
pression extends to the respiratory centre, breathing becomes difficult and 
the face cyanosed ; profound coma supervenes, respiration and the heart 
are paralyzed, and the patient dies. 



112 ALCOHOL. 

The reflex depression occurs early in the case, and accounts for the 
impunity with which a drunken man will often bear an injury which 
would cause death by shock to a sober one. 

The action of Alcohol upon the nervous system illustrates well, in the order of its 
events, the physiological fact that excessive stimulation is followed by depression ; as well 
as the law that drugs which affect the functions progressively exhibit their earliest powers 
upon those functions which are highest in development (being those latest acquired by 
the individual and last to appear in the species), and influence next the next lower, until 
finally the lowest, namely those of respiration and circulation. The primary stimula- 
tion and subsequent depression of function proceeds therefore, in a descending scale from 
the highest or least firmly fixed and latest acquired function, to the lowest or most firmly 
fixed one. Thus, by Alcohol, the intellect is affected very early and the judgment abol- 
ished very soon, even though the imagination, the emotions and the powers of speech 
remain stimulated. Soon these follow the same course, imagination is abolished, the 
patient loses command over his emotions, cries and laughs immoderately and without 
reason ; next loses control over his organs of speech, talking incoherently and thickly, 
and then can only make a noise. At the same time other delicate and lately developed 
movements, as those required for writing, feeding, etc. , are incoordinately performed and 
soon paralyzed. General muscular movements, being less highly and earlier developed, 
are next to become implicated, being first incoordinated, and soon abolished. The paraly- 
sis of reflex action follows, though lowered earlier in the case, then that of respiration 
and finally that of the heart. 

The antipyretic action of Alcohol is partly due to its power of lessening 
oxidation, but chiefly to the dilatation which even moderate doses pro- 
duce in the vessels of the surface. This dilatation subjects the warm blood 
from the interior of the body to the cooling influence of the atmosphere, 
as also to that due to evaporation from the skin ; and if kept up by 
repeated drams in a freezing temperature will soon so chill down the 
blood as to kill the subject. 

Under ordinary conditions the contraction of the cutaneous vessels, in a person ex- 
posed to cold, prevents the warm blood from approaching the surface in any great quan- 
tity and becoming cooled ; but this mechanism is temporarily paralyzed by every dose of 
alcohol, admitting the hot blood to circulate freely over the surface, and to be rapidly 
cooled down until the patient may be absolutely frozen to death as a result of repeatedly 
taking " something to keep him warm." This fact is well known to Arctic travelers and 
to the lumbermen of the northern forests, who have been taught by bitter experience to 
let alcohol severely alone when exposed to severe cold. 

Delirium Tremens occurs after an alcoholic debauch, usually in cases 
where the stomach is so deranged as to prevent the ingestion or assimila- 
tion of food. So long as the toper can eat and digest his food he is 
practically not liable to this affection. It generally begins in from two 
to four days after the patient has lost his appetite and commenced to 
reject or vomit his food ; and is marked by great restlessness, obstinate 
insomnia, a peculiar tremor of the tongue and limbs; also by delusions 
connected with the sense of sight, the patient imagining that he sees 
animals (dogs, rats, snakes, beetles, etc.) around him. The delirium is 
constant and active, may become violent and pass into mania, or the 
patient may die suddenly while in this state, without any warning symp- 
toms. In several cases observed by the writer the delirium appeared four 
and five days after the last alcoholic dose was taken, though the patient 



ALCOHOL. 113 

was eating, sleeping, and working during the interval, apparently conva- 
lescent. Under treatment, and especially if sleep is brought on, the de- 
lirium usually subsides gradually, and the patient recovers. 

Chronic Alcoholism is the result of the ingestion for a considerable 
length of time of an excessive quantity of alcohol, even though perhaps 
never sufficient to cause acute intoxication. One of the earliest symptoms 
usually observed is the vomiting of watery fluid or glairy mucus in the 
morning after rising. The bowels are generally loose, and the evacuations 
watery. The skin has a greasy look and a satiny feel, and the capillaries 
thereof on the face may become permanently dilated, giving to the cheeks 
a characteristic, dusky-red hue, and a flaming red color to the nose. In 
old drunkards, the latter organ often becomes covered on its tip with 
dusky-red tubercular enlargements, making it a very unsightly appendage. 
The stomach and liver are in a condition of chronic congestion, the food 
is not digested, and often to a great extent abandoned, the patient, in 
fact, living upon alcohol. Eructations of gas and flatulence are constant 
and distressing ; the body is usually puffed and bloated, the eyes bleary, 
red and watery. [One of the most graphic descriptions of the drunkard's 
personal appearance is that by Trollope, in " OrleyFarm," Chapter 57.] 

After a time the connective tissue of the liver increases (hyperplasia), 
its parenchymatous structure atrophies or undergoes fatty degeneration, 
the organ contracts (cirrhosis), the portal circulation is impaired, the 
veins of the abdominal integument become prominent, and soon ascites 
ushers in the final stage. Cirrhosis of the kidneys may accompany that 
of the liver. The general impairment of function extends early to the 
nervous system, the mental powers are dulled, the temper becomes irrita- 
ble, and tremor appears in the tongue, lips and hands. As a result of the 
prolonged use of alcohol very serious pathological changes take place 
throughout the organism. It exerts its essential and most injurious influ- 
ence on the vital organs by its presence in the circulation, being thus 
brought into direct contact with the cellular tissues of the vital organs. 
It sets up hyperplasia of the connective tissue, resulting in sclerosis, es- 
pecially in the stomach, brain, liver and kidneys ; produces fatty degen- 
eration (steatosis) of the blood, the arterial walls and the parenchyma of 
the various organs, depresses the brain, the heart and the arterial tension. 
Chronic disease of the heart, the arteries, and the mucous lining of the 
stomach and intestines, gout, diabetes, Bright's disease of the kidneys, 
paralysis, ataxia, peripheral neuritis, epilepsy, amaurosis, and insanity 
may result from the continued use and abuse of alcohol. The malt liquors 
(beer, ale, etc.) are less prone than the spirits to affect the brain, but are 
even more apt to set up fatty degeneration of the heart and liver. The 
heart is very liable to undergo gradual hypertrophy, partly by reason of 
the constant whipping up it receives from every dram of alcohol taken, 



114 ALCOHOL. 

and partly as a result of renal cirrhosis. Several of the largest hearts ever 
seen by the writer at autopsies, some of which were veritable instances of 
cor bovinum, occurred in subjects of chronic alcoholism associated with 
employment involving exposure and great anxiety, as in masters of steam- 
ships, superintendents of mines, etc. 

Impurities in Alcohol increase greatly its toxic action ; so that inferior 
brandy from a public liquor shop has a lethal action nearly one-half 
greater than that of pure ethyl alcohol. (Dujardin-Beaumetz.) 

Alcoholic Coma may be easily confounded with that of apoplexy, opium narcosis, con- 
cussion of the brain, acute pneumonia, uraemia and epilepsy, the differential diagnosis 
being amost impossible to make with accuracy when the coma is deep. The pupils 
afford no trustworthy indication, as they may be either dilated or contracted in alcoholism. 
They are often unequally contracted in apoplexy, and in apoplexy of the pons varolii 
they may be equally and minutely contracted, as in opium-poisoning. The difficulty of 
diagnosis is increased by the common practice of giving a dram of whiskey or brandy as 
a reviver, so that a stranger found insensible on the street and brought to a hospital, may 
smell of alcohol without having been a subject of alcoholism. When no accurate history 
of the case can be obtained the diagnosis is so difficult as to be all but impossible in 
many cases. 

Alcohol is rapidly diffused throughout the organism, which oxidizes a 
portion of it, about an ounce and a half for the adult in 24 hours, the 
oxidation yielding force, which is utilized as nervous, muscular, and 
glandular power. A larger quantity is decidedly poisonous, as it sets up 
structural changes in the various organs, and lowers the power of resist- 
ance to morbific influences. It renders its victims particularly liable to 
phthisis, and has frequently caused directly an intractable form of that 
disease, pulmonary sclerosis. It makes patients bad subjects for with- 
standing any severe illness, especially pneumonia, or to successfully 
undergo severe surgical operations. 

The portion not oxidized is excreted unchanged by the lungs, the skin 
and the kidneys, but does not appear in any quantity in the urine unless 
very large amounts have been ingested. The very young and the very 
old bear more alcohol relatively than the adult. It has been proven to 
exist normally in the human organism, and within the limit above stated 
it is undoubtedly a food, as is shown by the fact of its retention and 
combustion in the body, supplying the place of other foods, so that the 
quantity of food which without it would be insufficient, with its aid be- 
comes sufficient to maintain the body-weight. 

Treatment of Actite Alcoholic Poisoning. 

If a very large dose has been taken recently, the stomach should be evacuated of what 
is unabsorbed. Then Ammonia may be given by inhalation cautiously, warmth applied 
to the extremities, cold affusion to the head, faradism of the muscles of respiration. 
Milk, mucilaginous drinks, black coffee, are useful afterwards. Lupulin as a substitute 
stimulant, or Capsicum in 20 to 30 grain doses. Chloral, in 30 grain dose, repeated in 
two hours, to secure sleep, is very efficient, or 30 grs. each of Chloral and Potassium 
Bromide, for the same purpose. Chloral is said by teachers to be dangerous in old alco- 
holic cases, but the daily experience of physicians of inebriate asylums does not corrobo- 



ALCOHOL. 115 

rate this statement. Nutritious, digestible diet in liquid form and small quantity fre- 
quently repeated, is an essential feature of the treatment. Ammonium Chloride, 3 ss in 
y^ pint of water at one draught, and the Liquor Ammonii Acetatis, in doses of £ j, are 
said to have marvellous power in generally straightening up a drunken subject, restoring 
the faculties, and antagonizing stupor. 

Treatment of Delirium Tremens. 
Two principal objects are aimed at, — (1) to support the strength by nutritive diet, (2) to 
overcome the obstinate and exhausting insomnia and restlessness. For the latter pur- 
pose the mixture of Chloral and Potassium Bromide above mentioned is by far the most 
efficient agent, and the dose (gr. xxx of each) may be repeated every two hours until 
sleep is secured. Digitalis has been administered in large doses to quiet the delirium, 
and successfully in some cases, but this is a very dangerous treatment. (Brunton.) 
Opium or Morphine may be used in cases which show signs of exhaustion, but should be 
confined to such alone. Its general employment in this affection is decidedly injurious. 
Bismuth, with Magnesia and Hydrocyanic Acid, for the vomiting. Nutrient Enemata 
may be required, if the patient is unable to retain food. Alcohol should not be given. 

Treatment of Chronic Alcoholism. 
The continued ingestion of alcohol in excessive quantities is not a disease, as sentimen- 
talists would have us believe, but is simply a vicious drug-habit, and may be overcome, 
like any other drug-habit, by the exercise of the subject's will-power alone in abstaining 
therefrom. The effort to gradually reduce the amount consumed simply prolongs the 
agony and is much less efficient than the total and immediate withdrawal thereof en- 
tirely. This should be carried out in an inebriate asylum in most cases. Strychnine is 
a specific remedy for alcoholism, and the basis of all the so-called " cures " which are 
extensively advertised under the gold-extracting title of " Gold Cure." Ten to twelve 
minims of a solution of Strychnine Nitrate, gr.iij in 5jx of distilled water, should be in- 
jected hypodermically 3 or 4 times a day for two weeks, and less often for two weeks 
more, gradually reducing the dose and frequency of administration. 

Therapeutics of Alcohol. 
The external and local use of alcohol in medicine includes many appli- 
cations of its antiseptic, astringent, refrigerant and rubefacient qualities. 
Diluted, in the proportion of four parts to one of water, it makes an 
excellent lotion for bruises, sprains, and other slight injuries, where it is 
desired to cool the part and check impending inflammation. A per- 
fumed spirit, as Cologne Water, is commonly used as a lotion to the fore- 
head for the relief of headaches. Alcohol does good service as an appli- 
cation to prevent bedsores and cracked nipples, as it hardens the inflamed 
skin by abstracting water therefrom and coagulating the albumen tempo- 
rarily. Diluted alcohol is applied on the surface of the body in fevers, 
to cool the skin and check excessive sweating. Alcoholic liniments (Lin. 
Camphorse, etc.,) are rubbed into the cutaneous tissue for their rubefaci- 
ent effect, to aid the absorption of inflammatory products and to relieve 
pain, in chronic rheumatism, lumbago, myalgia, etc. As a gargle or 
spray, diluted alcohol is one of the very best local agents in tonsillitis, 
pharyngitis, and other inflammatory affections of the throat, especially 
diphtheria, in which disease it fulfils several important purposes, acting as 
an efficient local antiseptic, astringent and anaesthetic. Among miners, 
hunters, frontiermen and others, lotions of whiskey or brandy are in 
common use as applications to wounds and sores, and they could not find 



Il6 ALCOHOL. 

a more efficient agent for the purpose, when conjoined with thorough 
cleanliness of the lesions. 

Internally, in small quantities taken just before or during a meal, alco- 
hol is an efficient aid to digestion, especially in the aged and feeble, or 
persons who are greatly exhausted by overwork. In the atonic indigestion 
of nervous and depressed subjects and in cholera infantum, good brandy 
is universally found to be beneficial. Care must be taken, however, not 
to exceed the amount which agrees with the case, for large quantities 
precipitate pepsin, paralyze the gastric secretions, and set up a subacute 
gastritis, which will become a chronic one if the indulgence is persisted 
in, with eventual atrophy of the gastric glands. 

In the form of a sparkling wine, as champagne, or as brandy and soda- 
water, alcohol may control vomiting from many causes, especially that of 
yellow fever and sea-sickness. A single full dose of strong whiskey or 
brandy is often a very efficient combatant of fainting or of collapse, by 
its prompt reflex stimulation of the circulation. Diarrhoea of simple 
form may be checked by a dram of good brandy, acting as a tonic 
astringent to the intestines. An attack of acute coryza, or a cold from 
exposure beginning with a chill, may frequently be aborted by a full dose 
of spirits in hot water taken just before going to bed, for the purpose of 
relaxing the peripheral vessels and thus promoting diaphoresis and restor- 
ing the disturbed balance of the circulation. In anaemia and chlorosis 
good red wines are almost indispensable, also in convalescence from 
acute diseases, sudden and profuse hemorrhages, and many other morbid 
conditions. In phthisis alcohol does good service if it promotes assimila- 
tion and assists digestion, shown by increase of the body-weight during 
its employment. It is invaluable in poisoning by cardiac depressants and 
snake-venom, and in cardiac failure from any cause. 

In many fevers, Alcohol is often very serviceable, but may do harm if 
used therein without discrimination. Its powers of lessening oxidation, 
of being itself oxidized in the body and acting as a food, of reducing 
body-temperature and promoting perspiration and sleep, are all indica- 
tions for its beneficial employment in most febrile conditions ; while its 
stimulant action on the heart may be available in such diseases as typhoid 
fever, lobar pneumonia, etc., to tide that organ over a brief period of 
depression or a condition of impending collapse. Furthermore, for some 
unexplained reason, it often slows the pulse in fever, and when it does so 
its moderate use will be of general benefit to the patient. The danger is 
that if continuously given in such affections it may fail to make the 
required impression when an emergency calling for it occurs. The best 
rule to observe for its administration in typhoid, diphtheria, pneumonia 
and other fevers is to withhold it until the first sound of the heart becomes 
feeble and dull, and then to use it boldly but not excessively. Many 



ALETRIS ALLIUM. \IJ 

authorities urge its continuous administration in diphtheria, probably 
from a belief in its antiseptic action on the poison in the blood, similar 
to that which it undoubtedly exercises against the venom of the rattle- 
snake. It is an absolute necessity in the treatment of acute lobar pneu- 
monia, if the patient has been accustomed to its daily use as a beverage ; 
but in other subjects of this disease it is best given at the crisis only, to 
tide the patient over a brief period of extreme danger. 

The use of alcoholic beverages in moderate quantity by healthy per- 
sons is violently condemned by extreme total abstinence advocates, who 
make use of garbled quotations from medical authorities to support their 
arguments. Physicians generally agree with Mr. Lawson Tait, who has 
recently declared that he is " fully persuaded after thirty years of life, as 
hard in work and as full of responsibility as well could be, that the mod- 
erate use of alcohol is a necessity in our modern life." Dr. Robert 
Farquharson sums up the case for moderate drinking as follows: "All 
stimulant is unnecessary for the young and for people living perfectly 
healthy lives. But, under the stress and struggle of modern civilization, 
few of us beyond middle age are placed under normal physiological con- 
ditions, and a little alcohol helps us to round the corners, and to plane 
away the asperities of existence. In turns it may be a stimulant, or a 
sedative, or a tonic, or a digestive, or an actual food ; and unless we run 
on into excess, no physical damage can possibly be done to our tissues. 
The argument in its favor, when wisely and prudently used, seems com- 
plete. It does us good, and can do us no harm." 

ALETRIS, Colic-root (Unofficial), — is the rhizome of Aletris farinosa, the Star- wort, 
an indigenous perennial plant of the nat. ord. Hsemodoraceae, which grows in grassy 
places and in sandy woods. It contains starch, and a bitter principle, but no tannin. 
This plant was formerly official in the secondary list of the U. S. P. , and is now widely 
advertised by the proprietors of an Aletris Cordial, as being tonic, emetic, purgative, 
diuretic, carminative, sialogogue and anti-rheumatic, also " the most powerful of uterine 
stimulants." It is little more than a simple bitter in small doses, though in very large 
ones it may prove emeto-cathartic. It is advertised as a specific for dysmenorrhcea and 
a wonderful remedy for colic, dropsy and chronic rheumatism. Dose, of the powdered 
root, gr. x ; of the infusion (!|j to the pint), Sjss. 

ALLIUM, Garlic, — is the bulb of Allium sativum, a plant of the nat. ord. Liliacese, 
indigenous to Asia, but cultivated in Europe and America. It is sub-globular and com- 
pound, consisting of eight bulblets, covered by dry, membranous scales. Its odor is 
pungent and disagreeable and its taste warm and acrid. It contains a Volatile Oil, which 
consists mainly of the Sulphide of Allyl (C 3 H-) 2 S, on which its qualities depend. Allied 
species are Allium Cepa, the Onion, and Allium Porrwn, the Leek. 

Syrupus Allii, Syrup of Garlic, — contains 20 per cent, of Garlic, Sugar and Dilute 
Acetic Acid. Dose, 3J-iv, according to age. 

Garlic, Leeks and Onions are stimulant to the digestion and to the nervous system, and 
are supposed to have a special influence upon the bronchial secretion. Garlic is also thought 
to be emmenagogue and anthelmintic. It promotes diaphoresis and diuresis, and acts as 
a tonic and carminative. Many persons use it as a condiment. Large doses will often 
produce gastric irritation, flatulence, hemorrhoids, headache and fever. In domestic 
practice it is frequently employed as an external application in the cutaneous eruptions of 
children, and as a poultice or liniment in infantile disorders of many kinds. Internally 



I I 5 ALNUS ALOE. 

it is of real benefit in feeble digestion and flatulence, chronic catarrhal affections of 
children, in nervous and spasmodic coughs, and in nervous vomiting. 

ALNUS, Alder-Bark (Unofficial), — is the bark of Almis serrulata, the common 
American Alder, a small tree of the nat. ord. Betulacere. It has similar properties to 
those of A. glutinosa, the European Alder, and A. urcana, the Tag Alder, and contains 
a tannic acid, an oil, and a resin. The bark and leaves are astringent and bitter, and are 
chiefly used as gargles for the throat, as local applications to wounds and ulcers, and to 
restrain the secretion of milk. Dose of the powdered bark gr. x, in decoction or infusion, 
several times a day. The Tag Alder is highly recommended as a hemostatic. 

ALOE, Aloes, — is official in the two following named varieties, also 
as the Purified Aloes preparation, and the neutral principle, Aloin. 

Aloe Barbadensis, Barbadoes Aloes, — is the inspissated juice of the 
leaves of Aloe vera, a plant of the nat. ord. Liliaceae. It occurs in 
opaque, hard, orange-brown masses, of saffron-like odor and bitter taste. 

Aloe Socotrina, Socotrine Aloes, — the inspissated juice of the leaves 
of Aloe Perryi, a plant of the nat. ord. Liliaceae, inhabiting the island of 
Socotra and the eastern coast of Africa near the southern shore of the 
Red Sea, which has orange-colored flowers and resembles in appearance 
the American aloe or century-plant (Agave americand). It occurs in soft 
masses, hard exteriorly, of a yellowish-brown color, fragrant odor and 
bitter taste, soluble in alcohol and in boiling water, and containing a 
peculiar volatile oil, a resin and Soaloin, C 15 H 16 7 , a variety of the prin- 
ciple Aloin, which is common to all varieties of aloes, — also Aloetic and 
Chrysammic Acids. Dose, gr. j-v. 

Aloe Capensis, Cape or Natal Aloes, from Aloe ferox, is another 
variety of the same plant. 

Aloinum, Aloin, — a neutral principle obtained from several varieties 
of Aloes, chiefly the above-named, which yield respectively Barbaloin 
and Soaloin. These are soluble in 60 of water, 20 to 30 of alcohol, and 
in 380 to 470 of ether. Soaloin is soluble in 9 parts of acetic ether. 
Dose, gr. ss-ij. 

Preparations. 

Aloe Purificata, Purified Aloes, — prepared from Socotrine Aloes by melting and 
mixing with ith of Alcohol, straining and evaporating. The product is in irregular, 
dull-brown, brittle pieces, almost entirely soluble in alcohol. From it are prepared the 
following preparations. Dose, gr.j-v. 

Extractum Aloes, Extract of Aloes, — prepared by mixing I part of Socotrine Aloes 
with 10 parts of Boiling Distilled Water, standing 12 hours, decanting, straining and 
evaporating. Dose, gr. ss-v. 

Tinctura Aloes, Tincture of Aloes, — has of Aloes 10, Glycyrrhiza 20, Diluted Alco- 
hol to 100 parts. Dose, 3 ss-ij. 

Tinctura Aloes et Myrrhae, Tincture of Aloes and Myrrh, — Aloes 10, Myrrh 10, 
Glycyrrhiza 10, Alcohol and Water to 100 parts. Dose, 3 ss-ij. 

Pilulae Aloes, Pills of Aloes, — each has of Aloes gr. ij, with the same quantity of 
Soap. 

Pilulae Aloes et Asafetidae, Pills of Aloes and Asafetida, — each pill contains gr. 
1 1/3 of each ingredient. 



ALTH^A. 119 

Pilulse Aloes et Ferri, Pills of Aloes and Iron, — each pill contains gr. j each of 
Aloes, Sulphate of Iron and Aromatic Powder, with Confection of Rose. 

Pilulae Aloes et Mastiches, Pills of Aloes and Mastic, Lady Webster 's Pill, — each 
pill has of Aloes gr. ij, Mastic gr. ss, Red Rose gr. ss. 

Pilulae Aloes et Myrrhse, Pills of Aloes and Myrrh, — each pill contains of Aloes 
gr. ij, Myrrh gr. j, Aromatic Powder gr. ss, mixed with Syrup. 

Pulvis Aloes et Canellae, Powder of Aloes and Canella (Unofficial), — contains the 
powdered bark of Canella alba. Dose, gr. v-xx. 

Aloes is also a constituent of Pilulae Rhei Compositse and Tinctura Benzoini Com- 
posita (which see, under Rheum and Benzoinum respectively). 

Physiological Action and Therapeutics. 

Aloes is a tonic-astringent and resin-bearing purgative, an emmena- 
gogue and an anthelmintic against the thread-worm. As a cathartic it 
acts chiefly on the lower half of the large intestine, in doses of gr. j-iv 
producing in about 10 hours copious soft evacuations with some griping 
pain. This effect is produced whether the drug be taken internally or 
absorbed from an exposed surface, so that it probably diffuses into the 
blood and is eliminated by the mucous membrane of the colon. It is a 
stomachic tonic in small doses, a stimulant of the hepatic functions, and 
an excitant of the pelvic circulation. It may cause abortion in the female 
and priapism in the male, and is said to have frequently produced hemor- 
rhoids, which if existing it will certainly aggravate. Given to nursing 
mothers it imparts a purgative quality to their milk. 

Aloes is chiefly used in combination with Iron, Myrrh, Nux-vomica, 
etc., for amenorrhcea and chronic constipation with atonic dyspepsia and 
hypochondriasis. It is curative in certain forms of hemorrhoids, espec- 
ially those occurring after delivery and where the condition is not one of 
active pelvic congestion. It is also used internally and as an injection 
in gonorrhoea, and for simple atonic jaundice. It must be avoided in 
irritable rectum, hemorrhoids of active form, menorrhagia and pregnancy, 
unless given in small doses and with care. The Pil. Aloes et Ferri is 
perhaps the most generally useful agent in the anaemia, amenorrhcea and 
constipation of girls at the period of puberty. 

ALTHAEA, Marsh-Mallow, — is the root of Althcea officinalis, a European plant 
of the nat. ord. Malvaceae. It contains about 35 per cent, each of vegetable mucus 
and starch, with 2 per cent, of Asparagin, also pectous matter, sugar, fixed oil, but no 
tannin. It is a constituent of Massa Hydrargyri and Pilulse Phosphori, and is much 
used as an excipient in extemporaneous pharmacy. Dose, indefinite. 

Syrupus Althaeae, Syrup of Althcea, — has of Althaea 5 per cent., and should be 
freshly made. Dose, indefinite. 

xAlthaea is one of the best mucilaginous drugs, but has no active medicinal properties. 
It is used in Europe to make pectoral teas and syrups, and is extensively employed as a 
mucilaginous demulcent. The powdered root makes a good emollient poultice. In the 
Ger. Phar. a Compound Althaea Tea is official, which under the common name, " Ger- 
man Breast Tea," is a popular demulcent drink in bronchial affections, coughs, etc. 

Asparagin is an organic principle, occurring in large rhombic crystals, and found in 
many other plants, as in the shoots of asparagus, vetches, potatoes, liquorice, the sweet 
almond, the root of the locust, etc. It is considered a derivative of Succinic Acid, and 



120 ALUMEN ALUMINUM. 

has diuretic properties, besides being sedative to the circulation. It may be used in as- 
cites, especially in children, in the anasarca of Bright's disease, and in gout. Dose, gr. 
ij-iij, in water. 

ALUMEN, Alum, Potassium Alum, — is Aluminum and Potassium 

Sulphate, A] 2 K 2 (S0 4 ) 4 -f- 24H 2 0, which, when the 24 molecules of water 

are driven off, becomes Alumen Exsiccatum, Dried Alum, A1 2 K 2 - 

(S0 4 ) 4 . Alum occurs in large, octahedral crystals, or cubes, of sweetish 

astringent taste and acid reaction. It is soluble in 9 parts of water at 59 

F., and in 0.3 part of boiling water, but is insoluble in alcohol. The 

Ammonia-alum (Alumini et Ammonii Sulphas) was formerly official, and 

is still sold and dispensed as "Alum." Dose, gr. x-xx, — as an emetic 3J 

for a child. 

Alumen Exsiccatum, Dried Alum, — is a white, granular powder, slowly soluble in 
20 parts of water at 59 F., and quickly soluble in 0.7 of boiling water. Dose, gr. x-xx. 

Alum is an astringent, coagulating albumen and stimulating muscular 
contraction. At first it excites the flow of saliva and then markedly 
diminishes it. It coagulates pepsin and arrests digestion, stops peristalsis, 
and usually causes constipation, though sometimes inducing diarrhoea. 
Although coagulating albumen, even in weak solution, it enters the blood, 
constricts the capillaries, arrests secretions, especially those of mucous 
surfaces, and stops capillary hemorrhage. In teaspoonful doses Alum is 
an efficient and non-depressant emetic. In large doses it is a gastro- 
intestinal irritant, ^ j^$ of dried Alum having caused the death of an adult 
in 8 hours. 

Alum is used locally as an astringent in chronic catarrhs, leucorrhoea, 
gonorrhoea, hemorrhoids, bed-sores, ulcers, relaxed throat, colliquative 
sweats, catarrhal ophthalmia and granular lids. The dried powder is 
escharotic, destroying granulations and warty growths, and is used by 
insufflation in chronic nasal catarrh. Internally it is beneficial in gastric 
catarrh, gastralgia, enteralgia, passive hemorrhages, lead colic and con- 
stipation. As an emetic it is employed in croup, and it is a good antidote 
in lead-poisoning. Alum is best administered alone, as it forms precipi- 
tates with a large number of drugs. 

ALUMINUM. — This metal is not official, though of its salts two are official be- 
sides Alum. They are — 

Alumini Hydras, Aluminum Hydrate, Hydrated Alumina, Al 2 (OH) 6 , — is a white, 
light, amorphous, tasteless powder, insoluble in water or alcohol, but soluble in strong 
alkaline or acid solutions. Dose, gr. iij-xx in powder or mixture. 

Alumini Sulphas, Aluminum Sulphate, A1 2 (S0 4 > 3 + l6H 2 0, — is a white crystalline 
powder, soluble in 1. 2 of water at 59 F., almost insoluble in alcohol. Used locally. 

The Hydrate is a feebly astringent and desiccant powder, occasionally used in inflam- 
matory skin affections as a local application, and internally in diarrhoea. 

The Sulphate is antiseptic and astringent. It has been used internally in diarrhoeas, 
but is chiefly employed in a 5 per cent, solution locally to ulcers, or in stronger solution 
( ^iij ad ^ vj) in foul discharges from mucous surfaces. A saturated solution is a mild 



AMMONIACUM AMMONIUM. 121 

caustic, and may be used daily as a local application to enlarged tonsils, nasal polypi, 
ulceration of the os uteri, and various chronic enlargements. The Benzoinated Solution 
of Alumina is an unofficial preparation used for the same purposes. 

Alumnol (Unofficial), — is an aluminum salt of naphtol-sulphonic acid, and is 
readily soluble in cold water. It is markedly antiseptic and astringent, and though pre- 
cipitating gelatin and albumen, the precipitate is soluble in an excess of either, so that 
when it is used on purulent discharges they do not clog up cavities, and desirable pene- 
tration below the surface is accomplished. It has been used both dry and in solution, 
as a dressing for wounds, ulcers, etc. , also for acute inflammatory and parasitic affections 
of the skin, and in acute and chronic inflammations of mucous membranes. In I to 3 
per cent, solution it makes a fair injection for gonorrhoea, and a 4 per cent, solution is 
used by ophthalmologists to check lachrymal discharge during an examination of the eye. 
It neither irritates nor causes pain. It is four times as expensive in this country as in 
Germany, where it originated. 

AMMONIACUM, Ammoniac, — is a gum-resin, obtained from Dorema Anwio- 
niacum, a Persian plant of the nat. ord. Umbelliferse. When triturated with water it 
readily yields a milk-white emulsion, and contains a Volatile Oil, which differs from that 
of Asafcetida, in that it is neither sulphuretted nor phosphoretted. It also contains resin, 
gum, gluten, etc. Dose, gr. x-xxx. 

Emulsum Ammoniaci, Emulsion of Ammoniac, — an emulsion with water of 4 per 
cent, strength, the resin being suspended by the contained gum. Dose, ^ss-j. 

Emplastrum Ammoniaci cum Hydrargyro, Anwioniac Plaster with Mercury. — 
Ammoniac 72, Mercury 18, Oleate of Mercury 8 per cent., and contains also Lead- 
plaster, and Dilute Acetic Acid. 

Ammoniac is a stimulating expectorant and a laxative, and has a mildly irritant action 
on the skin. Its actions are similar to those of Asafoetida, but much less powerful. It 
is not much used, but may be employed with benefit in chronic bronchial affections, 
especially of the aged, the mixture with Ammonium Chloride or Carbonate facilitating 
expectoration and lessening wheezing. It is also recommended in asthma, and in gland- 
ular enlargements and indolent swellings the plaster is employed as a stimulating alter- 
ative and resolvent. 



AMMONIUM, NH 4 , — is a hypothetical compound radical, which 
does not exist in the free state, but which in combination with acids forms 
salts which closely resemble those of the elements Potassium and Sodium. 
Many of its salts are official, as well as the aqueous solutions of the gas 
Ammonia, NH 3 , which is produced during the putrefaction of all organ- 
isms, and of many organic nitrogenous compounds existing in the air and 
in the soil in the free state. The chief commercial source of Ammonium 
salts is the ammoniacal liquor from gas-works and bones. 

Aqua Ammoniae, Ammonia Water, — is an aqueous solution of Ammonia, contain- 
ing 10 per cent, by weight of the gas. It is a colorless liquid of pungent odor, acrid 
taste and strongly alkaline reaction. Sp. gr. 0.960 at 59 F. Dose, TTLv-^ss, well 
diluted. 

Aqua Ammoniae Fortior, Stronger Ammonia Water, — contains 28 per cent, by 
weight of the gas. Sp. gr. 0.901 at 59 F. 

Spiritus Ammoniae, Spirit of Ai?i7nonia, — is a 10 per cent, solution of the gas in 
alcohol. Sp. gr. about 0.810. Dose, rr^x- 3 j, diluted. 

Spiritus Ammoniae Aromaticus, Aromatic Spirit of Ammonia, — contains Am- 
monium Carbonate, Aqua Ammonite, Oils of Lemon, Lavender, and Nutmeg, Alcohol 
and Water. Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammo- 
niata. Dose, 3 ss-ij. 

Linimentum Ammoniae, Ammonia Liniment, — has of Aqua Ammoniae 35 parts, 
Cotton-seed Oil 60, Alcohol 5 parts. 



122 AMMONIUM. 

Ammonium Salts and their Preparations. 

Liquor Ammonii Acetatis, Solution of Ammonium Acetate {Spirit of Minder erus), 
— is prepared by neutralizing Dilute Acetic Acid with Carbonate of Ammonium, and 
contains about 7 per cent, of the Acetate. It should be freshly made. It is used in 
Liquor Ferri et Ammonii Acetatis. Dose, 3J-3J. 

Ammonii Benzoas, Ammonium Benzoate, NH 4 C 7 H 3 2 , — in minute four-sided, lami- 
nar crystals, soluble in 5 of water and 28 of alcohol at 59 F. Dose, gr. v-xv. 

Ammonii Bromidum, Ammonium Bromide, NH 4 Br, — in prismatic crystals or as a 
granular salt, soluble in I y^ of water and 30 of alcohol at 59 F. Dose, gr. ij-xx, well 
diluted. Children bear it well if epileptic from reflex causes. A child I year old will 
tolerate gr. v every 4 hours (Barton). 

Ammonii Carbonas, Ammonium Carbonate, NH 4 HC0 3 .NH 4 NH 2 C0 2 , — occurs in 
white masses consisting of both the bicarbonate and carbonate, which on exposure to 
air become a white powder (acid carbonate). Soluble in 5 parts of water. Dose, gr. 
iij-x. For children small doses, gr. J^-ij, frequently repeated. 

Ammonii Chloridum, Ammonium Chloride {Sal-ammoniac), HN 4 C1, — a white, 
crystalline powder, of saline taste, and slightly acid reaction ; soluble in 3 of water and 
very sparingly in alcohol. Dose, gr. j-xx. 

Trochisci Ammonii Chloridi, Troches of Ammonium Chloride, — each contains \)/ z 
grains of the Chloride. Dose, j-x troches. 

Ammonii Iodidum, Ammonium Iodide, NH 4 I, — a deliquescent, granular, white salt, 
soluble in 1 of water and 9 of alcohol at 59 F. Dose, gr. ij-x. 

Ammonii Nitras, Ammonium Nitrate, NH 4 N0 3 , — in colorless crystals or fused 
masses, soluble in 0.5 of water and 20 of alcohol at 59 F. Only used to prepare Nitrous 
Oxide Gas by heating to 365 F. , for anaesthesia. 

Ammonii Valerianas, Ammonium Valerianate, NH 4 C 5 H 9 9 , — in white, quadrangu- 
lar plates, deliquescent ; very soluble in water and alcohol. Dose, gr. j-v. 

Raspail's "Eau Sedative" (Unofficial), — consists of Aqua Ammonise ^ij, Sodii 
Chloridum 51J, Spiritus Vini Camphorat. ^iij, Aqua ^xxxij. For local use. 



Physiological Action. 

The gas Ammonia is intensely alkaline and irritant to mucous mem- 
branes; inhaled producing spasmodic cough and a sense of suffocation. 
Its prolonged inhalation will induce violent inflammation of the air-pas- 
sages and oedema of the glottis. It stimulates the nasal branch of the fifth 
nerve, exciting the vaso-motor centre by reflex action, and thus raising 
the arterial tension. Applied to the skin and allowed to evaporate, it has 
a slight rubefacient effect, but if evaporation be prevented it penetrates 
the epidermis, and has a powerfully vesicant action. The Aqua, swal- 
lowed undiluted, may cause death quickly by suffocation from the action 
of its vapor upon the air-passages ; if not, it may excite gastro-enteritis 
accompanied by coma, differing in the latter respect from potassium or 
sodium poisoning. After absorption it stimulates both the respiration 
and the circulation by direct action on their respective nerve-centres. 
Ammonia exists normally in the circulation, where it keeps the fibrin in 
solution and thus maintains the fluidity of the blood. It increases the 
glycogenic function of the liver, and is converted finally into urea. It 
is a powerful irritant to muscular tissue, causing tetanic contraction and 
subsequent rigor mortis when directly applied. 

Ammonium Salts all stimulate and finally paralyze the spinal cord, 



AMMONIUM. 123 

motor nerves and muscles, in animals, but the order and intensity of the 
action vary with the salts employed, some having a predominating influ- 
ence on the cord, others on the motor nerves. In general they may be 
said to form a series, of which the members at one end stimulate the cord, 
and those at the other paralyze both the cord and the motor nerves. At 
the stimulant end are Ammonia and the Chloride; at the paralyzant end 
the Iodide ; the Bromide, Phosphate and Sulphate lying between (Brun- 
ton). In medicinal doses they act on man as stimulating expectorants, in 
large quantity they injure the structure of the red blood-corpuscles, and 
if long continued they produce rapid emaciation by impairing digestion 
and increasing tissue-waste. 

The Chloride has decided cholagogue powers, increases the excretion 
of urea, in 20-grain doses is purgative, and is considered to have a select- 
ive action upon the gastric mucous membrane. The Carbonate is a 
powerful and very diffusible stimulant ; when administered internally in 
moderate doses it is probably decomposed by the HC1 of the gastric 
juice, nascent ammonia being set free and absorbed. It stimulates the 
respiratory centre, acts as a stimulating expectorant, and in very small 
doses stimulates the secretion of the gastric juice. It is also emetic, and 
has been supposed to prevent iodism when administered conjointly with 
Iodide of Potassium. The Solution of the Acetate is an active dia- 
phoretic if the body be warm, or a diuretic if it be cool. In wineglassful 
doses it will counteract many of the immediate effects of alcohol. The 
Phosphate is diuretic, and is believed to decompose the insoluble Sodi- 
um Urate in the blood, converting it into the soluble salts Ammonium 
Urate and Sodium Phosphate, and thus promoting its elimination. The 
Benzoate is also diuretic, and like Benzoic Acid passes out of the system 
in the urine as Hippuric Acid. It stimulates the liver, and acidifies the 
urine where there is phosphatic tendency thereof. The Nitrate and 
Sulphate are only used for the preparation of other salts, while the 
Iodide, Bromide and Valerianate correspond in action to that of their 
titular bases, and are described under their respective titles, Iodum, 
Bromum and Valeriana. 

Antidote's and Antagonists . 

When Ammonia is inhaled in excess give HC1 vapors by inhalation to form the chlo- 
ride ; if taken in solution, give Vegetable Acids, and demulcents to protect the mucous 
surfaces. Its physiological antagonists are the cardiac sedatives, Aconite, Digitalis, 
Veratrum, etc. 

Therapeutics. 

The strong solution of Ammonia may be used as a rubefacient and 

vesicant, and its vapor, by cautious inhalation, in syncope and the results 

of shock. Locally, it is a good application to bites of the less venomous 

reptiles and to the stings of insects. The Carbonate is used inter- 



124 AMMONIUM. 

nally in the eruptive fevers, delirium tremens, continued fevers, pneu- 
monia, etc., where much depression exists; as a stimulating expectorant 
in chronic bronchitis, in the broncho-pneumonia of children, and in 
cardiac asthma. It is highly recommended in scarlet fever in doses of 3 
to 5 grains every one, two or three hours, all acid drinks or fruits being 
prohibited while it is being administered. With ten-minim doses of tinc- 
ture of capsicum in an ounce of some bitter infusion it is exceedingly 
efficient, in 5-jo-grain doses, for the sinking sensations and craving for 
stimulants experienced by subjects of alcoholism. It may be used as an 
emetic in bronchitis, when the tubes are choked with mucus and the cir- 
culation of the patient is weak. It may also be employed by inhalation, 
and administered internally, for similar purposes as Liquor Ammoniae. 

In doses of 5 grains, administered hypodermically in the vicinity of wounds caused by 
poisoned arrows, the Carbonate was repeatedly used by Dr. Parke, Stanley's surgeon in 
Africa, with entire success in saving life when so employed immediately after injury. 
Those so wounded at too great a distance to receive this treatment invariably died within 
a short period of time. 

The Chloride has high repute in catarrh of the stomach, with anorexia, 
bad taste in the mouth, flatulence, coated tongue, etc., in short, the 
symptoms of so-called " biliousness ; " also, in chronic congestion of the 
liver, jaundice from catarrh of the bile-ducts, nervous and sick headaches, 
myalgia, amenorrhcea, muscular rheumatism and neuralgia. In the latter 
affection it should be given in 30-grain doses several times a day. It is 
also efficient in bronchial catarrh without fever, and in chronic bronchitis 
when the secretion is scanty and tough. It is remarkably efficient in 
straightening up a victim of acute alcoholism ; administered to one on 
the verge of delirium tremens, in dose of y% drachm in half a pint of 
water, swallowed at one draught, it is said to restore the patient's faculties 
so quickly as to astonish those who have never seen it so employed. 
Locally, in solution, it has been well employed in inflammatory swellings, 
as sprains, inflamed joints, orchitis, etc., as a lotion ; also, to allay itch- 
ing in prurigo, to remove ecchymoses and glandular enlargements. Eau 
Sedative is often a good local application in headaches. 

The Solution of the Acetate is especially beneficial in the exanthe- 
mata, influenza, coryza, anomalous febrile conditions of children, acidity 
and vomiting ; also in acute alcoholism and in erysipelas when there is 
feeble circulation, cyanosis and delirium. It is frequently combined with 
Spirit of Nitrous Ether, as a diuretic and diaphoretic in febrile affections. 
The Phosphate is particularly applicable to gout and lithaemia, and is a 
very efficient cholagogue. The Benzoate is useful in cystitis with alka- 
line urine and phosphatic deposits, as it acidulates the urine, at the same 
time stimulating and disinfecting the mucous coat of the bladder. 

Aqua Ammonite has been administered by intra-venous injection, with 
efficacy and safety, in sudden or threatened thrombosis, impending car- 



AMYGDALA. I 25 

diac paralysis during Chloroform anaesthesia, and in poisoning by Hydro- 
cyanic Acid and other cardiac depressants. In the same manner, it has 
been employed, but unsuccessfully, in poisoning by the bite of venomous 
reptiles. Ten drops of the strong Liquor are diluted with three parts of 
water, and carefully injected into a vein, all air being rigorously excluded 
from entrance thereinto. 

The therapeutics of the Iodide, Bromide and Valerianate are enume- 
rated under the titles Iodum, Bromum and Valeriana respectively. 



AMYGDALA, Almond. — The seeds of two varieties of Prunus 
Amygdalus (nat. ord. Rosacese), namely Amygdala a??iara and Amygdala 
dulcis, are official, together with several preparations, some prepared from 
one variety, some from another, while one is from either and one from 
both. An important point is the reaction between Amygdalin and Emul- 
sin in the presence of water producing Hydrocyanic Acid (see ante, page 
87). Amygdalin, C 20 H 27 NO n , is a crystalline glucoside, existing in 
Amygdala amara but not in Amygdala dulcis ; while the ferment Emulsin 
is common to both varieties. 

Amygdala Amara, Bitter Almond, — is the seed of Prunus Amygda- 
lus, var. amara, a tree of the nat. ord. Rosacese, indigenous to Western 
Asia, but cultivated in many other parts of the world. The seed has an 
embryo of bitter taste, which, when triturated with water, emits an odor 
of Hydrocyanic Acid. Cultivated chiefly in Spain and the Balearic Islands. 

Amygdala Dulcis, Sweet Almond, — is the seed of Prunus Amygdalus, 
var. dulcis, a tree of the nat. ord. Rosacea?. The bitter and sweet almond 
trees are identical botanically, and the fruits and seeds of the two varieties 
resemble each other closely, only differing in taste and the presence 
of Amygdalin (see above). The sweet almond is largely cultivated about 
Malaga and in California. 

Preparations. 

Aqua Amygdalae Amarae, Bitter Almond Water, — is a weak solution of the Oil ot 
Bitter Almond in Distilled Water (1 to 1000). Is only a flavored water. Dose in- 
definite. 

Oleum Amygdalae Amarae, Oil of Bitter Almond, — is a volatile oil, of peculiar and 
aromatic odor, bitter, burning taste, and neutral reaction ; soluble in 300 of water, but 
freely in alcohol and ether. Dose rr\^-j, in mixture. 

This essential oil, one of the products of the reaction between Amygdalin and Emul- 
sin (see ante, p. 87) , contains a varying quantity of Hydrocyanic Acid (3 to 14 per cent.), 
which may be removed by distillation with caustic potash. Nitrobenzol, or '* Oil of Mir- 
bane," closely resembles the oil of bitter almond, and like it is used for flavoring. It 
contains no Hydrocyanic Acid, but is a dangerous poison, producing toxic effects when 
inhaled, even in small doses. 

Spiritus Amygdalae Amarae, Spirit of Bitter Almond, Essence of Bitter Almond, 
— has of the Oil I, dissolved in Alcohol 80, and Water added to 100 volumes. Dose, 
to be regulated by the quantity of alcohol desired. 

Syrupus Amygdalae, Syrup of Almond , — has of Bitter Almond 4 per cent., of Sweet 
Almond 14. Dose indefinite. 



126 AMYL NITRIS. 

Emulsum Amygdalae, Emulsion of Almond, — made of Sweet Almond 6 per cent., 
with Acacia, Sugar and Water. A demulcent drink, used as a vehicle for cough mix- 
tures. Dose, ^ ij— 3 ss. 

Oleum Amygdalae Expressum, Expressed Oil of Almond, — is the fixed oil which 
is expressed from either Bitter or Sweet Almond. Used in Unguentum Aquae Rosre, and 
as a bland local application in skin affections. 

Physiological Action and Therapeutics. 

The bitter and sweet varieties of the species Primus A?nygdalus differ 
in action only through the agency of the principle Amygdalin contained 
in the former. The Sweet Almond is demulcent and nutritive, while the 
fixed oil expressed from either variety is a bland application, having the 
same action as Olive Oil. The action of the Bitter Almond and its oil is 
due to the Hydrocyanic Acid contained in them (see ante, p. 87). 

The Expressed Oil of Almond is demulcent, and in doses of gj-ij a 
mild laxative. It is used externally for excoriations, chapped hands, and 
inflammatory skin affections, and is applied to the ear in earache. The 
cake remaining after the expression of the fixed oil from the sweet almond 
is ground into flour, and used in the form of biscuits for diabetics as a 
substitute for bread, as it contains no starch. 

The Oil of Bitter Almond is used as a flavoring agent, and may be 
employed locally or internally in lieu of Hydrocyanic Acid. The Syrup 
is somewhat sedative, but is generally used as a demulcent or for flavoring 
purposes. The Emulsion is used in catarrhal affections and as a vehicle 
for cough-mixtures. The poisonous character of the Bitter Almond and 
its essential oil (Oleum Amygdalae Amarse) should be kept in mind. 



AMYL NITRIS, Amyl Nitrite, — is a liquid containing about 80 
per cent, of Amyl Nitrite, C 5 H n N0 2 , together with variable quantities of 
undetermined compounds. It occurs as a clear, yellowish liquid, of 
ethereal and fruity odor, aromatic taste, and neutral or slightly acid 
reaction, extremely volatile, insoluble in water but freely soluble in 
alcohol, ether, chloroform and benzin. It is produced by the action of 
Nitric or Nitrous Acid upon Amylic Alcohol, and when impure may have 
Nitric or Hydrocyanic Acid in it. Dose internally vi}{-) dissolved in 
alcohol, — by inhalation fitij-v; but larger doses are probably safe. 

Analogous Conipotinds 

Glonoinum, Glonoin, Nitroglycerin, Irinitrin, Glyceryl Trinitrate, C 3 H 5 (N0 3 ) 3 , — 
is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., produced 
by the action of Nitric and Sulphuric acids upon Glycerin. It is a dangerous explosive, 
and should not be kept in stronger solution than I per cent. Dose, T1V,2lyo to -^ or more, 
according to susceptibility. Official in the Spirit. 

Spiritus Glonoini, Spirit of Glonoin, Spirit of Nitroglycerin, — is a I per cent, solu- 
tion in alcohol. Dose, TT\^-x. The strong tincture sold by the homoeopathic pharma- 
ceutists and official in their American Pharmacopoeia is a 10 per cent, solution, or ten 
times the strength of the above. It is an extremely dangerous preparation, both as an 



AMYL NITRIS. \2J 

explosive and as a medicine. (See American Homoeopathic Pharmacopoeia , 2d ed., 
Boericke & Tafel, 1 883, page 235.) 

Tabellae Nitroglycerin! (B. P.), Tablets of Nitroglycerin, — are tablets of chocolate, 
each containing gr. t ^q of pure Nitroglycerin. Dose, j-ij. 

Sodii Nitris, Sodium Nitrite, NaN0 2 , and Potassii Nitris, Potassium Nitrite 
(the latter unofficial), — are used as substitutes for Amyl Nitrite and Nitroglycerin. The 
former is a white, crystalline powder, deliquescent in the air, in which it gradually oxidizes 
to sodium nitrate ; has a mild, saline taste, but no odor ; very soluble in water, slightly 
in alcohol. Dose, gr. ss-iij, according to individual susceptibility. 

Ethyli Nitris, Ethyl Nitrite, C 2 H 5 N0 2 , — constitutes about 5 per cent, of Spiritus 
.-Etheris Nitrosi. (See page 100, ante.) 

Physiological Action. 

Amyl Nitrite and the other Nitrites agree closely in their general 
action, producing great vascular dilatation by paralyzing either the sym- 
pathetic system, the vaso-motor centre or the muscular coat of the arteri- 
oles, — which, is yet undecided. They cause tumultuous action of the 
heart by relaxing its inhibition ; lowered respiration, from paralysis of the 
respiratory muscles and impairment of the ozonizing function of the blood ; 
diminution of sensation, motility, and reflexes; a sense of heat, but 
lowered body-temperature; also throbbing pain in the head, beating 
carotids, quickened pulse, flushed face and vertigo. 

The effect of an ordinary inhalation of Amyl Nitrite on man is very 
transitory, excepting the headache, which may last several hours. Of all 
the nitrites it is the most prompt but least enduring in action, and is best 
administered by inhalation. It causes sugar to appear in the urine and 
increases the quantity of urine voided. Mixed with blood it forms 
methaemoglobin, which is not so readily deoxidized as haemoglobin, and 
under its influence the blood in the body becomes of a dark chocolate 
color both in the arteries and in the veins. 

Nitroglycerin acts similarly, but less promptly, and its action is more 
enduring. Its headache is of intensely frontal character, and persists for 
hours after the other effects have passed off. It is more suitable for inter- 
nal administration. Sodium Nitrite is also slower in action than Amyl 
Nitrite, and does not cause so much throbbing headache as Nitroglycerin. 
It may be given in solution with water. The action of all these agents is 
probably due to the Nitrous Acid contained in them. 

Antagonists. 

Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other agents 
which increase the functional activity of the spinal cord and sympathetic are antagon- 
istic, though by reason of their slower rate of diffusion the antagonism may not be always 
available. Stimulants, artificial respiration, the alternate cold and hot douche, with cold 
to the head, and Ergotin or Atropine subcutaneously, are the best means to be used in 
cases of poisoning by the Nitrites. 

Therapeutics. 
The inhalation of Amyl Nitrite is a useful palliative in angina pectoris, 
epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic 



125 AMYLUM. 

asthma, whooping-cough, laryngismus stridulus, etc. It is also indicated 
in migraine of the pale-face form, and in the cold stage of intermittents 
and pernicious remittents, to prevent internal congestion, — also in convul- 
sions of various kinds, including the puerperal form. It has been some- 
times used in threatened death from chloroform anaesthesia, and in poi- 
soning by strychnine. 

Nitroglycerin is employed with benefit in neuralgic dysmenorrhea 
and sea-sickness; also in chronic interstitial nephritis, by redistributing 
to the kidneys their blood-supply cut off by degeneration of the renal 
ganglionic centres. It promptly relieves hiccough, also migraine of spas- 
modic character, and has afforded immediate relief in neuralgia of the 
fifth and in sciatica. Its administration in angina pectoris, though not 
producing such prompt results as that of Amyl Nitrite, gives excellent 
and much more lasting effects. It is useful in the weak heart of the aged, 
or that from fatty degeneration, or when, as in Bright's disease, the arte- 
rial tension is above normal ; also in irritable and overacting heart, which 
it relieves by rapidly dilating the arterioles and thereby lowering arterial 
tension. 

Sodium Nitrite has been successfully employed in angina pectoris, 
hemicrania, and in asthma of purely bronchial and neurotic origin. It 
has also proved decidedly beneficial in the abnormally high arterial ten- 
sion of chronic desquamative nephritis, especially when complicated with 
a weakened and dilated heart. Disagreeable symptoms caused by it may be 
prevented by prescribing it with spirit of chloroform or ammonia water 
and small doses of morphine. 

AMYLUM, Starch, C 6 H 10 O 5 , — is the feculaof the seed ot Zea Mays, 
Maize or Indian Corn, a plant of the nat. ord. Graminaceae. Though 
corn starch is the official kind, any other might be properly used, as the 
starch occurring in wheat, barley, oats, arrow-root, sago and tapioca, all 
of which foods were official in the U. S. P. of 1870. The last three are 
entirely composed of starch ; wheat contains about 70 per cent., and 
rice 90 per cent. 

Starch is a carbohydrate, and occurs in distinct grains, forming irregular angular 
masses, white, inodorous, and tasteless, easily pulverized, of neutral reaction, and insol- 
uble in alcohol, ether or cold water. Under the microscope the granules are seen to be 
lenticular in form and concentrically striated. When boiled with water it yields a 
whitish jelly of bluish tinge, which when cool gives a deep blue color with test-solution 
of iodine, the color disappearing on warming and returning on cooling. 

By boiling with dilute mineral acids Starch is converted into Glucose, 
Dextrin being formed as an intermediate product. Hot concentrated 
nitric acid converts it into Oxalic Acid, but cold fuming nitric acid dis- 
solves it, forming an explosive compound. Diastase, ptyalin and pan- 
creatin convert it into Glucose. [For Glycogen, Dextrin, Cellulose 



ANIMAL EXTRACTS. I 29 

and other allied substances see the article Saccharum in the following 
pages.] 

Glyceritum Amyli, Glycerite of Starch, — has of Starch 10 parts, Water 10, Gly- 
cerin 80, triturated and heated to a transparent jelly. Used as a vehicle for external 
applications. 

Starch, though a nutritive of the first order, may be regarded as inert 
medicinally. It serves as a protective and absorbent if dusted over the 
skin, as a vehicle for enemata, and as an antidote in iodine-poisoning. 
Mixed with glue it makes an excellent stiff bandage for surgical purposes. 



ANIMAL EXTRACTS (Unofficial).— The organs, tissues and 
secretions of animals were extensively employed as medicinal agents in 
ancient times, and many of them were official in the pharmacopoeias of 
the last century. At present the only ones so recognized are the diges- 
tive ferments, pepsin and pancreatin, ox-gall (fel bovis), and the secre- 
tion of the preputial follicles of the beaver (castoreum) and of the musk- 
ox (moschus). The first definite attempt in recent regular practice to 
apply animal tissues to the cure of disease was made in 1852 by Dr. 
Jackson of Philadelphia, who used as a tonic the blood of bullocks care- 
fully dried in vacuo, giving 5 to 10 grains thereof at a dose. Since then 
the drinking of fresh bullocks' blood has become a common practice in 
certain diseases. Raw meat was administered as a remedy for diabetes at 
St. Bartholomew's Hospital in London in 1874. The powdered Russian 
cockroach (Blatta orientalis) is still used as an efficient diuretic in drop- 
sies, and preparations of the bodies of various spiders and toads, also bee 
and serpent venoms, are recognized remedies in homoeopathic practice. 

The use of glandular extracts as remedies in disease is very old. It 
was revived in 1889 by Brown-Sequard's advocacy of orchitic (testicular) 
extract for impotence and several nervous affections, and was profoundly 
stimulated by the results of Dr. Murray's suggestion in 189 1 of thyroid 
extract for the cure of myxoedema. 

Testicle Extract is fully noticed in the ' ;< Seplasium or the Druggist's Shop Opened" 
by W. Salmon, published about 1 685. In this book the author describes the testicles 
taken from man or beast as consisting of " a Flegm, Spirit, Sulphur and Volatile Salt 
joined with some Earthy Particles ; the chief used are from Bull, Horse, Goat, Ram, 
Boar and Buck," which were cut out, carefully dried, and used to make a tincture, a 
spirit, an oil and a volatile salt. Salmon further says that " their virtues are very great, 
for they refocillate the Spirits, — Natural, Vital and Animal, — comfort the Head, Brain 
and Nerves, and resist all Diseases afflicting them, .... they restore in Con- 
sumptions, .... are also good against the Collick, and particularly strengthen 
the Instruments of Generation and provoke Lust." The same extract was also recom- 
mended by J. Fr. Leaulte, who wrote in 1717. According to Pliny the ancient Greeks 
and Romans ate the testicle of the ass for the purpose of curing impotence. 

According to the theory promulgated by Brown-Sequard, all glands, 
in addition to their ordinary secretions, elaborate certain materials of 
unknown chemical composition, which pass into the blood and perform 
9 



130 ANIMAL EXTRACTS. 

therein definite functions of some kind. We now know that such is the 
case with the thyroid gland, we suspect that it is equally true of the 
thymus, the spleen and the adrenals, and we have reason to believe it 
highly probable that the other glands of the body exert influences here- 
tofore unsuspected over distant parts of the organism. The effect of the 
entire removal of the thyroid, the pancreas or the adrenal glands is to 
produce the symptoms of characteristic and fatal disorders ; but if a por- 
tion of either of these glands be left behind these toxic symptoms 
do not develop, and the same is true of the thyroid and pancreas if, 
after their entire ablation, a portion be engrafted upon the peri- 
toneum. It is evident therefore that the disorders so produced are of 
auto-toxic origin, the result of chemical poisons in the blood which were 
previously neutralized, destroyed or eliminated by the removed gland or 
some of its secretions. It has also been shown that the subcutaneous 
injection of an aqueous extract of the dead gland will dispel the toxic 
phenomena which follow the removal of that gland, proving that the 
active principle thereof is a chemical substance existing in the gland itself, 
and that the previous immunity was not due to any action of its living 
cells other than that required to produce the active agent. The discovery 
that ablation of the testicles causes retrogression of the hypertrophied 
prostate, and that removal of the ovaries will cure osteo-malacia, as also 
the long-known facts that castrated individuals usually grow very obese 
and develope massive skeletons, while giants are generally endowed with 
atrophied testicles,— clearly point to the same conclusion. 

The animal extracts form a group of active medicinal agents which are 
proving worthy of careful investigation both physiologically and clinically. 
The study already given to them has yielded much new knowledge, and 
has shown indubitably that their employment as therapeutic agents rests 
on a scientific basis ; but most of them are as yet on trial, and the limits 
of their utility in medicine are by no means defined. They contain 
leucomaines, extractives and other chemical substances, all of which 
possess physiological powers, many proving distinctly poisonous when 
their excretion is prevented. Excepting thyroid extract and perhaps 
some others, the animal extracts are only active medicinally when injected 
subcutaneously or by the rectum, as most of them when given by the 
mouth are destroyed or altered in the stomach, or prevented by the liver 
from entering the general circulation. Physiological chemists are en- 
deavoring to separate their active principles, a line of research which 
promises more accurate and positive results. It is already demonstrated 
that some of their principles are the most powerful of all alteratives, and 
that others possess the most energetic action upon the muscular fibres in 
the walls of the arterioles. 

The initial doses of many animal extracts should be very small, in 



ANIMAL EXTRACTS. I 3 I 

order to avoid the possible systemic disturbance which has been frequently 
noticed by clinical observers as following on their administration. 

Sodium Phosphate in solution, administered hypodermically, is considered by Luton 
and Crocq, of Rheims, to be equally effective in reconstructive power with the animal 
extracts. (See under the title Phosphorus.) 

Thyroid Extract is the most efficient member of the group of ani- 
mal extracts. Its administration has been eminently successful in the 
treatment of myxoedema, which five years ago was classed among the in- 
curable diseases, but is now considered curable by thyroid feeding, or by 
the use of an extract of the thyroid gland of the sheep. Myxoedema is 
a symptom or combination of symptoms of thyroid absence or inadequacy, 
and occurs as a result of the removal of the gland or of disease impairing 
its functional activity. It is characterized by imperfect oxygenation of 
the blood, lowered body temperature, impairment of intellect, memory 
and speech, also increase of the fibrous tissue and subsequent mucoid de- 
generation thereof, with thickening of the skin, drying of the surface and 
shedding of the epithelial structures. When caused by ablation of the 
thyroid the disease is fatal to cats and dogs in a very few days, but their 
life has been saved by engrafting a portion of the removed gland in 
other situations, and also by intravenous injections of thyroid extract. 
This treatment of the idiopathic form of myxoedema was suggested and 
commenced by Professor Geo. R. Murray, of the University of Durham, 
in 1 89 1, and has since proved remarkably successful. At first the remedy 
was administered hypodermically, but it was soon found that the raw 
gland fed to the patient was equally efficient, or that a dry extract may 
be used. The latter represents the entire thyroid, divested only of its 
water, is easily administered and proves very efficient, improvement being 
usually noticed within a very few days, and going on steadily to apparent 
perfect recovery if the remedy is continued. The thickening of the skin 
disappears, the normal body heat returns, and speech, memory and intel- 
ligence are restored. In mild cases recovery is effected in a few weeks, 
but in severe ones several months of treatment are necessary ; and in 
most cases the symptoms of the disease return when the thyroid treatment 
is stopped, but disappear again when it is resumed. It is probable that 
the subjects of this disease will require to take a certain quantity of the 
remedy regularly and continuously for many years, perhaps for life. 

Dr. Murray has recently published the after history of the first case of myxoedema 
treated with thyroid extract. The patient, a woman, was 46 years of age in 1891, and 
had suffered from the disease for four or five years previously. Under the thyroid treat- 
ment, which was administered hypodermically, " she gradually lost all the symptoms of 
myxoedema, which however partly returned on two occasions when the use of the 
remedy was discontinued for a time. She has for long been free from myxoedema and 
is so now. The swelling has gone, and the skin is soft and moist ; the hair has grown 
again, the temperature is normal, and she leads an active life as the wife of a working 
man. She continues to take one drachm of thyroid extract during each week. As this 
case remains well at the end of more than four years it is evident that as long as she 



132 ANIMAL EXTRACTS. 

continues to take the extract she will not have myxcedema, even if she lives for another 
twenty years." {British Medical Journal, Feb. 8th, 1896.) 

Thyroid extract has produced great amelioration in cretinism (con- 
genital myxcedema) which is a thyroid disease, and the improvement has 
been steady and progressive in many cases while the remedy was used, 
but ceased as soon as it was discontinued. In psoriasis, eczema, ichthy- 
osis, pityriasis rubra, lupus, universal alopecia and some other skin affec- 
tions, it has been employed as a stimulant of the cutaneous functional 
activity with most satisfactory results ; several cases of psoriasis treated 
with this remedy alone recovered completely in the course of a few weeks 
(Bramwell). In exophthalmic goitre thyroid extract has been beneficial, 
and though some observers report ill effects from its use in this disease, 
others show that they were due to a primary aggravation of symptoms 
which subsides when the dose is largely reduced, and is then followed by 
distinct improvement under the administration of a very small quantity 
of the remedy (Bruns, etc.) In the insanity of the adolescent, climacteric 
and puerperal periods, the thyroid treatment has seemed to be especially 
beneficial (Bruce) ; but in several cases of insanity where there was paren- 
chymatous (not cystic) enlargement of the thyroid, the extract was used 
without result upon the mental affection though it diminished the size of 
the goitre and caused a marked loss of weight (Reinhold). In many 
cases its continued administration has produced emaciation, which fact 
suggested its employment for the reduction of obesity, and it has been 
successfully used for this purpose in many cases (Guttmann). It has 
given satisfaction in various other affections, including tetanus, ozaena, 
uterine fibroma and some forms of syphilis. 

A large dose of thyroid extract gives rise to marked constitutional 
symptoms, and several cases are recorded in which it has caused death. 
Nausea, vomiting, neuralgic pains in the back and limbs, and marked 
cardiac irritability and weakness even to syncope, are the principal symp- 
toms observed during its excessive use. It produces a distinct fall of the 
blood-pressure, even though the cardiac rate and force may remain un- 
affected, this effect being evidently due to its increasing the calibre of the 
vessels (Schafer and Oliver). In one case all the symptoms of diabetes 
developed under its continuous administration for psoriasis (James). In an- 
other instance a typical attack of gout came on, but subsided when the ex- 
tract was stopped, and reappeared when it was again administered (Harris). 

The chemical constituents of thyroid extract have not been definitely 
ascertained. According to Dr. Gourlay it contains a nucleo-albumin, a 
very small amount of proteid and possibly a ferment; but neither mucin, 
peptone nor proteose. 

Liquid Thyroid Extract is prepared from the fresh thyroids of the sheep, by macerat- 
ing them in equal parts of glycerin and water for 24 hours, and then squeezing through 



ANIMAL EXTRACTS. I 33 

fine calico. For hypodermic use the water employed in the menstruum should contain 
0.5 per cent, of carbolic acid. A dry extract, three times stronger than the liquid one, 
is made by expressing the juice from the glands, mixing it with sugar of milk, and dry- 
ing it on glass plates at a temperature of 90 F. The dose of this product is from 2^ 
to 5 grains at first, thrice daily by mouth ; which dose may be gradually increased as 
long as it causes no systemic disturbance. The Thyreoidin prepared by Parke, Davis & 
Co. of Detroit, is a dry powder, each grain of which represents 10 grains of the fresh 
gland or 1.6 grain of desiccated thyroid. The dose of this preparation is y z grain two 
or three times a day, to be increased at the discretion of the physician. 

Thyreo- Antitoxin is a substance recently obtained by Dr. Frankel from the thyroid 
gland, to which he has given the above name and assigned the formula C 6 H 11 N 3 (.) 5 . It 
is inodorous and tasteless, and produces rapid emaciation. It is improperly named an 
antitoxin. 

Thymus Extract. The thymus gland is active only during the developmental period 
of life, and becomes atrophied about the age of two years. The suggestion has been 
made that an extract thereof may prove useful in diseases characterized by defective de- 
velopment, as rachitis and pseudo-hypertrophic paralysis. It has been used with reported 
benefit in exophthalmos with anaemia and debility, also in leucocythaemia, chlorosis, idio- 
pathic and pernicious anoemia, and in Paltauf's so-called " status thymicus." The mode 
of preparation and dose are similar to those of thyroid extract. 

Bone Marrow Extract. — Red bone marrow has been long known 
as one of the sources of the red blood corpuscles, and it is thought prob- 
able that it contains chemical ingredients which may stimulate the pro- 
duction of blood cells by other blood-forming organs in which such 
natural stimulus may be lacking. In pernicious anaemia the marrow of 
the long bones shows characteristic changes, which fact suggested the 
administration of red bone marrow as a remedy for that disease. This 
treatment has proved remarkably successful even in cases which were 
apparently hopeless. One of the most striking cases so treated is that 
of the gardener patient of Professor Fraser of Edinburgh. Under the use 
of raw bone marrow by the stomach his blood corpuscles increased in 
number from less than 900,000 to over 4 millions per cmm., the propor- 
tion of haemoglobin rose from 18 to 35 per cent., and the man became 
well enough to resume his occupation. This use of bone marrow was first 
suggested by Dr. Dixon Mann, who administered a glycerin extract 
thereof in cases of haemophilia, chlorosis, profuse haematemesis and other 
anaemic affections, with good results. Its employment is indicated in 
disorders characterized by hyperfluidity of the blood, from whatever 
cause; and it may render good service in any debilitating or blood-im- 
poverishing affection, and in convalescence after severe osteitis. The 
raw marrow, freed from spicules of bone, may be administered to the 
amount of about 3 ounces daily in divided doses : or it may be given as a 
paste made with wine, glycerin and gelatin. Tablets, containing from 
1^2 to 5 grains each of the dried marrow, are on the market and may be 
used if preferred. 

Nuclein is a proteid substance, possessing a large proportion of Phos- 
phorus in the form of Nuclei7iic Acid, which is combined with a highly com- 
plex base, the latter being different in the different tissues. Nucleins are the 



134 ANIMAL EXTRACTS. 

chief chemical constituent of cell nuclei, and their number is limited only 
by the varieties of the cells. They are found in both animal and vege- 
table tissues ; wherever there is a nucleus we find a nuclein. They are 
generally insoluble in dilute acids, but are soluble in dilute alkalies, and 
resist peptic digestion. Their functions in the organism are supposed to 
be (i) that of a natural antiseptic, to destroy toxic products which may 
accumulate through faulty elimination, and (2) that of a natural bacteri- 
cide, to resist microbic invasion. Two nucleins only have been clini- 
cally studied in this country, that obtained from yeast-cells and that from 
the thyroid and thymus glands. 

Nuclein is harmless, causing no functional derangement when admin- 
istered by the stomach or subcutaneously, even in very large doses. When 
injected hypodermically its principal effect is to produce a very marked 
increase of leucocytic activity (an artificial leucocytosis), both in healthy 
and in tuberculous subjects. The increase is observed to be chiefly of the 
polynuclear leucocytes ; it varies in degree with the individual, appears 
within three hours after administration of the nuclein, and disappears 
after forty-eight hours or thereabouts (Huber). The effect is to energize 
any existing inflammation, or to awaken such when comparatively quies- 
cent, as in latent tuberculosis (See). 

Nuclein was introduced into medicine by Professor Vaughn of the Uni- 
versity of Michigan. Its employment as a therapeutic agent is based on 
the assumption that for immunity against and the cure of bacillary dis- 
eases we should look to non-toxic germicides of cellular origin, and to 
substances which stimulate the activity of those organs whose function it 
is to protect the body against such invasion. As the nucleins apparently 
fulfil these requirements they have lately excited considerable attention 
among the advocates of animal extracts. Nuclein has been successfully 
used in diphtheria, suppurative tonsillitis and other suppurative disorders, 
also in chronic rheumatism and malaria, chronic bronchial catarrh and 
neurasthenia, and has been employed in tuberculosis with encouraging 
results (Vaughn). In one case an ulcer of twenty years' standing was 
cured in four months by the local application of nuclein. A physician 
reports his own case, one of genito-urinary tuberculosis, as apparently 
cured by nuclein injections. In simple anaemia, chlorosis, typhoid fever, 
debility from any cause, and convalescence from acute diseases, such as 
pneumonia and influenza, the beneficial results of nuclein medication are 
prompt and permanent (Aulde). As bactericides the nucleins may prove 
therapeutically useful, by reason of their harmlessness to the human 
subject. 

Nucleins are prepared from separate animal tissues and glands, as the 
thyroid, thymus, liver, spleen, etc. {animal nucleins) ; also from all the 
tissues and glands combined (protonucleiri), and from yeast-cells (yegeta- 



ANIMAL EXTRACTS. 135 

ble nucleiri). Vaughn uses a solution of yeast nuclein, containing i per 
cent, of nucleinic acid, prepared by Parke, Davis & Co. The dose of 
this solution is 30 minims, administered hypodermically, and increased 
daily as long as no unfavorable symptoms appear. Tablets of nuclein 
are on the market, for administration by the mouth, the dose being 1 
grain or more, as may be deemed advisable. 

Protonuclein is the trade-name of an extensively advertised product, which is said 
to be a combination of nucleins obtained from all the available lymphoid structures of 
bullocks and pigs, including the entire brain, the pancreas, liver, spleen, salivary glands, 
thyroid, thymus, gastric and intestinal glands, etc. The manufacturer claims that it is 
••the true tissue-builder of the organism" and its "natural antitoxic agent," and pub- 
lishes the usual florid literature, which includes clinical reports of the therapeutic efficacy 
of protonuclein in some forty-five different affections. It is sold in tablets and powder ; 
also in a special powder containing no milk-sugar, and intended for inhalations and 
injections. The dose is 3 grains every 3 or 4 hours. 

Orchitic Extract (Didymin, Testicular Juice), — was the subject of a 
communication to the Societe de Biologie at Paris, in 1889, from Pro- 
fessor Brown-Sequard, in which the aged and distinguished writer declared 
that he himself had experienced a wonderful degree of rejuvenescence 
after its use, and recommended it as a general tonic for the aged and for 
subjects of impotence or a debilitated nervous system. In subsequent 
communications made to the Academie des Sciences by Dr. Brown- 
Sequard and his assistant Dr. D'Arsonval, it was claimed that general 
paralysis, locomotor ataxia, contractures, and certain forms of insanity, 
affections due to organic lesions of the nervous system or impairment of 
its functions, are cured or ameliorated by injections of testicular juice ; 
also that organic or constitutional diseases due to defective nutrition of 
the organs, as anaemia, glycosuria and tuberculosis, may be arrested by 
this procedure. Its remedial effects they held to be due to the action of 
a ferment or diastase contained in the fluid, which replaces the natural 
ferments produced by normal testes and other glandular organs of the 
body. Although Brown-Sequard's claims for this agent were undoubt- 
edly extravagant, and his assertions as to the results obtained therefrom 
were exaggerated, subsequent experience has confirmed his general state- 
ment of its effects, and the restorative power of testicular juice when in- 
jected subcutaneously is now admitted. 

Testicular extract injected into the human subject produces a steady in- 
crease of oxyhemoglobin in the blood, the cardiac force is strengthened, 
the vascular tone is exalted, and the oxygenation of waste products is 
promoted as shown by the increased excretion of urea and the lessened 
amount of phosphoric acid in the urine. Intestinal peristalsis is slightly 
stimulated, the mind becomes clearer and more active, and the body 
temperature is usually raised but may remain unaffected. The crude ex- 
tract is said to be mildly bactericidal. These effects closely coincide with 
those produced by Spermine (see below), and this substance is believed by 



I36 ANIMAL EXTRACTS. 

Poehl to be the active principle of the juice, but it does not possess the 
powerful reconstructive properties of the latter, and cannot be efficiently 
substituted therefor. 

This extract has been employed by many competent physicians in 
several diseases, often with most beneficial results. It is a powerful tonic, 
especially in the decrepit subject of old age or exhaustion from wasting 
disease, as it stimulates the tissues and organs to renewed activity and 
endows the body with greater strength and with a feeling of increased 
well-being. It has been used in general adynamia, anaemia, atonic gastro- 
intestinal affections, scurvy, malaria, epilepsy, cancer, nymphomania, 
perverted sexual habits, impotence, neurasthenia, hysteria, melancholia, 
diabetes, tuberculosis, hemiplegia, paralysis agitans and locomotor ataxia. 
In the last-named disease this remedy has shown the best results ob- 
tained therewith; and under its administration the characteristic pains 
have ceased, steadiness and accuracy of motion have increased, and in 
some cases the ataxia has wholly disappeared. In diabetes it has been 
more satisfactory than pancreatic or any other organic extract. Under 
its administration in anaemia one physician observed the haemoglobin to 
increase from 3 to 14 per cent, every three weeks; and in tuberculosis it 
has caused the temperature to recede to normal, the cough to lessen, the 
appetite and weight to increase, and the general condition to improve in 
every way. In sexual neurasthenia it has frequently proved to be of great 
benefit. No specific action is claimed for it in any of these affections, 
but all observers agree that it acts by stimulating functional activity. 
Many of the results observed have been ascribed to mental suggestion, 
but after the application of check experiments in similar cases the weight 
of evidence was found to be in favor of the remedy. 

D'Arsonval prepares this extract or emulsion in the following .manner. The testicles 
of bulls, enveloped in their membranes, are washed in a 10 per cent, solution of subli- 
mate, and again with sterilized water, are each divided into five or six parts, placed in 
aseptic glycerin (a pint to the pound of testicle) and allowed to macerate therein for 24 
hours. An equal quantity of a 5 per cent, solution of common salt in boiled water is 
then added, the mixture is filtered and sterilized by being subjected to a pressure of 30 
atmospheres of carbonic acid gas. The dose is 10 to 20 minims, hypodermically once 
daily or every other day, with strict aseptic precautions as to the syringe used and the 
site of injection ; the latter should be washed with a I to 1000 sublimate solution or 
a 2 per cent, solution of carbolic acid. The extract seems to have little or no effect 
when given by the mouth, but is efficient when used by the rectum. Some observers 
believe that it is dangerous by hypodermic administration, on account of its proneness 
to decomposition when prepared by the above method ; and one experimenter has made 
an extract from the crude juice for administration by the mouth, which he claims to have 
used in a thousand cases. 

The composition of the emulsion prepared by the above process is very 
complex, but it is supposed to include at least four active principles, viz. : 
— (1) Phosphorized Albumins, in large quantity, (2) Lecithin, known as 
phosphorized fat, (3) Spermine, and (4) Nuclein. The first two have 
undoubted value as nerve foods, the third is believed to increase the 



ANIMAL EXTRACTS. 137 

oxygen-carrying power of the blood corpuscles, and the last possesses 
bactericidal properties. The combination should prove of value as a 
remedy in many morbid conditions. 

Phospho- Albumen. Under this trade-name and the sub-title Syrup of Di-Oleyl- 
Lecithin, an animal extract is prepared in Chicago, which is said to be derived solely 
from the testes, spinal cords and brains of bulls. The juice is sterilized by D'Arsonval's 
carbonic acid process, and is mixed with simple syrup as a preservative menstruum and 
some flavoring material. It is supposed to contain lecithins, spermine, nuclein and phos- 
phorized albumins, is put up in 12-oz. bottles, and is apparently a favorite tonic with 
many prominent physicians of Chicago. It is not patented, copyrighted or advertised, 
is sold only on physicians' prescriptions, and its manufacturers assure the profession that 
so far as their methods of promotion are concerned it will remain practically inaccessible 
to the laity. 

Spermine has been found in the form of a phosphate in the thyroid and thymus 
glands, the spleen, the ovaries and the blood, as well as in the testes. Dr. Poehl be- 
lieves it to be an alkaloidal product of the retrogressive metamorphosis of albumins (a 
leucomaine) ; and a most powerful intraorganic restorative of the oxidizing properties 
of the blood. He states that it should not be regarded as a specific for any particular 
malady, but should be used as a means of promoting oxidation in the body. It has 
been employed with decided benefit in ataxy and delirious epilepsy (Poehl), as a tonic 
in tuberculosis (Upenski), also in senile marasmus and the nervous affections of the aged 
(Victoroff ). The Hydrochlorate is used hypodermically, in doses of ^ grain twice 
daily, in the morning and at noon, avoiding evening administration as it may cause in- 
somnia. No reaction follows its injection. 

Brain Extract (^Cerebrinin) is obtained from the gray matter of the 
sheep's brain by digestion in 5 times its weight of pure glycerin and then 
adding an equal quantity of a 12 per cent, solution of common salt. Its 
effects are almost identical with those of orchitic extract, the most notice- 
able being increased strength and a feeling of well-being, regulation of 
the organic functions and increase of the cardiac force. It has been em- 
ployed with benefit in locomotor ataxia, neurasthenia and allied affections, 
nymphomania, perverted sexual habits of cerebral origin, hysteria, melan- 
cholia, insomnia, the general debility of malaria, chlorosis and even more 
profound anaemias (C. Paul) ; also in cases of defective development of 
the spinal apparatus, as Freidrich's ataxia. Mental derangement is not 
helped by it, or at most but temporarily. The dose is 16 minims (1 cc.) 
once daily or every other day, administered subcutaneously. 

Cerebrine is an extract of the entire brain of the ox, prepared by Dr. Hammond of 
"Washington, by digestion for six months in a mixture of glycerin, alcohol, and a satur- 
ated solution of boric acid, and filtration through porous stone. The dose is 5 mimims 
diluted with an equal quantity of distilled water at the time of administration by hypo- 
dermic injection. 

Dr. Hammond prepares similar extracts of the spinal cord (medulline) , the heart 
{cardine). the pancreas {pancreatine), etc., and advocates their use medicinally on the 
organopathic theory that they are curative of depressed conditions of the corresponding 
human organs. 

Pineal Extract. The pineal gland is present during the entire life of the individual, 
and its removal has been followed in animals by structural changes in the central nervous 
system. It is thought that the substance of this gland may act remedially in organic and 
functional affections of the brain attended with failure of cerebral nutrition, as chronic 
softening, chronic mania and dementia. 

Pituitary Extract. The complete removal of the pituitary body (or gland) gives 
rise to symptoms which occur in a definite order, beginning with lowered temperature and 



I38 ANIMAL EXTRACTS. 

loss of appetite, then twitchings, tremors and nervous phenomena, and finally dyspnoea 
and death. Many of these symptoms have abated considerably after the administration 
of pituitary gland substance or an extract thereof. This organ has been found enlarged 
in cases of myxcedema in which the thyroid was functionally absent, and other observa- 
tions point to some connection between it and the disease known as acromegaly. Inter- 
nally administered it causes increase of the cardiac force and rate, and a rapid rise of 
the blood-pressure due to direct contraction of the vessels. It is administered with the 
view of reestablishing perverted brain nutrition and function, and also with the object 
of supplying tone and structural growth to the entire nervous and muscular systems, on 
which its secretion seems to act as an alterative. 

Adrenal Extract. The ablation of the supra-renal glands in guinea- 
pigs and frogs is followed by serious nervous disturbances, shown by lower- 
ing of the body temperature and progressive paralysis, and culminating 
in convulsions and death. Brown-Sequard made these observations in 
1856, and later showed that the subcutaneous injection of extracts of the 
healthy glands in such cases restored the animals to almost a normal state 
for a time. As Neurin has been found in the blood of animals suffering 
from Addison's disease, it has been suggested that it is the toxic substance 
which is neutralized by these organs in health ; but the recent researches 
of Schafer and Oliver have demonstrated that the function of these glands 
is not a defensive one, but that their secretions possess most positive and 
remarkable physiological properties, strongly contracting the muscular 
system in general, but especially the skeletal, the vaso-motor and the 
cardiac muscle. No other drug produces so great a rise of the blood- 
pressure as adrenal extract causes ; this effect being due to its extraordi- 
nary contractile power over the muscular fibres in the walls of the arterioles. 
In this respect its action is directly opposed to that of thyroid extract. 
Another remarkable property of this extract is the smallness of its active 
dose, the -j^tti of a grain of the dried gland producing a maximal effect 
upon the heart and arteries in a twenty-pound dog. From this the con- 
clusion is formed that its active principle is capable of producing a well- 
marked physiological effect in the dose of -g-J-g-th of a grain for an adult 
man. This is probably the smallest active dose on record for any article 
in the materia medica. 

The medulla of the suprarenal gland contains a dialyzable organic principle which is 
soluble in water. It is not eliminated by the gland itself or by the kidneys ; and is not 
oxidized or destroyed by the blood, inasmuch as it retains its full power after having been 
in contact with blood for 24 hours. It is probably stored in the organism and rendered 
harmless by some of the other glandular organs after it has performed its proper function. 
Though produced in very small quantity it doubtless preserves the normal action of mus- 
cular tissue, especially of that in the blood-vessels, and its absence gives rise to a series 
of symptoms which terminate in prostration, inanition and death. 

Adrenal Extract has been employed in a few cases of Addison's disease, 
anaemia and diabetes, with some benefit, but the improvement ceased 
with the discontinuance of the remedy. It may be tried in muscular dis- 
orders, especially those which involve loss of tone or changes of degenera- 
tive type. The dose of the dry extract, as put up in tablets, is from 5 to 
30 grains. 



ANISUM. 1 39 

Renal Extract. — An extract of the kidney substance is suggested as being possibly 
beneficial in affections arising from impairment or failure of nitrogenous metabolism, the 
promotion of which is one of the functions of that organ, according to the new physi- 
ology. There are no reliable data on which to base any opinion as to the merits of this 
agent as a remedy. 

Lymphatic Extract. — An extract prepared from the lymphatic glands of animals 
has been employed in exophthalmic goitre, lymphadenoma, and other glandular swell- 
ings, but there are no trustworthy reports as to the results. 

Pancreatic Extract. — In many cases of diabetes decided structural changes have 
been observed in the pancreas after death, and the ablation of this gland in animals is 
followed by emaciation and glycosuria ; but these symptoms will not occur if a portion 
of the pancreas is left, or if a part of it be engrafted on the peritoneum after its removal 
from its proper location. These facts have suggested the probability of the possession 
by the pancreas of power over carbohydrate metamorphosis, through the action of some 
substance elaborated by the peculiar, vascular epitheloid tissue which occurs in isolated 
patches throughout its substance, and which is not found in any other duct-bearing gland 
in the body. Upon this theory the pancreas, both in substance and extract, has been 
administered as a remedy for diabetes, but the results have been negative in nearly all the 
cases. A few instances are recorded in which its use was followed by some temporary 
amelioration of the symptoms of the disease. 

Splenic Extract. — Excision of the spleen, or the serious impairment of its functions 
by disease, is usually followed by marked tissue changes and great susceptibility to altera- 
tions of temperature, especially in malarial subjects. The substance of this organ has 
been used medicinally in various disorders of the blood, with the idea of supplying to that 
tissue some material which may be necessary to its health. The possession of bactericidal 
power by some secretion of the spleen is strongly indicated by certain facts, among which 
are the evident incompatibility of tuberculosis and malaria and the enlargement of the 
spleen in acute infectious diseases, as though purposely battling against the germs there- 
of. It has therefore been suggested that the splenic substance of animals naturally im- 
mune against certain of these diseases be employed as a remedy therein, — for example, 
in tuberculosis, malaria, and typhoid fever. By this method of treatment it is hoped that 
some light may be thrown on the functions of this organ, as has so recently been done in 
the case of the thyroid gland. 

Ovarian Extract. — The substance of the ovaries has been administered with some 
benefit in the nervous manifestations and pathological conditions which occur when the 
ovarian functions are partially or wholly arrested, as in cirrhosis or malignant disease 
thereof, or after the operation of ovariotomy. It is said to be a serviceable remedy in 
cases of depression or other mental disturbance coincident with the climacteric. 

Uterine Extract. — The substance of the uterus has been employed as a remedy in 
those disorders and cachexias which seem to be consequent on the removal of this organ 
and its appendages. The available data are not, however, sufficient to enable any con- 
clusion to be formed as to its efficacy. 



ANISUM, Anise, — is the fruit of Pimpinella Anisum, a European plant of the nat. 
ord. Umbelliferae. It occurs in ovate bodies, of grayish color, aromatic odor, and sweet, 
spicy taste, resembling conium fruit in appearance. Dose, gr. x-xx. 

Oleum Anisi, Oil of Anise, — is a volatile oil distilled from Anise, and represents the 
medicinal qualities of the plant. It congeals at 50 to 59 F. , is soluble in an equal part 
of alcohol, and is an ingredient of Tinctura Opii Camphorata, Troschisci Glycyrrhizse et 
Opii, and of the two following preparations. Dose, Tt\J-v. 

Aqua Anisi, Anise Wate?-, — has in 500 parts I of Oil of Anise triturated with Calcium 
Phosphate, and mixed with distilled water. Dose, indefinite. 

Spiritus Anisi, Spirit of Anise, — is a 10 per cent, solution of the oil in alcohol. 
Dose, 3J-ij. 

The Volatile Oil is the active constituent of Anise. It has a slightly stimulant action 
on the heart and the digestive organs, and liquefies the bronchial secretion, being probably 
in part excreted by the bronchial mucous membrane. It is a favorite flavoring ingredient 
of cough-mixtures, and relieves slight intestinal colic and flatulence in children. In full 
doses it has weak narcotic power. 



140 ANTHEMIS ANTIMONIUM. 

ANTHEMIS, Chamomile. — the flower heads of Anthemis nobilis, a. European per- 
ennial of the nat. ord. Composite, collected from cultivated plants. They contain a 
volatile oil, a camphor and a bitter principle, but no alkaloid. There are no official 
preparations. An infusion ( ^iv to Oj) may be given in doses of 3J-ij. 

Oleum Anthemidis, Chamomile Oil (Unofficial), — the volatile oil, is of a dark blue 
or green color, and is composed of various ethers, the Angelates and Valerianates of Butyl 
predominating. Dose, rryj-x, on sugar. 

Chamomile is a stomachic tonic. It improves the appetite and aids digestion by increas- 
ing the vascularity of the gastric mucous membrane. In large doses the warm infusion 
is emetic, and perhaps diaphoretic, though the latter action is chiefly due to the hot water. 
The oil is remarkably efficient in reducing reflex excitability in frogs, even after its excita- 
tion by Strychnine or Brucine. 

Chamomile is popular in domestic practice. An infusion is used by nurses for many 
infantile complaints, and externally as a fomentation to relieve pain, as in colic, etc. The 
oil is very efficient in reflex cough, pulmonary catarrh, acute dyspepsia, diarrhoea of chil- 
dren, spasmodic asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic 
affections of hysterical women. It should prove extremely useful in poisoning by Strych- 
nine, from its power over reflex excitability. 

The Chamomilla of the homoeopaths is the Matricaria Chamo?nilla, or German Cham- 
omile, official in the U. S. Pharmacopoeia as " Matricaria," which see. 



ANTIMONIUM, Antimony, Sb. — Metallic Antimony is not 
official, nor is it used in medicine. It is represented, however, by the 
following official salts and preparations, viz. : 



Compounds of Antimony and their Preparations. 

Antimonii et Potassii Tartras, Antimony and Potassium Tartrate, Tartar Emetic, 
2KSbOC 4 H 4 6 .H 2 0, — small white crystals or a granular powder of sweet, disagreeable 
metallic taste, soluble in 17 of water at 59 F., and in 3 of boiling water, insoluble in 
alcohol. Dose, gr. j^-\, but after tolerance is established as high as gr. ij may be given. 
Is an ingredient of the two following, viz. : — 

Vinum Antimonii, Wine of Antimony, — has of Tartar Emetic 4, Boiling Distilled 
Water 65, Alcohol 150, White Wine to 1000. Contains about 2 grains of Tartar Emetic 
to the 3 , and is an ingredient of Mistura Glycyrrhizae Composita. Dose, ir^v-xv, as a 
febrifuge and expectorant. 

Syrupus Scillas Compositus, Compound Syrup of Squill, Cox's Hive Mixture, Hive 
Syrup (See under SciLLA), — contains about I grain of Tartar Emetic to the J, with 
Squill, Senega, etc. Dose, rr\j-3J, cautiously in children. 

Antimonii Oxidum, Antimony Oxide, Sb 2 3 , — a heavy, gray powder, insoluble in 
water or alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acid solu- 
tions. Dose, gr. j-iij. It constitutes ^d of — 

Pulvis Antimonialis, Antimonial (or fames'} Powder, — consists of the Oxide of 
Antimony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as a 
diaphoretic, larger doses for emetic and cathartic effects. 

Antimonii Sulphidum, Antimony Sulphide, Sb 2 S 3 , — is the native sulphide, purified 
by fusion, and as nearly free from Arsenic as possible; steel-gray masses, or a black, 
lustreless powder, insoluble in water or alcohol. Dose, gr. %-]. 

Antimonii Sulphidum Purificatum, Sb 2 S 3 , — is purified by maceration in Aq. Am- 
moniae, washing and drying. Dose, gr. y^- j. 

Antimonium Sulphuratum, Sulphurated Antimony, Kermes Mineral, — is chiefly 
Sb 2 S 3 , with a very small amount of Sb 2 3 . A reddish-brown, odorless and tasteless pow- 
der, insoluble in water or alcohol. Is a constituent of Pil. Antimonii Compositse. Dose, 
gr. j-v. 

Pilulae Antimonii Compositae, Plummets Pills, — each pill containing about gr. y z 
each of Calomel and Sulphurated Antimony, with Guaiac and Castor Oil. 



antimonium. i4i 

Physiological Action. 

Tartar Emetic in its action represents the other official antimonial 
preparations, being a cardiac, arterial and general depressant, a proto- 
plasmic poison, a systemic and local emetic, a specific gastro-intestinal 
irritant, an expectorant and a diaphoretic. Like Aconite, Arsenic, Hy- 
drocyanic Acid and Potassium, it is destructive to protoplasm, destroying 
function in all nitrogenous tissue, and paralyzing the spinal cord, the motor 
nerves, the muscles and the sensory nerve terminations. It is especially 
depressant to the heart-muscle and the cardiac motor ganglia ; it combines 
with the red blood-corpuscles, lessening their oxidizing power, lowering 
the blood-pressure and reducing the body-temperature. Its taste is styp- 
tic and one of its earliest effects is the production of constriction of the 
fauces. It promotes waste and rapid excretion of waste-products, carbonic 
acid and urea being especially increased. Being eliminated by all the 
excretory organs, including the skin, it excites follicular inflammation at 
the points of elimination ; resulting in an eruption which is papular at 
first, then becomes vesicular, and finally pustular, the pustules being urn- 
bilicated, like those of variola. This same eruption is also produced by 
the application of the drug to the skin with friction. Aphthous ulcera- 
tions, extending from the mouth to the stomach, with salivation and pain- 
ful deglutition, may also result from its continued use. 

In small doses Tartar Emetic stimulates secretion in the bronchial and 
salivary glands, the stomach, intestinal canal, liver and pancreas. In 
larger doses it excites nausea, vomiting and purging, with evacuations like 
the " rice-water discharges " of cholera, and great prostration of the vital 
powers. Toxic doses produce similar symptoms, besides epigastric pain, 
cyanosis, delirium, cramps, motor and sensory paralysis, suppression of 
urine and collapse, — the same phenomena as in Asiatic cholera. 

The Sulphide occurs native, and is the source from which the other 
compounds are prepared. It seems to be inert medicinally. Sulphurated 
Antimony owes its efficacy to the small quantity of the Oxide contained 
in it, and as this is variable, the action of the preparation is uncertain. 
The Oxide has a similar action to that of Tartar Emetic, but being in- 
soluble in water, it is of much less certain activity. 

Antidotes, Antagonists and Inco?7ipatibles. 

Tannic Acid, or any substance containing it, is the antidote, forming the insoluble tan- 
nate. Opium, Alcohol, Ether, and other antispasmodics are physiological antagonists. 
Demulcent drinks should be freely administered to protect the mucous membranes. Al- 
kalies and Salts of Lead decompose Tartar Emetic. 

Therapeutics. 
Tartar Emetic was formerly much employed as an antiphlogistic on 
account of its power to cut short acute inflammations of sthenic type, and 



142 ANTIPYRINUM. 

its use was very much abused, so that it has now gone out of fashion as a 
remedy. The contra-stimulant treatment of pneumonia and other inflam- 
matory diseases, by large doses of this salt after tolerance was established, 
is only worthy of reference as an historical fact. The same may be said 
of its external use as a counter-irritant as well as of its employment as an 
euietic, in both of which capacities it is too severe, while its emesis is too 
tardy in action to be of any value in poisoning. It is, however, a very 
efficient agent in many grave affections, if used in small doses (gr. -g^— jq-)j 
being highly efficacious in acute inflammatory affections of the respiratory 
tract, especially pneumonia, broncho-pneumonia, acute oedema of the 
lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsillitis. 
In many respects it acts like Aconite in these and kindred affections, 
producing copious diaphoresis, slowing the pulse and allaying restlessness. 
It is considered a good remedy in puerperal peritonitis, mammitis, and 
orchitis, in lumbago and other muscular rheumatisms, also in photophobia 
and in gastric indigestion after beer-drinking. In still smaller doses 
(gr. y-i-g- hourly) it is particularly efficient in catarrhal inflammations of 
the respiratory mucous membrane in children, accompanied by rattling 
breathing and much mucus, which is expelled with difficulty. Such cases 
often simulate asthma, the attacks being marked by cough, wheezing, and 
difficult respiration, with sibilant rales in the chest, and usually follow on 
severe colds or on measles. The Compound Syrup of Squill is commonly 
used as an expectorant and nauseant in the treatment of bronchitis and 
croup. The quantity of Tartar Emetic in it (gr. j to the g) should be 
remembered in administering it to children. (See under Scilla.) 

The Oxide is chiefly employed in the form of James' Powder (Pulvis 
Antimonialis) for its mild diaphoretic qualities. The Sulphide is not 
used in medicine. Sulphurated Antimony is very uncertain in action 
and is but little used. The Compound Pill of Antimony (Plummer's 
Pill) was devised to obtain mercurial results without writing Hydrargyrum 
on a prescription. 

ANTIPYRINUM, Antipyrin, Phenyl-dimethyl-pyrazolon, C 20 H 18 - 
N 4 2 , — unofficial in the United States, but official in the Br. Ph. under 
the name Phenazonu?n, Phenazone, — is a crystalline substance obtainable 
from phenyl-hydrazine, and prepared by a patented and complicated pro- 
cess. It is a synthetical base, forming salts which are analogous to those 
of Ammonium ; and occurs as colorless and inodorous scaly crystals, with 
a bitter taste, freely soluble in water, alcohol and chloroform, less soluble 
in ether. It gives a deep red color with ferric chloride, a deep green with 
nitrous acid, and with nitric acid a yellow color which deepens to crimson 
on warming. It is not irritant to the stomach or the tissues and may be 
administered hypodermically. 



ANTIPYRINUM. 1 43 

Dose and Administration. 

The Br. Ph. states the dose at from gr. iij to gr. xx. An average adult dose may be 
placed at gr. x. For children the dose is gr. % P er year of age between 2 and 5 years, 
gr. y 2 per year from 5 to 10, not exceeding gr. v at a dose for any child under 15 years 
of age. 

Antipyrin has but little flavor, is not unpleasant, and is therefore readily taken by chil- 
dren, in which respect it is greatly superior to Quinine. It may be administered in com- 
pressed tablets, each having from I to 5 grains ; — or in Aromatic Elixir, — say gr. lxxx in 
3 iv, of which solution each 3 contains gr. ijss. If vomiting result, the same dose 
may be dissolved in half its weight of hot water, and injected hypodermically while warm. 

Incompatibles. 

Antipyrin may be decomposed when brought into contact with Nitrous compounds, a 
new and poisonous substance being supposed to be formed, of uncertain composition, but 
resembling the Anilin greens. The mixture of this drug with Spiritus Etheris Nitrosi is, 
therefore, highly dangerous, if this supposed reaction is at all likely to occur. 

It is more or less decomposed or thrown out of solution by a large number of chemical 
compounds and other preparations, of which the following are the most important, viz. : — 

Acid, Hydrocyanic, Dilute. Arsenic and Mercury, Solution of the 

Acid, Tannic. Iodides of. 

Butyl-chloral Hydrate. Mercuric Chloride. 

Chloral Hydrate. Naphtol /3 (solid). 

Cinchona, Decoction. Nitrites in solution (acid). 

Cinchona, Fluid Extract. Sodium Bicarbonate. 

Catechu, Infusion (cone). Sodium Salicylate (solid). 

Ferrum, Sulphate. Tinctures containing Tannin, Iron, or 

Ferric Salts in Solution. Quinine. 

Hamamelis, Tincture. Rose, Infusion. 

Iodine, Tincture. Uva Ursi, Infusion. 

Antipyrin and Phenyl-urethan liquefy when rubbed together. 

Unofficial Preparations. 

Salipyrin, Antipyrin Salicylate, — is formed by combining Salicylic Acid 57.7, and 
Antipyrin 42.3 parts ; and is the only salt of the base which has any therapeutic import- 
ance. Described under Salix. 

Hypnal. — is a combination of Antipyrin and Chloral, heated together, which is 
credited with hypnotic and analgesic power. It is described under Chloral. 

Migranin, — is a double Citrate of Antipyrin and Caffein, lately brought forward in 
Germany as a specific for sick headache and neuralgia. A report is published that the 
police authorities of Hamburg have issued a notice forbidding its free sale in the local 
pharmacies, and warning the public against using it except under a physician's direction 
(Squibb). The dose is placed at about gr. xv. 

Phenopyrin, — is prepared from equal parts of crystalline Phenol and Antipyrin. It 
is an oily liquid, colorless and odorless, insoluble in cold and sparingly soluble in hot 
water. It has as yet no medicinal importance. 



Physiological Action. 
Antipyrin is a powerful antipyretic, a local anaesthetic, and a general 
analgesic, — and also possesses diaphoretic, mydriatic, antiseptic, disinfec- 
tant, hemostatic and slight hypnotic powers. After the ingestion of a 
full medicinal dose (gr. xx-xxx), there is a stimulant stage of short dura- 
tion, in which the heart's action is increased, and a subjective sense of 
heat is experienced, with flushing of the face. This is soon followed by 
profuse sweating, coldness of the surface, slowed pulse, considerable de- 



144 ANTIPYRINUM. 

pression, and if fever be present by lowered te?nperature ; the latter com- 
ing on within half an hour after taking the drug and its degree being in 
direct ratio to the quantity administered, as also its continuance, — the 
former being usually from 3 to 5 degrees, and the latter from 1 to 10 
hours, a fair average being about 2 hours. In one case a fall of 12 F. 
was observed. When given with Kairin, the mixture of the two drugs 
has been found to produce a much greater fall of temperature, with longer 
continuance down, than that produced by an equal quantity of either drug 
given alone. After the antipyretic effect of the dose has passed off, the 
temperature (in fever) commences to rise again, — the onset being usually 
preceded by a chill, which is of slight degree when compared with the 
severe rigors and dangerous depression occurring under the action of 
Kairin, Chinolin, and other members of the group. 

In health the administration of a full dose gives rise to slight nausea, 
singing in the ears, and a reduction of the body temperature of scarcely 
any extent, about -^° F. It slightly raises the arterial tension and blood- 
pressure ; — sometimes (but seldom) induces vomiting, also an urticarial 
eruption on the skin ; — and may cause such a degree of depression as to 
amount to collapse. It has little or no effect upon the respiration, but 
acts as a sedative upon the cerebrum, leaving behind a somewhat depres- 
sant influence on the brain. It dilates the pupils and is rapidly eliminated 
by the kidneys, appearing in the urine within half an hour after its inges- 
tion. The profuse sweating which it causes may be prevented by giving 
in advance a small dose of Atropine or Agaricine. 

In toxic dose Antipyrin probably acts as a primary stimulant and a sec- 
ondary depressant of the spinal cord, paralyzes both the motor and sen- 
sory nerve trunks, decreases the arterial pressure, and exerts a poisonous 
influence on the blood, altering the shape of the red corpuscles, separating 
the haematin, and causing decomposition of that fluid tissue. A peculiar 
livid discoloration of the surface is one of the most characteristic symp- 
toms of antipyrin poisoning, and is probably due to the formation in the 
blood of methaemoglobin or some similar compound. 

As an Antipyretic^ Antipyrin, like Alcohol, acts by a double mode of 
operation, — (1) by diminishing oxidation, and (2) by promoting heat- 
loss. The latter is attained by dilating the cutaneous vessels, allowing 
free radiation from the surface, and by the refrigerant action due to evap- 
oration of the sweat. 

As an Analgesic, Antipyrin has a very considerable degree of power, 
in common with all the Chinolin derivatives ; but its property in this re- 
spect is found to act almost entirely upon pain due to manifestations of the 
rheumatic diathesis. In general anodyne action, it is not to be compared 
with the derivatives of Opium. Its hemostatic power is claimed to be 
superior to that of Ergotin. 



ANTIPYRINUM. 145 

Therapeutics. 
One of the most popular of the modern antipyretics, Antipyrin deserves 
high rank in professional esteem, being an excellent analgesic and one of 
the most certain and most powerful depressants of temperature, though 
somewhat dangerous, and devoid of any other influence upon the course 
of any febrile disorder. Its principal applications are as follows : (1) As 
an antipyretic, it has been employed in all diseases with high temperature, 
and it may be used in asthenic fevers, as it has little effect upon the circu- 
lation. It has held a high place for several years in the treatment of acute 
rheumatism, and affords valuable aid in the pyrexia of intermittent fever, 
a stage in which the slow action of quinine prevents that drug being avail- 
able for immediate relief. (2) As an analgesic, it is highly efficient ex- 
cept when the pain is dependent upon a local inflammation, in which 
case it is of no value for this purpose. It is often remarkably efficient in 
migraine and other headaches, in the fulgurant pains or the pain-crises of 
locomotor ataxia, and in other paroxysms of suffering dependent on dis- 
ease of the nerve centres, or having the character of nerve storms. It is 
very serviceable in neuralgia, neuritis and other painful affections, espec- 
ially when of rheumatic origin, as lumbago, sciatica, hemicrania, supra- 
orbital neuralgia, etc., in which ten-grain doses are generally sufficient 
and may be given hypodermically. It often relieves dysmenorrhcea, also 
the painful affections of hysteria, pain from cerebral tumors, and that due 
to cardiac disease. In acute gout, a preliminary dose of 25 grains, fol- 
lowed by 10 grain doses every two hours, promptly relieved the pain and 
shortened the duration of the paroxysms in one very carefully observed 
and thoroughly reported case. In chronic gout, very remarkable results 
are reported as due to Antipyrin, indicating a specific and curative influ- 
ence on that disease. For the relief of pain, the conjoint administration 
of Antipyrin and Morphine is said to be much more efficient than the use 
of either agent alone. (3) To allay nervous irritation ; thus it has been 
used with extraordinary success in nervous urticaria, and is often em- 
ployed with benefit in the restlessness of hysterical subjects. In the urti- 
caria-like eruptions of children its action has been so promptly efficient as 
to indicate for it a direct influence upon the vascular nerves ; and as a 
symptomatic remedy against itching it is equally efficient in nervous pru- 
ritus, true prurigo, urticaria, erythema, pemphigus vulgaris and lichen 
ruber. (4) To antagonize excitability of the motor nerve centres, as in 
laryngismus stridulus, whooping-cough, tetanus, epilepsy and chorea. In 
the latter disease Antipyrin is held in high esteem as a curative remedy, 
and although it often fails entirely in epilepsy, it sometimes acts therein 
with extraordinary power, especially when given in combination with 
ammonium bromide. (5) To affect secretion, as in infantile diarrhoea, in 
which it has rendered signal service, administered in doses of ^ to 1^ 



I46 ANTITOXINS. 

grain ; and as an antigalactagogue, when it is desired to arrest the secre- 
tion of milk, doses of gr. iv every two hours will prove efficient. It has 
also been employed with benefit in diabetes, both true and insipid, and 
has been found to be remarkably effective in promoting the absorption of 
pleuritic effusions. (6) As a local anaesthetic it is equal if not superior to 
cocaine, if applied to the mucous membranes in a 30 to 50 per cent, so- 
lution (St. Hilaire). (7) As a local hemostatic, it is highly efficient in 
15 per cent, solution as a spray for epistaxis, and hemorrhages of almost 
any kind are checked by the application of stronger solutions. It has the 
advantage of constricting the small vessels without causing any external 
clot which may break down. (8) As an antiseptic it possesses properties 
which compare favorably with most of the anilin and coal tar derivatives. 
Antipyrin has rendered good service in bronchial asthma, in sea-sick- 
ness, in cerebro-spinal meningitis, and in croupous pneumonia. In the 
latter affection it has been employed in combination with camphor and 
small doses of morphine with excellent results. 

ANTITOXINS (Unofficial). The remarkable reports which have 
been published during the last two years upon the antitoxin treatment of 
diphtheria and tetanus have excited fresh interest in bacterio-therapy, 
and seem likely to dispel the cloud which has rested thereon ever since 
the failure of Koch's tuberculin. After the discovery of the bacillus 
tuberculosis in 1882 several other micro-organisms were found to be con- 
stantly associated with certain acute infectious diseases, notably tetanus, 
diphtheria, cholera, pneumonia, erysipelas and typhoid fever. The 
specific microbes of these affections were at first believed to be the imme- 
diate cause of their respective disorders, but later researches have shown 
that such diseases are due to the action of chemical poisons (toxins and 
toxalbumins) produced by their specific bacteria growing on suitable soils 
either within the animal organism or outside it. (Compare the article 
entitled Toxins.) 

It was shown by Von Fodor in 1887 and subsequently by Nuttall that 
the blood serum of healthy animals is naturally bactericidal, that it 
possesses this quality in varying degrees of efficiency, and that it may be 
sufficiently powerful in this respect to prevent certain pathogenic bacteria 
from gaining lodgment on the organism, thereby conferring natural 
i?n??iunity against a particular disease upon the individual so protected, 
and in some cases even upon the species. Further study and experiment 
established the fact that temporary artificial immunity against certain dis- 
eases may be imparted to an individual animal naturally susceptible by 
repeated inoculations of the specific bacteria or their toxic products in 
gradually increasing degrees of virulence (Behring, Kitasato, Roux). 
The crowning discovery that the blood serum of such an immunized 



ANTITOXINS. 147 

animal maybe successfully employed for curative as well as prophylactic 
purposes against its particular disease upon other animals of the same or 
different species, was made by Professor Emil Behring of Berlin, in 1891. 
This was no chance discovery, but was the legitimate result of logical 
reasoning and hard work, and is formulated under the title Behring'' s 
Law, as follows : That the blood serum of an animal which has been arti- 
ficially rendered immune against a certain infectious disease, when injected 
into the body of another animal, has power to protect the latter individual 
against the same disease and to cure the disease after infection has occurred. 

An Antitoxic Serum or Antitoxin is a blood serum possessed of 

these immunizing and curative properties. The term Antitoxin is also 

applied, and more correctly, to the suppositious defensive proteids, which 

are chemical substances assumed to be contained in the antitoxic serum, 

and believed to be produced by the blood or tissue cells for the defence 

of the organism against the foreign bacterial toxins. Alexins are similar 

substances, natural antitoxins, which are supposed to exist in the blood 

of naturally immune animals. 

Ehrlich has shown that Behring' s law is valid also for the chemical poisons, Ricin and 
Abrin, the respective toxalbumins of the ricinuspalm and the jequirity bean. The blood 
of animals slowly immunized by increasing doses of these toxins contains antitoxic sub- 
stances named Antiricin and Antiabrin, which, if added to their respective poisons, will 
attenuate and even neutralize the latter. These facts are advanced as proof that the 
slowly increasing artificial immunity is not a simple tolerance acquired by the organism, 
as Sternberg taught, but is due to the production of new antagonistic and defensive sub- 
stances by the living cells of the organism. 

Theories deduced from the observed facts are as follows : (1) That, as 
the various pathogenic bacteria produce the causative toxins of their re- 
spective diseases, so the organic cells of the body, reacting under the 
stimulus of the poisons thus introduced, immediately proceed to elaborate 
defensive antitoxins, which if produced in sufficient quantity will neu- 
tralize the effects of the toxins. (2) That residual antitoxins remaining 
in the blood after recovery render the animal immune for a time against 
the disease. (3) That the immunizing and curative effects obtained by 
the injection of the blood serum of an immunized animal into the circu- 
lation of another animal are due — either to direct chemical neutralization 
of the toxins themselves by the antitoxins so introduced (Behring, Kita- 
sato), or to a particular influence exerted by the antitoxins upon the 
living cells of the organism, which, being affected in two opposite direc- 
tions, remain neutral to the disease (Buchner). 

Specific action is a characteristic of the antitoxins with perhaps a few 
exceptions ; which means that the serum from an animal inoculated with 
the toxin of the diphtheria bacillus is effective only against diphtheria, 
and the tetanus antitoxin only against tetanus. A dose of an antitoxin 
followed by a dose of the corresponding toxin produces no effect from 
either, the action of the one being rendered ineffective by the other. 



140 ANTITOXINS. 

The corresponding toxin and antitoxin may be mixed together outside 
the body and then injected with like result, though of course there must 
be a certain amount of antitoxin present to counteract a given dose of 
toxin. The immunizing or vaccine property of the antitoxins, though 
transient, are probably destined to be of considerable importance. In- 
stances are already recorded in which epidemics of diphtheria in schools 
were apparently stopped by vaccinating all the children therein with 
diphtheria antitoxin. 

An Antitoxic Serum is prepared as follows. Either a highly virulent 
culture of the specific micro-organisms of the particular disease, or still 
better, a strong toxin of tested strength prepared therefrom, is injected 
into the cellular tissue of a suitable animal, generally a horse, at first in 
very small quantity. The effect is soon shown by the onset of fever and 
other symptoms of acute disease, which are known as the "reaction." 
After an interval of time sufficient for recovery from these symptoms, the 
injection is repeated with a stronger toxin or with a culture of greater 
virulence, or with a larger quantity of the original toxin. With proper 
care the amount injected may be gradually increased, until ultimately a 
dose many hundred times greater than one which would have been fatal 
at first can be given with impunity. This process is continued for several 
months, or until the animal no longer " reacts " to the poison, and then 
sufficient antitoxin is presumed to exist in its blood to render it immune 
to the toxin and to the disease. After each inoculation the animal's 
blood serum is tested as to its value by experiment on guinea-pigs of defi- 
nite weights. When the desired degree of immunity is reached the ani- 
mal is bled from the jugular vein under strict aseptic conditions, from 6 
to 12 pints being taken from a horse, according to his size and general 
condition. The blood is received in sterilized flasks, which are carefully 
stoppered and stored on ice until the clot has separated from the serum. 
The latter is tested to determine its value in antitoxin, has carbolic acid 
added to it in the proportion of 0.5 per cent., and is bottled in vials 
which contain in each the dose for one patient. The vials are labeled 
with a statement of the number of normal antitoxin units per ccm. of the 
contents, expressed in multiples of a standard normal serum. The effec- 
tive antitoxin value of a serum intended for protective purposes is much 
less than that of one intended for curative action, and the earlier in the 
course of the disease that' the latter serum is employed the smaller will be 
the quantity capable of producing a certain remedial effect. 

Serum-therapy properly means the prophylactic and curative treatment 
of certain acute infectious diseases by the subcutaneous injection of a 
blood serum containing an antitoxin specific to the particular disease. 
As generally used, however, this term includes the treatment of the same 
disorders by the toxins produced by attenuated cultures of their respective 



ANTITOXINS. 149 

microbes; but these toxins, though sometimes grown on blood serum, 
may be cultivated on other media, and are never administered in a serum 
as the antitoxins invariably are. The antitoxins at present employed in 
serum-therapy are those of diphtheria, tetanus, tuberculosis, erysipelas, 
pneumonia, cholera, syphilis, and typhoid fever, but only the first three 
have come into anything like general use. The toxin treatment is 
described under the title Toxins. 

Diphtheria Antitoxin, though not the first antitoxin discovered is 
by far the first in practical importance. The bacillus of diphtheria was 
discovered by Loeffler and Klebs in 1884, its toxic products were isolated 
by Roux, and the antidote to them was found by Behring, who estab- 
lished the preventive and curative properties of this antitoxin. In the 
meantime Sidney Martin had proved the chemical identity of the labora- 
tory toxins discovered by Roux with those produced in the body by the 
bacillus. The clinical results obtained in Paris by the use of Behring's 
diphtheria antitoxic serum were announced by Roux at the Buda-Pesth 
Congress of Hygiene in 1894, and attracted universal attention. Since 
then the statistics of diphtheria serum-therapy have grown voluminous, 
have included a large number of reports from official and private sources 
of the highest professional authority, and the weight of evidence has 
steadily grown more and more favorable to this treatment. 

The statistics first presented by Roux covered 300 cases of true diphtheria, treated at 
the Hopital des Enfants Malades in Paris, with a mortality under the serum treatment 
of 26 per cent., against a mortality of 5 1. 7 per cent, in the same hospital during the pre- 
vious four years in 3971 cases, and a mortality of 60 per cent, in 520 cases during the 
six months immediately preceding. Professor Virchow stated, at the last Christmas 
fete of the Empress Frederick Hospital in Berlin, that from April to November, 1895, 
out of 335 diphtheria cases treated therein with the serum 305 were cured ; and that the 
diphtheria mortality in that hospital, formerly 43 per cent. , had declined to 9^ per cent, 
under the antitoxin treatment. Professor Welch of Baltimore has collected and an- 
alyzed the statistics available in July, 1895, covering 7,166 cases from 80 different sources, 
and showing a general mortality under the antitoxin treatment of 17.3 per cent., against 
a previous general mortality of 42 per cent. Tabulating the results according to the 
time at which the treatment was commenced, he shows for 814 cases treated on the first 
and second days of the disease a mortality of 5^ per cent. ; — for 531 cases treated on the 
third and fourth days 15.2 per cent., — and for 286 cases treated after the fourth day 31. 8 
per cent. (Bulletin of the Johns Hopkins Hospital, 1895, No. vi.). Similar evidence is 
presented in nearly every report published, and in estimating its weight it should be 
remembered that these reports are not made by unknown men, but emanate from trained 
clinicians and recognized professional authorities in the most populous centres of the 
civilized world. 

The clinical history of the disease under the serum treatment, as re- 
corded by its observers, is equally favorable, and shows an extraordinary 
decrease in the severity of the symptoms. The membrane loosens and 
clears off rapidly, the temperature if high is lowered, and the pulse slows 
and gains in force (Washbourn). Evident signs of distress vanished 
within 24 hours, and apparent strength and good-humor took the place 
of a previously low condition both mental and physical (Kossel). In no 
case did the larynx become involved after the use of the serum if not so 



I50 ANTITOXINS. 

previously, and many cases showing laryngeal symptoms recovered with- 
out tracheotomy (Kossel). Even in the fatal cases life was prolonged 
(Caiger). 

While diphtheria antitoxin properly prepared and used under aseptic 
precautions is generally conceded to be harmless, some ill effects are re- 
corded as caused by it. An urticarial eruption on the skin, also pains in 
and swellings about the joints occur in about 5 per cent, of the cases, but 
these symptoms are usually transient and without serious consequences. 
Abscess at the site of the injection has occurred, but rarely forms if proper 
aseptic measures are used. Welch states that over 100,000 injections 
have been given, and that the serious mishaps directly attributable to the 
serum can be counted on the fingers. Two deaths are recently reported, 
one in Berlin and one in Oregon, as having occurred within a few minutes 
after the injection of the antitoxin in healthy children. 

The following seem to be established facts as to the use of antitoxin in 
diphtheria. That the immunized serum is far more efficient as a curative 
agent than any remedy heretofore employed, the general mortality of the 
disease having been reduced by its use to about 17 per cent, from a pre- 
vious rate of about 42 per cent. That a marked improvement in both 
the local and general symptoms is usually noticed within 24 to 48 hours 
after the injection of the serum. That the remedy has decided power to 
prevent the spreading of the false membrane into the larynx and trachea. 
That it is powerless to repair damage already done to the tissues by the 
diphtheria toxins, hence the earlier that the serum is administered the 
better are its results. That it is decidedly more efficient in the fibrinous 
form of the disease than in the septic form, and in cases of simple infec- 
tion than in those of double or mixed infection. That the [liability to 
paralysis and albuminuria is not lessened but is perhaps somewhat in- 
creased by this treatment, though genuine nephritis is less frequently seen 
under its use than in cases treated by other methods. That the serum 
may cause certain untoward symptoms, as cutaneous eruptions, swellings, 
etc., but that these are not serious and are not attended with danger to 
life. That its injection is very rarely followed by serious local disturb- 
ances, as abscess, and probably would never be complicated thereby if the 
serum were always pure and used with strict aseptic precautions. That 
recent improvements in the methods of preparation and more definite 
knowledge as to the dose and manner of employment have made the later 
reports even more favorable than the earlier ones. At the 1895 meeting 
of the British Medical Association, Professor Klein made the statement 
that " the scientific basis for the application of antitoxic serum is as 
firmly founded and as thoroughly established as the use and application 
of any known drug." 

Local antiseptic treatment of the throat is still insisted on in connec- 



ANTITOXINS. 151 

tion with the serum injection in every case of the disease. If thoroughly 
carried out in the incipiency it may destroy the dangerous streptococci 
and other microbes, thereby preventing the mixed infection which proves 
so virulent ; if continued throughout the case and during convalescence 
it will minimize the danger of infecting other persons. In some in- 
stances bacilli were found as long as two months after recovery. 

Diphtheria Antitoxin is now prepared in all European countries and in the laboratories 
of several boards of health, manufacturing druggists and others in this country. The 
serum on the English market differs somewhat in strength, Aronson's being a highly 
concentrated form obtained by precipitating the greater part of the inert constituents, 
while Klein's is prepared by injecting both the toxins and the bacilli into the animal to 
be immunized. The serum furnished by the British Institute of Preventive Medicine 
contains 1,500 normal units in each 10 ccm. In Germany the preparation of the serum 
is conducted by a private firm under the supervision of Professors Behring and Ehrlich, 
and is tested by official experts before its distribution is permitted by the government 
authorities entrusted with the control of its manufacture. 

Behring 1 s Diphtheria Antitoxin is standardized in comparison with a 
• " normal therapeutic serum " of which one-tenth of a gramme will neu- 
tralize one gramme of diphtheria toxin, and 1 ccm. of which is termed 
equivalent to one "normal" or " immunizing unit." As distributed the 
serum contains at least 100 such normal units in each ccm., the label on 
every vial showing the potential strength of its contents, thus: "This 
phial contains 6 ccm. of 100 times normal strength = 600 normal units." 
Four different potentials are furnished, — one with a yellow label, possess- 
ing 200 units, and intended only for prophylaxis, and three for therapeu- 
tic employment, viz : (1) that with a green label, containing 600 units, 
for use only in fresh cases on the first or second day; (2) that with a 
white label, possessing 1,000 units, to be used in more serious cases on 
the first or second day, or in less serious cases of longer standing ; (3) 
that with a red label, possessing 1,500 units, and meant for adults or for 
very severe cases in children. 

The dose for prophylaxis is 200 units, to be repeated after two or three 
weeks if the case is still exposed to infection ; but this amount is too 
small if the patient is in the incubation period of the disease. The im- 
munity is only temporary, its duration depends on the quantity of anti- 
toxin injected, and it gradually decreases as the latter is eliminated, but 
it can be maintained for a long time by the repeated use of smaller doses 
at short intervals. 

The dose for curative purposes should be rather large than small, in 
order to guard against a virulent infection, 200 to 300 units for a light 
case, 500 to 800 for a severe or advanced one ; to be repeated on the 
next or even on the same day if the case seems grave, until 800 to 1,000 
or even 1,500 units have been given. The maximum quantity decided 
on may be administered in one dose, and as a rule will not require to be 
repeated. The necessary amount for any case can only be determined 
by comparative estimation of the quantity of toxin present as indicated 



152 ANTITOXINS. 

by the symptoms ; remembering that this quantity increases rapidly with 
every day after infection. The prognosis is unfavorable if the case is so 
far advanced before treatment that the toxin has had time to accumulate 
and to exert its paralyzing influence on the nervous apparatus of the heart. 

Gibier's Diphtheria Antitoxin is prepared at the biological laboratory of the New- 
York Pasteur Institute from the blood of horses made immune by injection for over a 
year with diphtheria toxin. Two forms are supplied, a liquid and a dry one. The 
liquid product is supplied in bottles containing 5, 10 and 25 ccm. each, representing re- 
spectively 500, 1,000 and 2,500 units. The smallest size is intended for immunizing 
purposes, the medium one is a single curative dose for incipient cases, and the largest for 
repeated injection and extended treatment in fully developed or grave cases. In the 
latter the dose should be 25 ccm. at first, 25 ccm. more within 24 hours, and even 
100 ccm. may be injected within a few days, the serum being entirely innocuous. The 
dry form is a powder, one gramme of which is to be dissolved in 15 to 25 ccm. of 
sterilized water in a sterilized vial, furnishing the equivalent of over 1,500 units. This 
amount will suffice for an incipient case, for a severe one two or even three times the 
quantity may be used on the first day of treatment. 

The injections are given by means of a sterilized hypodermic syringe, preferably in the 
lateral part of the abdomen, after the site of injection has been carefully washed with a 
4 per cent, solution of carbolic acid or a I per cent, solution of lysol. They are almost 
painless, and subsequent massage is unnecessary as the swelling caused by the fluid disap- 
pears quickly. 

Gibier's Double Antitoxin is a serum obtained from a horse which has been im- 
munized against streptococcus virus after having been previously rendered immune against 
the diphtheria bacillus. It is supposed to contain both the diphtheria and streptococcus 
antitoxins, and is intended for the virulent cases due to a mixed infection with these two 
poisons, but it may be used in any case of diphtheria. It is supplied in vials containing 
25 ccm. each, which quantity should be injected in two doses 12 hours apart in an 
ordinary case; but for severe cases the amount used should be 25 ccm. at first and 25 ccm. 
more within 24 hours, to be repeated daily until 100 ccm. have been administered. 

Concentrated Diphtheria Antitoxins, containing 200, 300 and 400 antitoxic units 
to the ccm. , have been produced at the laboratory of the New York Board of Health. 

Tetanus Antitoxin. Tetanus was one of the first diseases to be 
studied successfully by the bacteriologists, and its antitoxin was the first 
one prepared. Breiger (1880) showed that a crystalline substance of high 
toxicity could be obtained from tetanic fluids, and that it would repro- 
duce the symptoms of tetanus when injected into healthy animals. Rosen- 
bach found the tetanus bacillus in human cases of the disease, and Nico- 
laier demonstrated its existence in soils. Kitasato soon afterward obtained 
pure cultures of the bacillus, and demonstrated the immunizing power of 
the serum of animals inoculated with its toxin. As human tetanus is a 
comparatively infrequent disease there are but few available statistics of 
its treatment with antitoxic serum, all the reported cases numbering less 
than a hundred ; but its previous mortality, as shown by the two largest 
sets of statistics, covering 2,789 cases, was 88 per cent., which has been 
reduced to 20 per cent, under the serum treatment (Kreiger). Dr. Marson 
has reported a series of 38 cases so treated by various physicians, with 25 
recoveries, a mortality of 34.2 per cent. In spite of its failure in many 
instances, the antitoxic serum is unquestionably the most efficient remedy 
known for this disease. As tetanus is only recognizable by symptoms due 



ANTITOXINS. 153 

to nerve lesions, which symptoms are not manifested until the nervous 
system has been damaged by the toxin, an early diagnosis is impossible ; 
and when first seen by the physician the disease has usually advanced too 
far for the curative action of the remedy to be available. For this reason, 
and as the immunizing properties of this antitoxin are very potent, it is 
advised that a preventive inoculation thereof should be given in all cases 
where infection is possible, such as lacerated wounds soiled with earth or 
rust, especially when occurring in those tropical countries where the disease 
is most common. For this purpose a dose of 10 ccm. would suffice, if 
repeated at intervals of two or three weeks. For curative purposes the 
serum should be injected as soon as possible, the quantity being deter- 
mined according to its stated strength, the gravity of the symptoms, the 
patient's age and the time since infection. The shorter the time of in- 
cubation or the more serious the symptoms, the larger should be the initial 
dose. As a rule one injection should be given every other day, using a 
smaller quantity at each repetition, so as to maintain sufficient immunity 
and prevent relapse. Along with the serum treatment the usual remedial 
measures should be employed, namely : excision of the part or the actual 
cautery if the wound is recent, chloroform anaesthesia, chloral, etc. The 
actual cautery, or the application of a strong solution of corrosive sub- 
limate with tartaric acid, are the most efficacious means of neutralizing 
the tetanus germs in the wound. 

The tetanus antitoxin prepared by Dr. Gibier of the New York Pasteur Institute is 
dispensed in dry form only, may be transported any distance without injury by heat or 
frost, and is said to preserve its qualities for an indefinite time if kept in a dark and dry 
place. It represents as many antitoxic units as are contained in about 12 times its weight 
of liquid serum. The powder is put up in 25 ccm. bottles, each containing 3 grammes, 
to be filled with sterilized water when required for use, and shaken thoroughly until the 
powder is dissolved. Each bottle then contains two doses of antitoxic solution, and this 
amount is to be administered daily for four or five days, beginning on the very first appear- 
ance of symptoms of the disease. For prophylactic use I or 2 ccm. of the solution 
should be injected immediately after the infliction of a suspicious wound. 

Tuberculosis Antitoxin has superseded Koch's tuberculin, which 
was a toxin treatment, in the serum-therapy of tuberculous disease. 
Boinet immunizes goats with injections of tuberculin, and claims to have 
used the resulting serum in eight cases of tuberculosis with marked bene- 
fit. Professor Maragliano, of Genoa, has treated 82 cases with a serum 
similarly prepared. He reports that the cases of unmixed infection, with 
circumscribed foci of disease, slight surrounding consolidation, and but 
little fever, are distinctly benefited by the treatment and even some are 
cured thereby ; but that those with much broncho-pneumonic consolida- 
tion or with cavities do not show any great improvement. 

Dr. Maragliano administers in apyretic cases or those with slight fever I ccm. of the 
serum every second day for the first ten days, then a similar dose every day for another 
ten days, then two similar injections daily for the next ten days. If there is high fever 
10 ccm. should be given at once, and after three days a daily injection of I to 2 ccm. if 



1 54 ANTITOXINS. 

the fever does not rise again, but if it persists a second dose of io ccm. is given eight 
days after the first one. Improvement is noticeable often within two weeks but sometimes 
not until after two months have elapsed. Even when a cure seems complete the injec- 
tions should be continued for at least a month and even for a year. General hygienic 
measures must not be neglected, and the efficiency of the digestion must be especially 
attended to. 

Dr. Paul Paquin of St. Louis has reported upon 22 serious cases of this 
disease, treated by him in the city hospital with a serum obtained from 
horses immunized by injection of the toxins of the bacillus tuberculosis. 
He states that a large percentage of these cases increased in weight from 
5 to 16 pounds each during 6 to 8 weeks, and at the same time showed 
other evidences of general improvement, without the use of tonics or any 
special diet, only the regular fare of the city hospital or poor-house being 
available for them. After the lapse of six months the entire 22 were alive, 
all having improved and more than one-half the number having been dis- 
charged from the hospital as well enough to work. Numerous reports from 
other observers testify to good results obtained with Paquin' s serum in the 
worst cases, e.g., knee-joint tuberculosis (Cale), laryngeal tuberculosis 
(Loeb), and acute pulmonary tuberculosis (Lemen). 

The effects observed after injecting Paquin's serum include erythema, 
urticaria, local swellings, pain, swelling and stiffness of joints, numbness, 
pain in the spine, in the back of the head and in the stomach. The most 
serious complication is a sudden disturbance of the circulation, caused 
by the injection entering a vein or the muscular tissues, which requires 
the prompt administration of cardiac stimulants, as alcohol, nitroglycerin, 
etc. Over 3,000 injections were made in human subjects without one 
serious accident. 

Dr. Paquin administers a beginning dose of 10 minims, with strict aseptic precautions, 
hypodermatically into the subcutaneous tissue of the back, avoiding vessels and muscular 
tissue. He repeats the injection once daily, increasing the daily dose by 5 minims so long 
as it does not raise the temperature above 1° F. A dose of 25 minims is usually sufficient 
as a maximum. He advocates the use at the same time of a continuous acting vaporizer 
containing creosote and other antiseptics ; also the inhalation of the vapor of the essential 
oils of peppermint, eucalyptus and cinnamon from a" lip-trough inhaler" worn under the 
nose, and repeated disinfection of the mouth and throat by an antiseptic gargle. He 
states that a fever rising above ioi F. usually indicates a mixed infection, in which the 
serum treatment is not indicated ; the cases amenable to it being the incipient ones and 
those in the first and second stages of the disease. 

Antiphthisin, the remedy prepared by Dr. Klebs, may be mentioned in this connec- 
tion, though it is not an antitoxin, but a derivative of Koch's tuberculin, the germicidal 
constituents of which it is supposed to possess, separated from the toxic ones. It is more 
fully described under the title Toxins. 

Streptococcus Antitoxin has been employed successfully in erysip- 
elas, puerperal fever, and several forms of septicaemia and pyaemia due 
to streptococcus infection. The credit for the suggestion and preparation 
of this antitoxin is due to Dr. Marmorek, of the Pasteur Institute, Paris, 
who has treated therewith 411 cases of erysipelas with a mortality of 3.4 
per cent. He also treated 16 cases of puerperal fever with this serum; 



ANTITOXINS. 155 

seven of which, due to streptococcus infection, recovered; one, due to 
bacterium coli, died ; and among eight of mixed infection with strepto- 
coccus, bacterium coli, and staphylococcus, five died, Several cases of 
puerperal fever, erysipelas, and other forms of streptococcus infection, are 
reported by Pozzi, Charrin, Roger and others, as having been treated 
successfully with this antitoxin. Many of the most virulent cases of diph- 
theria are due to a double infection with the diphtheria bacillus and the 
streptococcus, and for the treatment of such cases a combination antitoxin 
has been prepared by Marmorek and also by Gibier of New York. (See 
under Diphtheria Antitoxin, ante). The treatment of sarcoma and 
carcinoma by injections of streptococcus antitoxin is noticed under the 
title Toxins, and the sub-title Erysipelas and Prodigiosus Toxins. 

Streptococcus Antitoxin is obtained from the horse immunized against streptococcus 
erysipelatis by inoculations with the toxins of cultures which have been rendered exceed- 
ingly virulent by passage through a certain series of animals. The serum possesses great 
activity, and is dispensed in vials containing a quantity sufficient for four injections of 6 
ccm. each, two of which may be given immediately and the remaining two on the follow- 
ing day. 

Syphilis Antitoxin. — A serum obtained from the blood of lambsand 
dogs has been used by Tommasoli and other Italian experimenters in the 
secondary and tertiary manifestations of syphilis, with encouraging results. 
It has been recently suggested that the natural insusceptibility of certain 
animals to this disease may be increased by injecting into them the blood 
serum from human subjects in the primary or active secondary stages of 
syphilis. This has been carried out by Triboulet and others, without pre- 
judicial effect on the animals injected, and their serum was used in the 
treatment of extensive tertiary ulcerations, with the result that these lesions 
almost completely disappeared, although they had resisted a six months' 
course of the ordinary treatment. Hericourt records a striking improve- 
ment in a case of syphilitic tabes under the same method, and other simi- 
lar observations have been reported with equally favorable results. The 
doses employed were 2 ccm. of the serum on successive or alternate days. 
The only complications observed were a transitory roseolar eruption, 
slight albuminuria, and a brief elevation of temperature. 

Antivenene is the name given to an antitoxin prepared by Fraser in 
consequence of Calmette's observation that the serum of an animal 
immunized by the injection of increasing doses of serpent venom pos- 
sesses antidotal and immunizing properties against the effects of the bites 
of poisonous snakes. The active principle of serpent venom is of albu- 
minous nature and is analogous to the so-called toxalbumins, active ingre- 
dients of the bacterial toxins. Antivenene does not seem to be specific, 
as the antitoxins in general are, for Fraser finds that when obtained by 
the inoculation of cobra-poison it is equally effective against the venom 
of several serpent species, including the cobra, the rattlesnake, etc. 



I$6 APIOLUM APOCYNUM. 

Calmette states that tetanus antitoxin antagonizes the effects of cobra 
venom to a certain extent, also that intra-venous injections of calcium 
hypochlorite produce a blood serum which possesses antitoxic properties 
against the effects of the cobra poison. 

Other Antitoxins have been prepared by inoculating the cultures or the toxins of 
Frankel's pneumococcus, the typhoid bacillus, and the bacteria of cholera, erysipelas, 
anthrax, vaccinia and the plague. Even rabies has its so-called antitoxin, though its 
bacterial origin has never been demonstrated. The results reported therefrom have so 
far been few and unimportant. Typhoid Antitoxin is obtained by injecting sheep for 
three months with broth cultures of the typhoid bacillus. The resulting serum is found 
to be efficient in neutralizing the effects of the typhoid toxins in guinea-pigs, and a few 
cases of human typhoid have been treated with it, apparently with good results. Vac- 
cinia Antitoxin is supposed to exist in the serum of vaccinated heifers, and M. Beclere 
has treated a few cases of variola with such a serum, in one case using 1,560 ccm., with 
the result that the patient recovered rapidly without suffering any inconvenience. In 
another case an infant 21 days old received injections of the serum to the amount of ^th 
of its weight, and was cured of a serious form of small-pox. 

APIOLUM, Apiol (Unofficial), — is a non-volatile, oily liquid, of green color, acid 
reaction and pungent taste, soluble in alcohol, ether, chloroform, and in glacial acetic 
acid. It is extracted from the fruit of Petroselinum sativum (Parsley), a biennial plant 
of the nat. ord. Umbelliferae. which also contains a gelatinous substance named Apiin, 
and a Volatile Oil which is by some considered to be the true emmenagogue principle of 
the plant. Apiol is probably a mixture of several substances, and as found in commerce 
is often an impure oleoresin. Dose, TT^iij— x in capsule two or three times a day ; as an 
emmenagogue, TT^xv in one daily dose. 

A camphor, also named Apiol, C 12 H 14 4 , is obtained from the same source, and occurs 
in white needles, of a feeble parsley odor, insoluble in water, but freely soluble in alcohol 
or ether. Dose, gr. xv as an antiperiodic, gr. v-x against dysmenorrhcea. 

In small doses (rr\^iij— v) Apiol is carminative, diuretic, diaphoretic, expectorant and 
stimulant to the circulation. In full doses (rt\xv) it is decidedly emmenagogue and 
feebly antiperiodic, producing headache, tinnitus aurium, intoxication, giddiness, etc., its 
action generally resembling that of Quinine. Large doses (ttlxxx-^j) are decidedly 
narcotic. 

It has had some reputation in intermittents and in malarial neuralgise, but is most fre- 
quently employed in amenorrhcea and dysmenorrhcea, being of especial advantage in the 
amenorrhcea of anaemia, also when the menstrual discharge is fetid. It is becoming 
fashionable as a supposed abortifacient, but is useless for this purpose, and if freely used 
may produce decided narcotism, especially if the preparation employed should happen to 
be an active one. 

The capsules of Apiol put up in France and sold in this country over the counters of 
drug-stores to any applicant are generally inert ; hence cases of poisoning by this drug 
are seldom observed. They are, however, an important source of revenue to the retailers, 
as, being " imported " preparations, they command a high price, which is readily paid by 
gullible women who wish to " bring around their courses." 

APOCYNUM, Canadian Hemp, — is the root of Apocynum camtabinum, an in- 
digenous perennial plant of the nat. ord. Apocynaceae, and is inodorous, but of bitter, dis- 
agreeable taste. It contains a peculiar active principle, Apocynm, also tannic and gallic 
acids, resin, wax, caoutchouc, etc. Dose of the powdered root, gr. v-xxx. A decoction 
( ^ ss to the pint) may be given in doses of ^ j-ij thrice daily. 

Extractum Apocyni Fluidum, Fluid Extract of Apocynutn, — Dose, rr^v-xxx. 

Apocynum is powerfully emetic and cathartic in full doses, also diaphoretic, expecto- 
rant and sometimes actively diuretic. It lowers the pulse-rate, produces much nausea, 
and induces drowsiness. It should not be confounded with the Indian or American 
Hemps (Cannabis sativa), which have entirely different qualities. 

The only condition in which Apocynum has proven of much value is dropsy, especially 
the anasarca of Bright's disease and ascites, in which 15-grain doses are indicated. The 
active principle, Apocynin, is a good expectorant, in doses of gr. % to gr. l / 2 . 



AQUA. 157 

AQUA, Water, H 2 0, — is natural water, in its purest attainable 
state ; a colorless limpid liquid, devoid of odor or taste, and of neutral 
reaction. Besides entering into the composition of most of the official 
extracts, fluid extracts, and many other pharmaceutical preparations, from 
it are prepared the 17 official Waters (Aquae), and also the following : — 

Aqua Destillata, Distilled Water, H 2 0, — 1000 parts of water are distilled, the first 
100 parts obtained being thrown away, 800 parts are preserved. It is as near chemically- 
pure water as can be obtained. 

Aqua Carbonata, Carbonated Water, Soda Water, — is described under AciDUM 
Carbonicum, ante, page 80. 

Nomenclature of Water. 

Aqua Fluvialis, River-water. Aqua Destillata, Distilled Water. 

Aqua Pluvialis, Rain-water. Aqua Bulliens, Boiling Water. 

Aqua Fontana, Spring or Well-water. Aqua Fervens, Hot Water. 

Aqua Marina, Sea-water. Aqua Communis, Common Water. 

Aqua Carbonata, Carbonated Water, Balneum Maris, Warm-water Bath. 

Soda Water. Balneum Vaporis, Vapor Bath. 

Mineral Waters. 
Natural Water differs from Distilled in containing saline and other 
constituents in varying proportions, — from common water (Aq. Com- 
munis), in which they are so small in quantity as not to alter the taste, 
color, etc., up to the Sea- water, having 3^ per cent., and that of the 
Dead Sea with 26*^ per cent. Spring waters, impregnated with foreign 
substances so as to have a decided taste and a marked action on the human 
system, are called Mi?ieral Waters, which may be subdivided into various 
groups, according to their prevailing constituents, as Carbonated, Alka- 
line, Saline, Sulphuretted, Silicious, etc. Full analyses of all the princi- 
pal mineral waters of Europe and America are given in the 15th edition 
of the United States Dispensatory, but a few of the most prominent will 

be mentioned here. 

Alkaline Mineral Waters. 

Ems, Germany. Perry Spring, Ills. 

Salzbrunn, Germany. St. Louis Spring, Mich. 

Gleickenberg, Austria. Buffalo Lithia Spring, Va. 

Vichy, France. Hot Spring, Va. 

Vals, France. Warm Spring, Va. 

Bladon Spring, Ala. Berkeley Spring, Va. 

Congress Spring, Cal. Bethesda Spring, Wis. 

Seltzer Spring, Cal. Gettysburg Spring, Pa. 

These waters are generally cold, those of Vichy and Ems being warm. They contain 
a considerable amount of Sodium Carbonate, also Sodium Chloride and Sulphate, and 
various other Chlorides, Carbonates and Sulphates, with Carbonic Acid gas in varying 
quantity. Vichy and Vals waters depend for their efficacy almost wholly on the quantity 
of Sodium Carbonate contained in them, which is for Vichy from 26 to 50 grains and for 
Vals about 60 grains to the pint. 

Saline Mineral Waters. 

Friedrichshall, Germany. Cheltenham, England. 

Hunyadi Tanos, Hungary. Kissengen, Bavaria. 

Baden-Baden, Germanv. Reichenhall, Bavaria. 



I58 AQUA. 

Saline Mineral Waters. 

Wiesbaden, Germany. Adelheidsquelle, Bavaria. 

Carlsbad, Bohemia. Kreutznach, Prussia. 

Pullna, Bohemia. Saratoga Springs, N. Y. 

Seidlitz, Bohemia. Ballston, N. Y. 

Marienbad, Bohemia. Hot Springs, Arkansas. 

St. Catherine's, Ontario, Canada. 

These waters are of more complex composition, the various waters of Saratoga contain- 
ing more than thirty constituent salts. Those usually present are the Sulphates and 
Carbonates of Sodium, Calcium, Magnesium, etc. [Magnesian waters) ; Chlorides of 
Sodium, Potassium and Lithium (Chlormated waters) ; Ferrous salts {Chalybeate waters), 
with Iodine, Bromine, Manganese salts, and Phosphates in some few. Carbonic Acid 
gas is present in all. Most of them are purgative, some are considered alterative, and 
many are warm (ioo°-i6o°). 

The most powerful member of the saline group is Hunyadi Janos, which contains about 
150 grains each of Magnesium and Sodium Sulphates to the pint, and is, therefore, effec- 
tively purgative. Nearly as strong is Pulhta water, with 124 grains of Sodium Sulphate 
and 93 grains of Magnesium Sulphate to the pint. Friedrichshall is less powerful, but 
perhaps a better aperient water in doses of 6 to 10 fluid ounces. Marienbad contains no 
Magnesium Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, II 
of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint ; in transpor- 
tation, however, it loses its Carbonic Acid and deposits the Iron. It is not aperient in 
ordinary doses. Carlsbad water contains 20 grains of Sodium Sulphate and 9 each of 
Sodium Carbonate and Chloride to the pint. The so-called " Carlsbad Salt " is simply 
Sodium Sulphate with a trace of the Carbonate. Hartnack gives the following formula 
for its artificial preparation : Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium Chlo- 
ride 40 ; a dessertspoonful in water as a mild saline purgative. These waters are imported 
into, and made in the United States in large quantities, and may be ordered through any 
druggist. 

Sulphtirons Mineral Waters. 

Aix-la-Chapelle, Prussia. Blue Lick Spring, Ky. 

Bareges, S. France. Sharon Spring, N. Y. 

Eux-Bonnes, S. France. Yellow Sulphur Spring, Va. 

Llandrindod, Wales. White Sulphur Spring, W. Va. 

Harrowgate, England. Salt Lake Warm Springs, Utah. 

These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid gas and Car- 
bonates, Chlorides and Sulphates of Sodium, Potassium, Magnesium and Calcium ; some- 
times Carbonate and Oxide of Iron, Iodide and Bromide of Sodium. 

Carbonated Mineral Waters. 

These waters are cold, contain generally Carbonates of Calcium, Magnesium and 
Sodium (in some, Iron), which are held in solution by the excess of Carbonic Acid, also 
Chlorides of Sodium and Potassium, Sulphates, Phosphates, etc. They are described 
under Acidum Carbonicum, ante, page 80. 

Silicious Mineral Waters. 
Hot Springs, Iceland. Geysers of Yellowstone Park. 

The constituents of these waters are chiefly alkaline Silicates. 



Physiological Action of Water. 
Water is an essential constituent of all the tissues of the body, form- 
ing from 0.2 per cent, of the enamel of the teeth to 77 per cent, of the 
ligaments. In the liquids of the organism it is contained in the propor- 
tions of 78 per cent, of the blood to 93 of the urine, and 99 of the tears. 



AQUA. 159 

In moderate quantity it is necessary to digestion, but in large amount it 
weakens digestion by diluting the gastric juice. Ice-cold water, if freely 
used, suspends the action of the pepsin, depresses the nerves of the 
stomach, and lowers its blood supply. The free use of water internally 
produces increased cutaneous and renal excretion, and promotes the elimi- 
nation of some of the products of tissue-change, as urea, phosphoric acid, 
etc. In some subjects it favors the deposition of fat. 

Cold Water applied externally, as by a bath (4o°-6o° F.), abstracts a 
portion of the body-heat, lowering the surface temperature and depress- 
ing the cutaneous nerves, producing spasmodic breathing and a quickened 
pulse. If the temperature of the water is not too low and the bodily 
vigor is good, reaction soon occurs, and the general effect is tonic to the 
muscular power, circulation and respiration. If this does not take place 
a secondary chill occurs, and serious depression may result. 

Warm Water (q5°-ioo° F.) applied to the surface of the body, as 
by baths of water or steam, packing, etc., acts in the opposite manner at 
first, increasing the circulation in the skin, the rapidity of the pulse and 
respiration and the body temperature. Rapid tissue-change occurs, the 
waste products being eliminated chiefly by the skin and the pulmonary 
mucous membrane. If long-continued, precordial oppression, giddiness 
and muscular debility are experienced. 

Hot Water (iio°-ii2° F.) at first dilates the vessels of the part to 
which it is applied, and soon afterwards contracts them. It is a valuable 
means of relieving congestion and inflammation, and is a most effective 
hemostatic when the bleeding is from small vessels or of capillary charac- 
ter. Whether generally or locally applied it is one of the most reliable 
means of relieving spasm. Hot Vapor applied to the surface accelerates 
the circulation and produces profuse sweating. Its general action is 
similar to that of warm water. 

Mineral Waters taken internally act chiefly by virtue of the water, 
partly in accordance with the effects of their various constituents. As 
baths, their action is doubtless entirely due to their temperature. 

Pathogenic Microbes of several diseases, notably those of cholera and typhoid fever, 
are conveyed to the human system in drinking water contaminated therewith. But these 
organisms are destroyed by a temperature of I44 F. in the absence of their spores, while 
a temperature of 212 F., that of boiling water, maintained for five minutes, destroys the 
spores of all pathogenetic organisms which have been tested (Sternberg). This fact is of 
the highest practical importance, as it shows that no germs of disease need ever gain en- 
trance to our bodies through our drinking water, if we will only boil it. Many years ago 
an English physician's report was quoted in Braith wake's Retrospect, in reference to the 
immunity of the Chinese from typhoid fever, though, he said that in Pekin there was no 
system of sewerage, but that all excreta were thrown on the ground to find their way into 
the watercourses by which the city was supplied, to soak into wells, etc. Yet, the author 
said, that contrary to all experience elsewhere, typhoid fever was unknown in Pekin. 
The reason is to be found in the fact that the Chinese boil all the water they drink. Those 
who know them best say that they never drink cold water, but always tea, i. e. , boiled 
water. There must be something to account for their remarkable health under otherwise 
adverse hygienic surroundings. 



l60 AQUA. 

Therapeutics of Water. 

Cold Water or Ice has many external applications of value in the 
treatment of disease. As a wet pack it is used in tonsillitis, diphtheria and 
croup. Cold baths are the most effective antipyretic in the high tempera- 
ture of fevers, and the cold wet pack is used for the same purpose. Ice 
or cold water is applied to the head in acute cerebral congestion, and to 
the spine in chorea, etc.; also locally in hemorrhoids, bubo, orchitis, and 
to the uterus in post-partum hemorrhage. Cold affusion to the body is 
employed as a preventive of spasmodic croup, as well as to lessen the ten- 
dency to taking cold. 

Hot Water externally as fomentations, hot wet pack, baths, etc., is 
most effective in reducing local congestion and setting up resolution of 
local inflammation. Hot fomentations to the renal region are useful in 
functional inactivity of the kidneys. The hot spinal douche is used in 
affections of the spinal cord and meninges, and in the backache of women. 
The hot wet pack is highly esteemed in inflammation of the chest organs, 
and hot injections for chronic inflammation of the uterus. Hot water 
dressings for wounds are strongly favored by many high surgical authori- 
ties. Vapor and Turkish baths are used as diaphoretics in advanced kid- 
ney disease, in acute and chronic rheumatism, mineral poisoning, and 
syphilis. Warm baths, with cold applications to the head, are esteemed 
of value in infantile convulsions and chorea. 

Internally, water is chiefly of value as a diuretic, and if hot as a dia- 
phoretic. A glass of cold water before breakfast daily is often an effective 
means of overcoming constipation, while the drinking of hot water an 
hour before each meal has been of great value to many dyspeptics. The 
value of the popular teas in chronic diseases is almost entirely due to the 
diluent, diuretic and diaphoretic actions of the hot water used. 

Therapeutics of the Mineral Waters. 
An undue value is placed by the laity and interested proprietors on the 
medicinal value of mineral waters, causing the various localities of the 
best advertised springs to become resorts for invalids and idlers from every 
civilized country. The benefit derived is in most instances due to the 
change of climate and scene, freedom from home cares and business 
worry, regularity of life and diet, drinking of water in quantity, and in 
many cases the substitution of water for alcoholic beverages. In order 
to get the worth of their money, people will gladly submit to rigid 
hygienic and dietetic restrictions at a watering-place which they would 
totally ignore under treatment at home. The same may be said of the 
treatment at the so-called "hydropathic" or "water-cure" establish- 
ments. As a rule, those springs will prove of most value which are 



ARGENTUM. l6l 

furthest removed from the patient's residence, for " distance lends en- 
chantment " in these matters as well as in many others. Invalids whose 
homes are in the vicinity of some wonder-working spring will not usually 
derive much benefit from its water, but will by that of another spring, 
similar in constituents, but located several hundred miles away. 

The principal affections in which mineral waters are esteemed most 
highly are the following : dyspepsia, cirrhosis of the liver, gout, rheu- 
matism, lithiasis, diabetes of hepatic origin, constipation, strumous dis- 
orders, obesity, plethora of the pelvic organs, hypochondriasis, skin dis- 
eases, especially those dependent on gastric derangement, phthisis, con- 
stitutional syphilis, metallic poisoning, etc., in all of which the influences 
above mentioned are especially efficacious, and are no doubt the chief 
factors in producing any benefit which may be attainable. Aperient and 
purgative waters are useful in many cases where a prejudice exists against 
purgative medicine, but none against the same agents in a natural water. 
The strong saline-aperient waters, as Carlsbad, Hunyadi, Friedrichshall, 
etc., have considerable repute in the treatment of the uric-acid diathesis 
and calculous affections, and the waters of St. Catherine's Wells are 
credited with decided influence upon local and chronic rheumatism. 

The special therapeutics of mineral waters are to be found in this volume under the 
heads of their principal constituents, as Acidum Carbonicum, Sodium Chloride, Sodium 
Sulphate, Magnesium Sulphate, etc., also in the therapeutical part of the book. 



ARGENTUM, Silver, Ag, — is represented by the following four 
official salts, viz. : — 

Silver Compozmds and their Preparations. 

Argenti Nitras, Silver Nitrate, AgN0 3 , — occurs in colorless rhombic crystals, of 
bitter caustic taste and neutral reaction, soluble in 0.6 of water and 26 of alcohol at 59 
F. Is best given in pill or distilled water ; never with tannin or a vegetable extract, lest 
an explosive compound result. Dose, gr. ]/(,-%, — if watched, up to gr. j may be given. 
When melted with 4 per cent, of Hydrochloric Acid, it makes — 

Argenti Nitras Fusus, Moulded Silver Nitrate, Lunar Caustic, — for local use 
as a mild caustic and astringent. Argenti Nitras Dilutus, Diluted Silver Nitrate, 
Mitigated Caustic, — is the same salt melted with twice its weight of Potassium Nitrate. 
Is used locally by ophthalmologists. 

Argenti Cyanidum, Silver Cyanide, AgCN, — has no medicinal use except for the 
extemporaneous preparation of Hydrocyanic Acid. (See ante, page 87.) 

Argenti Iodidum, Silver Iodide, Agl, — a greenish yellow powder insoluble in water 
or alcohol. Is used instead of the nitrate internally, as it is supposed not to discolor the 
skin. Dose, gr. J^-j in pill. 

Argenti Oxidum, Silver Oxide, Ag 2 0, — a brownish black powder, nearly insoluble 
in water and insoluble in alcohol. It should not be triturated with readily oxidizable or 
combustible substances, and should not be brought into contact with ammonia. Dose, gr. 
^-ij in pill. Is not dangerous. 

All the silver salts should be protected from light in dark amber-colored vials. 

Physiological Action. 
Silver Nitrate is a powerful astringent and a limited escharotic. Ap- 
plied to the skin or mucous membrane it combines with the albumen of 
11 



l62 ARGENTUM. 

the tissue, excites superficial inflammation, which is soon followed by an 
altered condition of the part, and stains the same black under the influ- 
ence of light. The stains may be removed by washing with a strong so- 
lution of Potassium Cyanide. Given internally in small doses it increases 
secretion, stimulates the heart, promotes nutrition, and acts as a nerve 
tonic. Its continued use produces symptoms which are collectively 
termed Argyria, and are as follows : gastro-intestinal catarrh, tissue waste, 
uraemia, albuminuria, fatty degeneration of the heart, liver and kidneys, 
hemorrhages, fluidity of the blood, a slate-colored line along the margin 
of the gums, and a similar discoloration of the skin and mucous mem- 
branes, with centric impairment of the nervous system producing paralysis 
on a large scale, loss of coordination power, convulsions, and finally death 
by paralysis of respiration. Large doses produce violent gastro-enteritis, 
also ulcer of the stomach from thrombosis of its veins, and destruction of 
the gastro-intestinal mucous membrane. 

The Iodide and Oxide are sometimes used to produce the same consti- 
tutional effects, they being supposed not to discolor the skin, but this has 
been found to be fallacious. The oxide is much the least irritant of the 

silver salts. 

Antagonists and Incompatibles. 

Common Salt freely used is the antidote, precipitating the silver as the insoluble chlo- 
ride and acting as an emetic. The Nitrate is exceeding sensitive to organic material 
and light, which decompose it readily. Incompatibles are all the soluble Chlorides 
(hence it should be used in distilled water), most of the Mineral Acids and their salts, 
Alkalies and their Carbonates, Lime-water and astringent infusions. 

A course of silver medication should be regulated by suspending the remedy after 5 or 
6 weeks' use, and then promoting elimination by purgatives, diuretics and baths. To 
prevent the general discoloration Potassium Iodide should be given conjointly with the 
silver, and baths of Sodium Hyposulphite used frequently. 

Therapeutics. 

Locally the Nitrate is much used as a stimulant application, an astrin- 
gent, a caustic, an alterative and an antiphlogistic. To ulcers and in 
throat affections the solid stick may be used, but solutions of various 
strengths, from gr. j to gr. xl to the ]§, are much better. The mildest so- 
lutions are employed in conjunctivitis (never over the cornea), the stronger 
in throat and mouth affections, and the strongest in lupus, erysipelas and 
other skin diseases. A solution in Nitrous Ether (gr. xl to the g) is said 
to abort superficial inflammations if applied early to the neighboring in- 
tegument, and in erysipelas a solution of gr. xx to the g is often used over 
the inflamed surface and beyond, after careful washing and drying, in the 
hope of preventing the extension of the disease, which it will not do. The 
mucous membrane of the conjunctiva, fauces, larynx, urethra, bladder, 
uterus, vagina and rectum, have all been subjected to the local action of 
this salt. 

Internally the silver salts are used in dyspepsia with vomiting of yeasty 



ARNICA. 163 

fluid, chronic gastritis and gastric ulcer, dysentery of chronic type, espe- 
cially if rectal ulcer (the Nitrate internally and by enema), the diarrhoea 
of phthisis and typhoid fever (Nitrate with Opium), chronic spinal inflam- 
mations causing locomotor ataxia or paraplegia, and epilepsy; in the 
latter affection the Nitrate having occasionally given good results. 

The Oxide has been used internally for gastric neuralgia, irritative 
dyspepsia, pyrosis, gastric and pulmonary hemorrhages, and menorrhagia. 
The Iodide is employed to obtain the constitutional effects of silver, but 
has no advantage over the other preparations. 



ARNICA, — is the plant Arnica montana or Leopard's Bane, a peren- 
nial of the nat. ord. Compositse, indigenous to the mountains of Northern 
Europe and Siberia, and said to have been also found in the mountains 
about the headwaters of the Missouri and Columbia rivers. It has large 
orange-yellow flowers, and a small, curved rhizome with several rootlets. 
Both the flowers and the roots are official. Its most important constituent 
is Trimethylaniine, C 3 H 9 N, an ammoniacal alkaloidal principle, which is 
probably the active ingredient. It also contains Arnicin, Inulin, Capro- 
nic and Caprylic Acids, tannin, mucilage, resins, and two essential oils, 
one of which exists in the flowers, the other in the root. 

Arnicae Flores, Arnica Flowers, — the flower-heads of Arnica mon- 
tana, large and yellow, of feebly aromatic odor and bitter, acrid taste. 
Used in Tincture and Infusion. 

Arnicae Radix, Arnica Root, — the rhizome and rootlets of Arnica 
montana, is externally brown and rough from leaf-scars, internally whitish, 
with a thick bark containing a circle of resin-cells and a large, spongy 
pith. Odor somewhat aromatic, taste pungent, aromatic and bitter. 
Resembles Valerian, which is distinguished by its smell ; Serpentaria, 
which has many contorted rootlets; and Veratrum Viride, which has 
thicker rootlets. Dose, gr. v-xx. 

Preparations of the Flowers. 

Tinctura Arnicae Florum, Tincture of Arnica Flowers, — strength 20 per cent. 
Dose, Tl\v-xxx. 

Infusum Arnicae, Infusion of Arnica (Unofficial), — Arnica flowers 20, to 100 parts 
of water, is thought by many observers to be the best form for local use, as it does not 
excite dermatitis, probably from containing none of the Volatile Oil, nor the insoluble 
principle Arnicin. 

Preparations of the Root. 

Extractum Arnicae Radicis, Extract of Arnica Root, — Dose, gr. j-iij. 

Extractum Arnicae Radicis Fluidum, Fluid Extract of Arnica Root, — Dose, 
n^v-xx. 

Tinctura Arnicae Radicis, Tincture of Arnica Root, — 10 per cent. Dose, TTlv-xxx. 

Emplastrum Arnicae, Arnica Plaster, — contains Extract of Arnica Root 23 parts to 
67 of Lead Plaster. 



164 ARNICA. 

Derivative. 

Trimethylamina, Trimethy 'famine, C 3 H 9 N (Unofficial), — is a thin, colorless, strongly- 
alkaline liquid, boiling at 50 F. , and at ordinary temperatures is a colorless, inflammable 
gas. The Hydrochlorate is the most stable salt, crystallizing in white or colorless prisms, 
nearly odorless, of pungent taste, very deliquescent, and freely soluble in water and in 
alcohol. Dose, gr. ij-iij in syrup every 2 hours. 

Trimethylamine has been obtained from Arnica flowers and those of several other 
plants, from Ergot, Hops, Codeine, Cod-liver Oil, and decomposing albuminous sub- 
stances, such as human urine, herring-pickle, and the residue left in making sugar from 
beets. It is sometimes incorrectly named Propylamine, a term also applied to an impure 
trimethylamine, but in reality an allied and isomeric compound. 

Physiological Action and Therapeutics. 

Arnica is irritant, stimulant, depressant, antipyretic, diuretic and vul- 
nerary. It irritates the gastro-intestinal tract, and in some persons the 
local use of an alcoholic preparation of the flowers will excite erysipela- 
tous inflammation of the skin, though those of the root have not been 
observed to do so. In small doses internally it increases the action of the 
heart, raises the arterial tension and stimulates the action of the skin and 
the kidneys. Large doses produce a transient excitement, followed by 
depression of the circulation, respiration, and nerve-centres ; headache, 
unconsciousness, and even convulsions being induced, the body-tempera- 
ture lowered, the pupils dilated, and muscular paresis produced. Atoxic 
dose paralyzes the nervous systems of animal and organic life, causing 
collapse and death. 

Arnica is a popular remedy with those who patronize the so-called 
homoeopathic school of practice, but like many other agents which the 
homceopathists claim to have given to medicine, it is a remedy much 
older than homoeopathy, and was investigated originally by regular physi- 
cians, notably by Van der Kolk in the sphere of mental affections. Ex- 
ternally, the tincture in water has a popular reputation in sprains, bruises, 
etc., though an infusion is better for local use. Ecchymoses are rapidly 
dispersed by its administration internally as well as externally ; and, in 
internal bruises from shocks or concussions, its internal use has proven 
very efficacious. The aqueous preparation locally promotes the rapid 
union of cut surfaces. 

Internally, besides its value as noted above, Arnica is undoubtedly 
employed effectively in typhus and typhoid fevers as a stimulant and 
antipyretic ; also in delirium tremens, rheumatism and rheumatic gout, 
hemorrhages, epistaxis, haemoptysis, amaurosis, concussion of the brain, 
chronic dysentery, and paralysis of the bladder, it has rendered good 
service. 

In idiopathic mania, after the first excitement has diminished, Arnica, 
in aqueous preparation internally, has given great satisfaction. It has 
often checked an exhausting diarrhoea after many other remedies have 
failed. 



ARSENUM. 165 

Trimethylamine is an active escharotic and a gastro- intestinal irritant. It lowers the 
rate and force of the heart, decreases the body-temperature, and diminishes (though 
sometimes increases) the excretion of urea. The Hydrochlorate is a powerful antipyretic 
in doses of gr. ij every 3 hours. It has been found useful in acute rheumatism and gout, 
relieving pain, reducing temperature, and diminishing the frequency of the pulse. In 
chronic rheumatism, as a liniment (1 to 3 of Glycerin), it is said to give relief equal to 
that produced by any anodyne. It has also been used with benefit in chorea, moderating 
the spasmodic movements when not suspending them entirely. 



ARSENUM, Arsenic, As. — The metal Arsenic is not used in 
medicine, but is represented by one of its Oxides, a salt of another Oxide, 
and the Iodide, which are official ; together with four preparations of 
these compounds, or of their salts, viz.: — 

Arsenic Compounds and their Preparations. 

Acidum Arsenosum, Arsenous Acid (Arsenic Trioxide, White Arsenic), As 2 3 , — 
is a heavy, white solid, occurring as an opaque powder, or in semi-transparent masses 
having usually a striated appearance, soluble in 30 to 80 of water at 59 F., the solubility 
varying with its physical condition, also soluble in 15 of boiling water, in alkalies and 
their carbonates, hydrochloric acid and in glycerin. It is volatilized at 424.4 F., with- 
out melting, and when thrown on ignited charcoal it emits an alliaceous odor. Arsenous 
Acid is obtained by roasting native arsenides, and condensing the fumes in a long hori- 
zontal chimney. Dose, gr. ^ to y 1 ^. 

Liquor Acidi Arsenosi, Solution of Arsenous Acid, — is a I per cent, solution in 
HO and Distilled Water. Dose, TT\^ij— viij , thrice daily in water after meals. 

Liquor Potassii Arsenitis, Solution- of Potassium Arsenite (Fowler's Solution}, — is 
a I per cent, solution, prepared by boiling together Arsenous Acid I, Potassium Bicar- 
bonate 2, Comp. Tincture of Lavender 3, and Distilled Water to 100. Dose, tryj-viij, 
in water thrice daily after meals. 

Sodii Arsenas, Sodiu?n Arsenate, Na 2 HAs0 4 + 7H 2 0, — is a salt of the second 
oxide, Arsenic Acid, As 2 5 . Occurs in colorless prismatic crystals, of feebly alkaline 
taste and a faintly alkaline reaction, soluble in 4 of water at 59 F., very soluble in 
boiling water, hardly soluble in alcohol. Dose, gr. T ^— \ ; of the dried salt, gr. 2i~rV 

Liquor Sodii Arsenatis, Solution of Sodium Arsenate (Pearson' 's Solution), — is a I 
per cent, solution of the dried Arsenate in Distilled Water. Dose, mjj-xv, in water after 
meals. 

Arseni Iodidum, Arsenic Iodide, Asl,, — occurs in glossy, orange-red crystalline 
masses or scales, gradually losing iodine by exposure to the air, soluble in 7 of water and 
in 30 of alcohol at 59 F. ; is gradually decomposed by boiling water and by boiling alco- 
hol, and is completely volatilized by heat. Dose, gr. -^q-\. 

Liquor Arseni et Hydrargyri Iodidi, Solution of Arsenic a7id Mercuric Iodide 
(Donovan 's Solution), — has Arsenic Iodide and Mercuric Iodide, of each I part in 100 of 
Distilled Water. Dose, TT^ij— viij, in water after meals. 

Unofficial Arsenic Compounds. 

Cupri Arsenis, Cupric Arsenite, — occurs in the various cupro- arsenical pigments used 
for wall-paper coloring and as insect-poison, viz. — Scheele's green, Mineral green, Paris 
green, etc. Is highly poisonous. Dose, gr. T ^ daily, in divided doses. 

Liquor Arseni Bromidi, Solution of Arsenic Bro?nide, Clemens' 1 Solution, — so named 
by Dr. Clemens, who described it as a chemical union of Arsenic and Bromine, but the 
action of Bromine on Arsenous Acid results in the formation of Arsenic Acid and Hydro- 
bromic Acid, and the preparation is rather a Liquor Potassii Arsenatis et Bromidi. It 
contains Arsenic equal to I per cent, of Arsenous Acid ; and is prepared by boiling to- 
gether Potassium Carbonate and Arsenous Acid, 3 j of each in 3 x of distilled water, 
until a clear solution is formed ; when cold ,^ij of Bromine and 3 xij of water are added, 
and the mixture is allowed to stand until all color disappears, when it is ready for use. 
Dose, TT\j-v, thrice daily in water after meals. 



1 66 ARSENUM. 

Solutions of the Bromides of Arsenic and Gold (Arsenauro), of Arsenic, Gold 
and Mercury (Mercauro), of Arsenic, Gold and Calcium (Calcauro), and of Arsenic, 
Gold and Manganese (Mercauro), are described under the title Aurum. 

Physiological Action. 

Arsenous Acid, when applied to the skin denuded of its epidermis, acts 
as a painful escharotic, producing violent inflammation and resulting in 
a slough which forms a barrier to its absorption. If applied in dilute 
solution over a large surface, it will be absorbed, and may produce the 
systemic effects to be described. 

In small doses it is a stomachic and general tonic, promoting the appe- 
tite and digestion, increasing the cardiac action, the respiratory power, 
and the intestinal secretions, — stimulating peristalsis, exalting mental 
activity and the sexual appetite, and producing a fair skin and a rotund 
form. When tolerance of the drug is established, large doses are used 
with impunity, as by the arsenic-eaters of Styria, who can swallow at once 
as much as 5 grains with safety. They are careful, however, not to take 
any water into the stomach at the same time, so that the dose is slowly 
absorbed, and probably eliminated rapidly. Not all those who begin its 
use can acquire tolerance of it, but those who do so seem to continue it 
without injury, and live to an old age, undergoing great exertion without 
exhaustion, and being enabled to ascend steep mountains without diffi- 
culty of respiration. 

In full medicinal doses, continued for some time, it causes itching and 
oedema of the eyelids, ptyalism, nausea and vomiting, diarrhoea or dysen- 
tery, epigastric pain and soreness, feeble and irritable heart, dyspnoea, 
disordered sensibility, herpes zoster, urticaria, eczema and other skin 
eruptions, jaundice and albuminuria. 

In large doses, it is a powerful irritant to the gastro-intestinal and 
bronchial mucous membranes. Toxic doses may produce either symptoms 
of gastro-enteritis, or those of profoundly narcotic character. In the 
first and most usual form of acute arsenical poisoning, there is burning 
pain in the throat and stomach extending over the abdomen, vomiting, 
thirst, bloody stools, strangury, suppressed, albuminous or bloody urine, 
rapid and feeble heart, great anxiety, cold breath, finally exhaustion and 
collapse, — a group of symptoms much resembling cholera. Autopsy 
shows erosions, ecchymoses, and softening of the gastro-intestinal mucous 
membrane, congestion of the lungs and bronchi, and fatty degeneration 
of the liver, kidneys and cardiac muscle. The poison is found in the 
urine, saliva, tears, sweat, etc., and may be detected even in the paren- 
chymatous tissues. In the nervous form of poisoning by Arsenic, pro- 
found coma and insensibility come on suddenly without any gastro-intes- 
tinal symptoms. 

Arsenical preparations are generally classed as alteratives, but they are 



ARSENUM. 167 

valuable tonics and antiseptics, and possess antiperiodic powers second 
only to those of Quinine. 

Chronic Arsenical Poisofiing may occur from the inhalation of arsenical 
vapors or dust arising from wall-papers or other substances containing the 
poison. The quantity necessary to produce symptoms of poisoning 
when inhaled seems to be very small. The most prominent symptoms 
are, at first increased appetite, next colicky pains, mucous or dysenteric 
stools, irritation of the eyes, coryza, a short, dry cough, and a white and 
silvery tongue, all accompanied by great bodily prostration. 

The long-continued use of arsenic may induce peripheral neuritis, the 
chief symptoms of which when so caused are — severe darting pains in the 
limbs, paralysis of the muscles of the extremities, especially the extensors 
of the hands and feet, ataxic gait, herpes zoster, and rapid muscular 
atrophy. In several cases it has caused general brown pigmentation of 
the skin, and may give rise to brown pigmentation of psoriasis patches. 
After death from chronic poisoning, in addition to the gastro-intestinal 
and nervous lesions, there is found wide-spread fatty degeneration, affect- 
ing most of the organs, but particularly the liver, kidneys, stomach and 
muscles, including the heart. 

To avoid arsenical poisoning during a course of the drug, full doses 
(rq,x of Fowler's Solution) should be used at the commencement, and 
always taken on a full stomach. The dose should then be steadily re- 
duced. Susceptible persons often tolerate it better if a few drops of 
Tinctura Opii are administered with each dose. 

Antidotes and Incompatible^. 

Poisoning by Arsenic is treated by prompt evacuation of the stomach, and washing it 
by means of the stomach pump, then Magnesia, Chalk and Lime-water freely, or better 
still, the chemical antidote to Arsenic in solution, viz., the Hydrated Oxide of Iron, 
freshly precipitated and in a soft magma, in the proportion of gr. viij for each grain of the 
poison ingested. (See Ferri OxiDUM Hydratum for the preparation of this antidote.) 
Oil or mucilaginous drinks should be given to protect the mucous membranes, and dilu- 
ents, alkaline mineral waters or Iodide of Potassium to promote elimination. Dialyzed 
Iron has been shown to be quite efficient as an antidote, and is more easily obtained than 
the hydrated oxide. It has rendered good service in many cases of poisoning from 
inhalation of arsenical fumes. 

Incompatibles are salts of Iron, Magnesium and Calcium, also Astringents. 

Therapeutics. 
Externally, Arsenic has been employed in the form of paste as a depila- 
tory, and as an escharotic in cancers, but is excessively painful. Most of 
the secret " cancer cures " have arsenous acid for their basis. Internally, 
it is used as a tonic and astringent to the intestinal canal, as a tonic and 
antispasmodic in nervous diseases, and for its action on tissue change. It 
is of especial value in irritative dyspepsia, gastralgia, pyrosis, gastric 
ulcer or cancer, regurgitation of food without nausea, diarrhoea coming 
on immediately after taking food, vomiting of drunkards and chronic 



1 68 ASAFCETIDA. 

alcoholism. It has proven of signal service in the commencement of 
phthisis, and in catarrhal pneumonia, probably by causing fatty degen- 
eration of the exudation in the alveolar cavities, thus breaking it up and 
quickening' its absorption. It is often very serviceable in chronic bron- 
chitis with copious expectoration, in acute catarrh, hay fever, whooping- 
cough, asthma, chorea, epilepsy, angina pectoris and other spasmodic 
nervous disorders. In many forms of neuralgia it often gives prompt and 
permanent relief, especially in cases due to malarial poisoning. As an 
antiperiodic, it has high rank, being, however, of particular value in chronic 
malarial poisoning, and as an adjunct to Quinine in the intervals between 
the paroxysms of intermittents. . Anaemia and chlorosis are remarkably 
benefited by it, and in rheumatic arthritis and chronic rheumatism it is 
sometimes of great service. In chronic scaly and papular skin diseases 
its value is very great, but it is not serviceable in acute forms, and the 
more chronic the cutaneous affection the more likely is it to be amen- 
able to Arsenic. Epithelioma may be retarded by small doses long con- 
tinued, and it has certainly been useful in delaying the progress of other 
cancers, particularly scirrhus of the stomach and uterine carcinoma. 
Hypodermically its solutions have been extremely efficient in histrionic 
spasm, local chorea of the head and neck, obstinate cases of general 
chorea, and in lymphadenoma. 

The so-called Bromide of Arsenic, in the form of Clemens' Solution, 
has rendered good service as a remedy for diabetes mellitus of hepatic 
origin. Cupric Arsenite is being highly recommended in typhoid fever. 



ASAFCETIDA, Asafetida, — a gum-resin obtained by incision from 
the living root of Ferula foetida, a perennial herb of the nat. ord. Um- 
belliferse, native of Persia and Afghanistan. It occurs in whitish tears 
embedded in a grayish sticky mass, of alliaceous odor and taste, soluble 
in alcohol to at least 60 per cent., and when triturated with water it yields 
a milk-white emulsion. Its principal constituent is a Sulphuretted Volatile 
Oil, consisting chiefly of Allyl Sulphide, C 6 H 10 S ; it also contains a gum 
and a resin, with ferulaic, malic, acetic, formic and valerianic acids. 
Dose, gr. v-xx. 

Preparations. 

Tinctura Asafcetidae, Tinchire of Asafetida, — strength 20 per cent. Dose, 3 ss-ij. 

Emulsum Asafcetidae, Emulsion of Asafetida, Milk of Asafetida, — strength 4 per 
cent, in water. Dose, 3 ss-ij. 

Pilulae Asafcetidae, Pills of Asafetida, — each pill has gr. iij with gr. j of Soap. Dose, 
j-iv pills. 

Pilulae Aloes et Asafcetidae, Pills of Aloes and Asafetida , — each pill has gr. i 1 /^ of 
each ingredient with the same of Soap. Dose, j-iv pills. 

Mistura Magnesias et Asafcetidae, Mixture of Magnesia and Asafetida, Dewees' 
Carminative (Unofficial), has of Magnesium Carbonate 5, Tinct. Asaf. 7, Tinct. Opii I, 
Sugar 10, Aqua Dest. q. s. ad 100 parts. Dose, ^ss-^ss. 



ASCLEPIAS ASPIDIUM. 169 

Spiritus Ammoniae Fcetidus (Unofficial), — Asafetida 1)4, Liquor Ammonk Fortior 
2, Spirit 20 parts. Dose, gss- j. 

Physiological Action and Therapeutics. 

Asafetida is a powerful antispasmodic, a stimulant to the brain and 
nervous system, a stimulating expectorant, also tonic, laxative, diuretic, 
diaphoretic, emmenagogue, aphrodisiac and anthelmintic in action. Its 
odor and taste are extremely nauseous and persistent. In small doses con- 
tinued it is said to cause impaired digestion, alliaceous eructations, acrid 
sensation in the fauces, gastralgia, flatulent distention, fetid flatulence, 
burning urination, diarrhoea and tenesmus. Full doses produce various 
nervous or hysterical phenomena, with nausea, vomiting and purging. 

The Volatile Oil diffuses into the blood and tissues, and is excreted in 
the urine, sweat, breath, etc. By its action the circulation is stimulated, 
the arterial tension raised, the power of the cardiac motor ganglia is in- 
creased and the inhibition relaxed. Asafetida also stimulates the brain 
even to pleasant intoxication, and produces a subjective sensation of 
warmth without any rise of body temperature. It stimulates the nervous 
system, the secretions and excretions, the menstrual flow and the sexual 
appetite. In Asia it is used as a condiment with food, and though at first 
it is extremely nauseous to most people, a taste for it may be readily ac- 
quired. 

The disgust which is generally felt for this remedy makes its use very 
restricted, though a valuable medicine. The Emulsion is extremely ser- 
viceable in the flatulent colic of infants, and as an enema in infantile 
convulsions. There is no better remedy in hysteria and hypochondriasis 
with indigestion and flatulence, — in constipation with amenorrhoea of 
anaemic subjects, due to ovarian and intestinal torpor, — in bronchial 
affections, cough of habit, chronic catarrhs, and flatulent indigestion. It 
has recently been highly praised in the treatment of habitual abortion. 



ASCLEPIAS, Pleurisy Root, — is the root of Asclepias tuberosa, a plant of the nat. 
ord. Asclepiadaceae and a native of the Eastern and Southern States. Two other species 
of Asclepias are used in medicine and were formerly official. 

Extractum Asclepiadis Fluidum, Fluid Extract of Asclepias, — Dose, ,^ss-j. 

An Infusion or Decoction may be made in the proportion of ^j of the powdered root 
to a quart of water, and given in teacupful doses every 2 or 3 hours. 

Asclepias contains two resins, a peculiar principle, tannic and gallic acids, albumen, 
pectin, gum, various salts and a volatile, odorous, fatty matter. It is emetic and cathartic 
in full doses, also diaphoretic and expectorant, as well as depressant to the action of the 
heart, and probably slightly sedative and astringent. It is a popular remedy in the 
Southern States for pleurisy (hence its common name), and has been used in medicine for 
catarrh, pneumonia, phthisis, diarrhoea, dysentery, rheumatism, gastralgia, and to promote 
the eruption in exanthematous fevers. It is undoubtedly a powerful diaphoretic. 



ASPIDIUM,— is the rhizome of Dryopteris Filix-mas (Male Fern) 
and of Dryopteris marginalis (Marginal Shield Fern), plants of the nat. 



I70 ASPIDOSPERMA.- 

ord. Filices, the former found in most parts of the world, the latter indi- 
genous to N. America. The active principle is Filicic Acid, C u H 18 5 , 
which is extracted in the oleoresin. It also contains a green, fatty oil, a 
volatile oil, resin, tannin, etc. Dose, 3ss-5jss in a single dose fasting, or 
in divided doses at short intervals, followed by a purgative. 

Oleoresina Aspidii, Oleoresin of Aspidium, — is an ethereal extract and deposits 
Filicic Acid on standing. It should be well shaken before being used. Dose, sjss-^j, 
in capsules, repeated every 3 hours for 2 or 3 doses. 

Aspidium is an efficient vermicide against tapeworm, particularly the 
unarmed variety (Bothriocephalus latus). The oleoresin is the best form 
in which to use it, the patient having fasted for the previous day, or only 
used a milk diet, 5j m ay then be given in 4 doses ^ hour apart. This may 
be repeated the next morning and followed by three drops of croton oil in 
emulsion. This is one of many methods. Cusso may be combined with 
it advantageously. A formula for a mixed treatment by Aspidium, 
*Pomegranate and Pumpkin-seed is given under the title Granatum. 



ASPIDOSPERMA, Aspidosperma, Quebracho,— -is the bark of 
Aspidosperma Quebracho- bianco, a large evergreen tree of the nat. ord. 
Apocynacese, growing in Chili and the Argentine Republic. The name 
is one given in S. America to any very hard wood (quebrar hacho, to 
break the axe), and the particular tree above named is known as Quebracho- 
bianco, from the white color of its wood. It contains several alkaloids, 
no one of which represents the action of the bark itself; the most 
important being Aspidospermine, C 22 H 30 N 2 O2, and Quebrachine, C 21 H 26 - 
N 2 3 . Several false Quebrachos are found on the market, that most 
frequently seen being the bark of Loxopterygium Lorenizii, or Quebracho 
Colorado, an Argentine tree of the order Terebinthaceae. 

Preparations. 

Extractum Aspidospermatis Fluidum, Fluid Extract of Aspidosperma, — is the 
only official preparation. Dose, tl\v-^j. 

Tipctura Quebracho, Tincture of Quebracho (Unofficial), — strength 20 per cent. 
Dose, 3J-iv. 

Vinum Quebracho, Wine of Quebrac/io (Unofficial). Dose, 3J-^j- 

Extractum Quebracho, Extract of Quebracho (Unofficial). Dose, gr. ij to x. 

Physiological Action and Therapeutics. 
Aspidosperma is a bitter tonic of disagreeable taste, promoting appetite 
and increasing digestion. It lowers the action of the heart, reduces arte- 
rial tension, and slows respiration, also decreasing the sensation of need 
of air after active exercise. In large doses it causes severe salivation, 
nausea, vomiting, vertigo and headache. In animals it paralyzes the 
motor nervous system and lowers the reflexes, producing great dyspnoea 
and finally death, apparently from asphyxia. 



AURANTIUM. 1 7 I 

This drug has long been used in Chili as an antiperiodic, a stomachic 
tonic, and a remedy for dyspncea. In the latter condition it is reported 
to be remarkably palliative, especially when due to emphysema, uraemic 
and spasmodic asthma, spasmodic cough and chronic bronchitis. It is 
not efficient in dyspncea from organic diseases of the heart, nor in that of 
aged subjects of atheroma. 

Aspidospermine is actively poisonous to the respiratory apparatus and 
circulation in both cold- and warm-blooded animals, in the former the 
respiration being chiefly affected, in the latter the motor ganglia of the 
heart. Lowered temperature, dyspncea, stupor and convulsions occur 
before death. It has been used as an antipyretic, also in cardiac neuroses 
and in asthma. Its salts are freely soluble in water, but the alkaloid 
itself is only soluble in oils and fats, 6 to 8 parts being readily incorpo- 
rated with ioo of cod-liver oil by the aid of heat. The average dose is 
about gr. j-ij. 



AURANTIUM, Orange, — occurs in two official varieties of fruit 
and flowers, viz., those of Citrus vulgaris, the Bitter Orange, and Citrus 
Aurantium, the Sweet or Portugal Orange, both trees of the nat. ord. 
Aurantiacese, cultivated in almost all warm climates. Other varieties are 
described under Limon. The official titles are — 

Aurantii Amari Cortex, Bitter Orange Peel, — the rind of the fruit 
of Citrus vulgaris, characteristics well known. Contains a Volatile Oil 
isomeric with Oil of Turpentine, C ]0 H 16 , and a bitter, crystalline princi- 
ple, Hesperidin or Auranliin. 

Aurantii Dulcis Cortex, Sweet Orange Peel, — is the rind of the 
fresh fruit of Citrus Aurantimn. It contains a Volatile Oil differing from 
that of the bitter orange, and less of the bitter principle. 

Preparations. 

Extractum Aurantii Amari Fluidum, Fluid Extract of Bitter Orange Peel. — 
Used as flavoring. Dose, 3jss-j. 

Tinctura Aurantii Amari, Tincture of Bitter Orange Peel, — strength 20 per cent. 
Dose, 3J-ij- A flavoring preparation. 

Tinctura Aurantii Dulcis, Tincture of Sweet Orange Peel, — strength 20 per cent. 
Dose, 3 j-ij. A flavoring preparation. 

Syrupus Aurantii, Syrup of Orange,— Sweet Orange Peel 5, Calcium Phosphate 
Precip. 5, Sugar 70, Alcohol and Water to 100. Dose, 3 j-ij. Used for flavoring. 

Syrupus Aurantii Florum, Syrup of Orange Flowers, — Sugar 85, Orange-flower 
Water to 100. Dose, gj-ij. A delicate flavoring agent, but having to some persons 
an extremely sickish taste. 

Spiritus Aurantii, Spirit of Orange, — Oil of Orange Peel 5, Deodorized Alcohol 
95. Dose, to be regulated by the quantity of alcohol desired. 

Spiritus Aurantii Compositus, Compound Spirit of Orange, — Oil of Orange Peel 
20, Oil of Lemon 5, Oil of Coriander 2, Oil of Anise )/ z , Deodorized Alcohol to 100. 
Dose, as for alcohol. 



172 AURUM. 

Aqua Aurantii Florum Fortior, Stronger Orange-flozver Water, — is water saturated 
with the volatile oil of fresh orange flowers. Dose, indefinite, for flavoring. Used to 
prepare — 

Aqua Aurantii Florum, Orange-flower Water, — consists of equal volumes of the 
preceding and Distilled Water, mixed immediately before use. Dose, indefinite. 

Oleum Aurantii Corticis, Oil of Orange Peel, — a volatile oil, obtained by expres- 
sion from the fresh peel of either orange. Is soluble in about 4 times its volume of 
alcohol, and is an ingredient of the two official Spirits of Orange and also of Spiritus 
Myrciie (Bay Rum). Dose, gtt. j-v. 

Oleum Aurantii Florum, Oil of Orange- Flowers [Oil of A r eroli), — a volatile oil, 
distilled from the fresh flowers of the bitter orange. Is the most important constituent 
of Cologne Water (Spiritus Odoratus), and is soluble in an equal volume of Alcohol. 
Dose, gtt. j-v. 

Elixir Aromaticum, Aromatic Elixir [Simple Elixir), — has of the Comp. Spt. of 
Orange 1.2, Precipitated Calcium Phosphate T.%, Syrup 37^, Deodorized Alcohol and 
Distilled Water to 100. A flavoring vehicle. Dose, 3J-5J, or more. 

Physiological Action and Therapeutics. 
Orange is aromatic and tonic, also more or less bitter, but has little 
action except a mild stimulant influence on the nervous system due to its 
volatile oil. Persons much exposed to its fumes are liable to cutaneous 
eruptions and various nervous disorders. The oil may produce violent 
colic and convulsions in children, one case being reported in which death 
resulted from eating the rind. Its use in medicine is confined to flavor- 
ing purposes, though the preparations of the Bitter Orange may be used 
as gentle tonics and stimulants to the digestion, but they are usually com- 
bined with agents more energetic for these purposes. 



AURUM, Gold, Au., — is represented by only one official salt, the 
Gold and Sodium Chloride, but triturations of the metal itself may be pre- 
pared, according to the general pharmacopceial formula for such prepara- 
tions. The unofficial solution of Gold and Arsenic Bromide (see below) 
is a very efficient preparation. Fine gold and a solution of the perchlo- 
ride are in the Br. Ph., and powdered gold, also the oxide, chloride, 
sodio-chloride, iodide, and cyanide, are official in the French Codex. 

Preparation. 

Auri et Sodii Chloridum, Gold and Sodium Chloride, — is a mixture composed of 
equal parts of dry Gold Chloride, AuCl 3 , and Sodium Chloride, NaCl ; and occurs as an 
orange-yellow odorless powder, of saline and metallic taste, slightly deliquescent in damp 
air, very soluble in water, partly soluble in alcohol, and contains about 32 per cent, of 
pure gold. Its solutions are decomposed by organic substances, by light, and by almost 
all salts. Dose, gr. -^-\, once or twice a day. The Ph. Ger. gives the maximum single 
dose as gr. ^, and the maximum daily dose as gr. iij, but these doses are entirely too 
high. 

Unofficial Preparations. 

Auri Pulvis, Poivdered Gold, — maybe obtained by triturating gold leaf with ten times 
its weight of sugar of milk or potassium sulphate until brilliant particles are no longer 
visible in it, and then washing the diluent away with boiling water. A Trituration of 
Gold may be prepared in the same manner, retaining the sugar of milk, as directed by 
the pharmacopoeia under the title Tritur ationes. Dose of powdered gold is gr. £-gr. j, 
or a little of it may be applied by friction to the sides of the tongue. 



AURUM. I73 

Auri Chloridum, Gold Chloride, — also called the perchloride or terchloride of gold 
(A11CI3), the "potable gold" of the alchemists, — occurs in needle-shaped prisms of a 
deep orange color, very deliquescent and freely soluble in water, in alcohol and in ether. 
Dose, gr. ? V~5^» m P^ or somt i° n > preferably the latter. The commercial salt so named, 
and much used, by photographers, is not the pure chloride but a crystallized double salt of 
gold and sodium, containing 50 per cent, of metallic gold. 

Auri Bromidum, Gold Bromide, AuBr 3 , — occurs as a yellowish-gray, friable mass, 
which is insoluble in water but soluble in ether, and contains 55 per cent, of Bromine. 
Dose, gr. -^q-^, but a gainst migraine the minimum quantity should be used twice daily an 
hour before meals. 

Auri et Sodii Bromidum, Gold and Sodium Bromide, AuBr 3 XaBr. 2H 2 0, — may 
be used hypodermically in solution, 2 parts to 100 of distilled water, the dose of which is 
ttlviij increased to rtv,xxxij, respectively representing \ to f of a grain. 

Liquor Auri et Arseni Bromidi, Solution of Gold and Arsenic Broniide (Barclay), — 
is marketed under the trade-name " Arsenauro,'' and contains gr. J% of each salt in n\x. 
Dose, tt\v-xv in water, thrice daily after meals, or hypodermically. 

This solution may be prepared as follows : (1) Take of Nitric Acid 3 j and of Hydro- 
chloric Acid ^iij, mix them and dissolve in the mixture 21 grains of pure Gold, then 
evaporate to dryness in a water-bath. Dissolve the resulting Chloride of Gold in distilled 
water 5j, and add slowly a solution of 35 grains of Ammonium Bromide in 5 iv of water. 
Shake with Squibb's ether until all the gold is taken out, separate in a separating funnel, 
and treat the ether solution with fused calcium chloride to remove all water. Distil off 
the ether, and dissolve the remaining Gold Bromide in 3 iv of water, to make Solution 
No. 1. (2) Dissolve 48^ grains of Arsenous Acid in !|iv of distilled water by the aid of 
heat, and when cold add gj of Bromine and let the mixture stand for 24 hours. Then 
drive off the excess of bromine by boiling in a sand-bath until the solution is colorless, 
which gives Solution No. 2. (3) Mix the two solutions and add sufficient water to make 
I quart. 

Liquor Auri, Arseni et Hydrargyri Bromidi, Solution of Gold, Arsenic and Mer- 
cury Bromide (Barclay), — is marketed under the trade-name " Mercauro" and contains 
gr. 3 1 - of each bromide in rt\x. Dose, 1T\v-xv in water, thrice daily after meals, or hypo- 
dermically. 

Similar solutions, of the bromides of gold, arsenic and calcium (" Calcauro ") and of 
the bromides of gold, arsenic and manganese (" Manganauro "), are on the market, and 
may be used in like doses. 

Physiological Action. 

The action of the salts of gold upon the human organism is analogous 
in many respects to that of mercury, causing local irritation and escharo- 
tic effects when applied in substance or in strong solution. In continued 
medicinal doses given internally they produce a condition of general 
erethism which strongly resembles the mercurial fever, and is accompanied 
by salivation but without tenderness or ulceration of the gums. The 
Chloride is one of the most active salts, being, according to Chrestien, 
even more toxic than corrosive sublimate. Locally, it produces irritant 
and caustic effects, and imparts a yellow stain to the skin, which later on 
turns violet and even black, from reduction of the metal therein. In 
overdoses it causes gastric pain and inflammation, also ulceration of the 
gastro-intestinal mucous membrane, and otherwise acts as a corrosive 
poison ; toxic doses produce a violent gastro-enteritis with such nervous 
phenomena as convulsive tremor, cramps, priapism, insomnia and insen- 
sibility (Magendie). 

The salts of gold, administered in small medicinal doses, increase the 
appetite and the digestive power and stimulate the functional activity of 



174 AURUM. 

the secreting organs, especially the skin and the kidneys. They also 
stimulate the generative apparatus, causing diaphoresis and diuresis, and 
exciting the menstrual flow in women and the sexual appetite in men. 
The observations of several competent physicians have established the 
power of these salts to excite the vascular and muscular systems and to 
produce fever, to increase the urine and the sweat, to cause salivation 
without stomatitis, a sense of heat in the stomach, headache and diarrhoea, 
to promote menstruation, excite the genitalia, and profoundly affect the 
nervous system. In large or continued doses they cause dryness of the 
tongue, redness of the pharynx, gastric and intestinal colic, nausea and 
vomiting, and even erosion of the gastric mucous membrane. The 
Bromide, though containing only 55 per cent, of bromine, is found to be 
many times more active, weight for weight, than the ordinary bromides. 
Administered in doses of from y 2 grain to 3 grains per kilogramme of 
body weight, it depressed the cortical motor centres to such a degree that 
the strongest electrical stimulation thereof failed to produce an epileptic 
seizure (Shtcherbak). 

Antidotes and Antagonists. 

Poisoning by gold salts is treated like that by corrosive sublimate. The Antidote is 
Albumen in some form, followed by evacuation of the stomach, as the albuminate is not 
wholly inactive. The Antagonists are Bismuth, Tannin, Sodium Sulphite, and diluted 
Nitric Acid, in water, as gargles and mouth-washes for the salivation; Belladonna to 
lessen the salivary secretion, Hyoscyamine for the tremor, and Morphine for shock. 

Therapeutics. 
The literature of gold shows that it is one of the most ancient 
medicines. Pliny, in the first century, recorded its use as a recognized 
remedy for several conditions in which it is still employed, including 
lichenoid eruptions, fistula, hemorrhoids, warts, putrid ulcers, and sores 
emitting an offensive smell. In the finely divided metallic state it was 
employed as a panacea by the Arabian physicians and by the alchemists. 
During the 17th and 1 8th centuries it was highly esteemed as an anti- 
syphilitic, also for leprosy, dropsies, epilepsy, the pest, fevers, amenorrhcea, 
sterility and uterine diseases. During the first quarter of the present cen- 
tury it was in high repute among the Continental physicians as a remedy 
for syphilis and for scrofula. 

Mitchill (1818) administered gold salts for syphilis in the New York Hospital, with 
excellent results. In his opinion " the muriate of gold will effect all that is achieved by 
the muriate of quicksilver, with incomparably less inconvenience to the patient, who gets 
well under the former without the hazard of a sore mouth or a salivation, and with very 
little wear and tear of constitution." Trousseau ( 1 851) says that the happy results of 
gold in the treatment of venereal diseases are incontestable ; and von Schroff of Vienna 
(1868) gave it great praise for the restoration of a case of syphilis in which the strongest 
mercurials had failed to avert destruction of the nasal bones or the deep, spreading ulcers 
of the skin. Phillips (1894) says that its efficacy is best seen in the later developments 
of syphilis, such as ulceration of the nose and larynx, cutaneous syphilides, hard nodes, 
etc., also that it may especially be employed in long-standing cases with chronic peri- 
ostitis and when mercury has already been given to saturation. Still it has never obtained 



AURUM. I 



/ D 



general professional favor in the United States or in England, until recently. Professor 
Barton, of Tefferson Medical College, Philadelphia | 1^27 , , pronounced the following 
iudgment upon it in his lectures on materia medica. " On the whole view of what has 
been said in favor of gold, I am not inclined to attach great importance to it as a remedy. 
It is well enough in its proper place and for its proper purposes, for which it is more use- 
ful than as a medicine. Plenty of it would doubtless cure many diseases of mind and 
body." Such has been the general opinion since the above words were printed, but of 
late years a number of compounds of gold with other elements (chlorine, bromine, iodine, 
arsenic and mercury) have been employed as medicines with considerable satisfaction. 

Dr. Piffard of New York finds that Gold is unquestionably useful in 
the later stages of syphilis, and says that its best effects are obtained with 
very small doses, gr. -^ or less, which he rarely continues for more than 
one or two weeks at a time. Several other observers have given it great 
praise as a remedy in constitutions which are broken down by the com- 
bined influence of syphilis and mercury, for syphilis in strumous subjects, 
and for the various manifestations of scrofula. Under its use the auric 
fever may develop, and the local affections for which it is administered 
may assume an aggravated intensity, and even new ones appear ; but 
these phenomena do not call for the suspension of the remedy, for the dis- 
ease retrogrades rapidly in a few days after they appear (Trousseau^ ; and 
on lessening the dose pyrexia subsides and good effects are more con- 
spicuous (Phillips). 

Strumous affections have been recently reported as cured by the internal 
and local use of auric preparations, including scrofulous ulcers, lupus, 
ozjena, enlarged and indurated cervical glands, and hypertrophy of the 
tongue with induration thereof. Gold has been credited with many cures 
of cancer of the uterus, mammse and tongue, but it is probable that such 
have really been cases of scrofulous ulceration. Squamous skin diseases, 
the "dartres" of the older writers, are, next to syphilis, the most suc- 
cessful field for the action of gold. In cutaneous diseases it is used 
locally as well as internally. Dropsy is one of the affections in which it 
was anciently recommended, and in which modern therapeutists have 
found it efficient, especially in ascites due to chronic hepatic disease or 
induration of the abdominal organs, also in post-scarlatinal dropsy and 
ovarian dropsy. 

Many disorders of the female generative organs have proved amenable 
to gold when persistently employed. Amenorrhoea due to ovarian torpor 
and chronic metritis with scanty menstruation are often benefited : 
by, while sterility dependent on these states or due to coldness, is more 
certainly cured by the auric preparations than by any other merely 
medicinal means. The tendency to habitual abortion may be averted by 
the use of the Chloride, which is also beneficial for mental symptoms of 
hysterical character, especially when connected with uterine dis 
Many competent clinicians have highly commended gold in suicidal 
melancholia, hypochondriasis accompanying hepatic or testicular disease, 



I76 AURUM. 

in decline of the sexual power in men, and as a tonic for low-spirited, 
pining boys with undeveloped testes. 

Sclerosis of the internal organs, especially the liver and kidneys, may 
be retarded by the persistent use of the Gold and Sodium Chloride, in 
doses of gr. -gV"-^ thrice daily. Nervous dyspepsia, characterized by a 
red and glazed tongue, epigastric pain increased by food, and relaxation 
of the bowels after eating, is greatly benefited by the same salt in equally 
small doses. Catarrh of the duodenum and bile-ducts, and jaundice 
therefrom, also vertigo and vertiginous sensations connected with gastric 
disorders or due to cerebral anaemia, are often removed by a course of 
treatment with the salts of gold. The Bromide has been employed in 
doses of from gr. ^ to gr. ^ with decided benefit in obstinate cases of 
hysteria and epilepsy. Goubert used it successfully for migraine, epilepsy, 
chorea and exophthalmic goitre, in daily doses of gr. ^ to ^, continued 
until its characteristic headache was produced. He claims for it greater 
efflcacy in epilepsy than is possessed by the other bromides, and says 
that, as compared with them, it is better tolerated and does not induce 
depression and emaciation or the other pronounced symptoms of brom- 
ism. 

A combination of Gold and Arsenic (Auri Arsenas) was introduced by 
Chrestien and extensively employed by Massart in cancer and phthisis, 
with sufficient success to merit the approval of the medical societies of 
Lyons and Toulouse. It is said to be particularly serviceable in scrofu- 
lous affections, especially lupus, and to exercise a highly beneficial influ- 
ence on anaemia and chlorosis. A solution of the Bromides of Gold and 
Arsenic has been successfully employed for several years by Dr. Barclay 
and others in the various diseases of which sclerosis is the chief factor, 
such as cirrhosis of the liver and lungs, interstitial nephritis, atheroma and 
calcareous degeneration of the arteries, senile degenerative changes and 
neurotic disease, fibroid phthisis, locomotor ataxia, etc ; also in cervical 
adenitis, arthritis deformans, syphilitic neuralgia and iritis, miliary tuber- 
culosis, epilepsy, chronic neuritis, sciatica, chronic muscular rheumatism 
and neurasthenia. Arsenauro is the trade-name of this solution, which 
has lately been the subject of extended reports from competent observers, 
many of whom claim to have obtained from the use of this combination 
results which neither of its constituents are capable of when administered 
alone. It is held to have marked alterative power upon the glandular 
system and upon all non-malignant scleroses ; to be not only a blood- 
maker but a blood-builder, increasing the number of the corpuscles and 
improving their quality, and also increasing the amount of haemoglobin 
therein. It' is eliminated by the kidneys and produces no irritation when 
administered either by the mouth or hypodermically. A similar solution 
of the Bromides of Gold, Arsenic, and Mercury, named Mercauro, is on 



AVENA SATIVA BALSAMUM PERUVIANUM. \JJ 

the market, and is highly praised in the treatment of the late manifestations 
of syphilis, particularly those affecting the nervous system. 

A so-called " Bichloride-of-Gold Cure " for inebriety has lately become 
notorious through extensive advertising and other commercial methods, 
but from the most reliable information obtainable it is reasonably certain 
that the only preparation of gold which plays a prominent part therein 
is the gold coin which passes from the patient's pocket to that of the 
manager of the "institute." The physiological symptoms produced by 
the remedy employed are those of strychnine and atropine, the adminis- 
tration of which hypodermically several times daily for three or more 
weeks is decidedly dangerous. In many cases cardiac failure has occurred 
soon after the completion of the treatment, and in a large number of 
instances insanity or other serious psychoses have developed immediately 
after the subjects had been through one of these so-ealled "cures." 



AVENA SATIVA, — the common Oat, a plant of the nat. ord. Graminaceae, — was 
official in the U. S. P. 1870, as Ave nee Farina, or Oat-meal. A concentrated tincture or 
fluid extract has been extensively advertised by drug manufacturers as a nerve stimulant 
and tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, nervous 
exhaustion, alcoholism and the Opium-habit. The seeds contain starch, gluten, gum, 
etc., and form a nutritious food, the meal being made into a porridge, or gruel. In the 
latter form it is a good demulcent for coughs. The pericarp contains an amorphous 
alkaloid, which has doubtless some stimulant and narcotic power ; but the claims ad- 
vanced for it, as a specific remedy for the cure of the opium-habit, have been strenuously 
denied by many competent observers. Dose of the concentrated tincture or fluid ex- 
tract may be stated at rr\_x-gij. 



AZEDARACH (Unofficial), — is the bark of the root of Melia Azedarach, or Pride 
of China, a handsome tree of the nat. ord. Meliaceae, indigenous to China and India, but 
naturalized in the Gulf States. A decoction of the fresh bark (^ ij to Oj boiled to 0)4) 
may be used in tablespoonful doses. 

This drug is known to produce symptoms of narcotic poisoning, as giddiness, dimness 
of sight, mental confusion, stertorous breathing, dilated pupils and stupor. Large doses 
are necessary to cause these effects, and some authorities question their occurrence. It is, 
however, a gastro-intestinal irritant, producing vomiting and purging, and also an anthel- 
mintic against the round- worm. Its active principle has not been isolated. It is only 
employed as an anthelmintic against lumbricoid worms, and as the fresh bark is difficult 
to obtain in any region where it does not grow, other agents will be more generally used. 
It is given to horses affected with " bots." 



BALSAMUM PERUVIANUM, Balsam of Peru,— is a bal- 
sam obtained from Toluifera Pereirce, a Central American tree, of the 
nat. ord. Leguminosae. Occurs as a thick, brown-black liquid, its odor 
reminding of benzoin and vanilla, soluble in 5 of alcohol, almost insolu- 
ble in water, which only extracts from it some Cinnamic Acid and Cin- 
namein. It is not a true balsam, as it contains no volatile oil. Composi- 
tion is, — Cinnamein (Benzyl Cinnamate, C 16 H u 2 ) 60 per cent., Cinna- 
mic Acid 6 per cent., Resins 30 per cent. ; also Benzoic Acid and other 
bodies. Dose ttlx-xxv, in emulsion. There are no official preparations. 



I78 BALSAMUM TOLUTANUM BAPTISIA. 

The action of Balsam of Peru is that of its several constituents, namely, 
antiseptic, disinfectant, stimulant to the circulation, and sedative to the 
nervous system ; acting chiefly on the mucous membrane, it is tonic and 
expectorant, diuretic and diaphoretic. In large doses, it causes gastralgia, 
nausea and vomiting, colic and diarrhoea. It closely resembles in physio- 
logical action its congeners, Styrax and Benzoin. 

Balsam of Peru is used locally in chronic skin diseases of inflammatory 
type and sore nipples, to relieve itching, cleanse bed-sores, promote the 
healing of wounds and ulcers, and to kill the acarus scabiei, being con- 
sidered by some authorities the best of all applications in itch. Inter- 
nally, it is used as a stimulant and disinfectant expectorant in chronic 
bronchitis, asthma, etc., as well as in gonorrhoea, gleet, leucorrhoea, and 
other discharges from mucous membranes. Incorporated with Iodoform 
it partially covers the odor of that drug. 



BALSAMUM TOLUTANUM, Balsam of Tolu,— is a balsam obtained from 
Toluifera Balsamum, a tree of the nat. ord. Leguminosse, native in Venezuela and New 
Granada. Its composition and properties are similar to those of Balsamum Peruvianum, 
except that it is of lighter color, more agreeable odor, and contains a volatile oil, Tolene, 
in the proportion of about I per cent. 

Tinctura Tolutana, Tincture of Tolu, — contains 10 per cent, of the Balsam dis- 
solved in alcohol. Dose, VQ^ x-xxx. 

Syrupus Tolutanus, Syrjtp of Tolu, — has of the Balsam I per cent., with Sugar 85, 
in Alcohol 5, and Water to 100. Is much used in cough mixtures, and covers the taste 
of Chloral Hydrate well. Dose, 3J-ij. 

Balsam of Tolu has similar action to that of Balsam of Peru, but being more agreeable 
in flavor it is used internally more than the latter. It is chiefly employed as a pleasant 
excipient in cough mixtures, and is a constituent of the Compound Tincture of Benzoin. 



BAPTISIA, Wild Indigo (Unofficial),— is the root bark of Bap- 
tisia tinctoria, a plant of the nat. ord. Leguminosse, native in North 
America, and contains an alkaloid and a resin, neither of which have been 
examined critically. The so-called Baptisin is an impure resinoid, ob- 
tained by precipitation from the alcoholic extract with water. 

Unofficial Preparations. 
Extractum Baptisiae, Extract of Baptisia. — Dose, gr. j-x. 
Extractum Baptisiae Fluidum, Fluid Extract of Baptisia, — Dose, rryj-xx. 
Tinctura Baptisiae, Tincture of Baptisia, — Dose, TTLv-xxx. 
Baptisin, — the resinoid. Dose, gr. j-v. 

Baptisia has a bitter and acrid taste ; in small doses it is laxative, in 
large ones violently emeto-cathartic, and may excite severe gastrointesti- 
nal inflammation. It is a decided stimulant of the liver, and increases 
the secretions of the glandular appendages of the gastro-intestinal 
mucous membrane. It has considerable power as an antiseptic. 

Baptisia has been used locally in decoction or cataplasm to obstinate 



BARII DIOXIDUM BELLADONNA. I Jg 

and painful ulcers, in threatened or existing gangrene, and gangrenous 
sores. Internally, it is a useful remedy in amenorrhoea, typhoid and 
typhus fevers, variola, scarlatina, and epidemic dysentery. In the common 
continued fever, or in the first stage of typhoid, it will be found of great 
service in drop-doses of a fresh tincture, repeated every hour. 



BARII DIOXIDUM, Barium Dioxide, Barium Peroxide, Ba0 2 — is the commer- 
cial anhydrous Barium Dioxide, a heavy, grayish- white, amorphous powder, odorless and 
tasteless : gradually decomposed by exposure to the air, from which it slowly attracts 
moisture and carbon dioxide. Used to prepare the Aqua Hydrogenii Dioxidi. 

Though almost insoluble in cold water, Barium Dioxide forms therewith a definite 
hydrate, and imparts thereto an alkaline reaction. It is decomposed by most of the min- 
eral acids, producing the corresponding barium salts, and liberating Hydrogen Dioxide, 
H 2 2 , which remains in the solution for a considerable length of time, if the reaction has 
taken place in the cold, and if an excess of the acid is present. In this way is prepared 
the official Aqua Hydrogenii Dioxidi (Solution of Hydrogen Peroxide), for which seethe 
title Oxygen i m. 



BELLADONNA, Deadly Nightshade.— The Atropa Belladonna 

is an herbaceous, perennial plant, of the nat. ord, Solanacese, having 
dark-purple, bell-shaped flowers, and glossy, purplish-black berries about 
the size of cherries. It is indigenous in the mountainous districts of Cen- 
tral and Southern Europe and Asia, and is cultivated in Europe and in 
the United States. It contains two alkaloids, — the official Atropine (see 
below), and Belladonnine, the latter being considered by many authori- 
ties as identical with Hyoscyamine, Daturine, and Duboisine. These 
exist in the plant in combination with Malic Acid. The plant also con- 
tains the usual vegetable constituents, as albumen, gums, etc., and a col- 
oring principle named Airosin. 

The official titles are as follows : — 

Belladonnae Folia, Belladonna Leaves, — ovate and tapering, brown- 
ish-green above, grayish-green below, of slight odor and bitter, disagree- 
able taste. Stramonium leaves are more wrinkled, Hyoscyamus leaves 
are more hairy. Dose, gr. j, gradually increased. 

Belladonnas Radix, Belladonna Root, — cylindrical, tapering, 
wrinkled pieces, ^ to i inch thick, nearly odorless, taste bitter and 
acrid. Dose, gr. j, cautiously increased. 

Preparations of the Leaves. 

Extractum Belladonnae Foliorum Alcoholicum, Alcoholic Extract of Belladonna 
Leaves. — Dose, gr. -jL to \. 

Tinctura Belladonnae Foliorum, Tincture of Belladonna Leaves, — 15 per cent. 
Dose, TT\j-xxx. 

Emplastrum Belladonnas, Belladonna Plaster, — has of the above extract 20 per 
cent. , mixed with Resin and Soap Plasters, of each 40 per cent. May produce the 
physiological action of the drug. 

Unguentum Belladonnae, Belladonna Ointment^ — has of the above extract 10, 
Diluted Alcohol 5, Benzoinated Lard 85. 



l80 BELLADONNA. 

Preparations of the Root. 

Extractum Belladonnas Radicis Fluidum, Fluid Extract of Belladonna Root. — 
Dose, mj-v. 

Linimentum Belladonnae, Belladonna Liniment, — has of Camphor 5, dissolved in 
Fluid Extract of Belladonna Root to 100. 

Atropine and its Derivatives. 

Atropina, Atropine C n H 23 N0 3 , — in white, acicular crystals, odorless, of bitter taste 
and alkaline reaction ; very soluble in alcohol and in chloroform, also in 130 of water at 
59 F. Is decomposed by prolonged contact with caustic alkalies and is resolvable into 
Tropin and Tropic Acid. 

Atropinae Sulphas, Atropine Sulphate, (C 17 H 23 N0 3 ) 2 H 2 S0 4 , — a white powder of 
bitter taste and neutral reaction, soluble in 0.4 of water and in 6.2 of alcohol at 59 F. 
Dose, gr. T \ lS -^ 5 . 

Homatropina, Ho7?iatropine, C 16 H 21 N0 3 (Unofficial), — is a derivative alkaloid, ob- 
taineby the action of dilute HC1 on Amygdalate of Tropin. The Hydrobromate is 
used by ophthalmologists as a mydriatic, its effects passing off much sooner than those 
of Atropine. Homatropine slows the heart, Atropine quickening it. 

Tropeius (Unofficial), — is a result of the action of a mineral acid on Tropin. 

Physiological Action. 

Belladonna is an irritant narcotic, a mydriatic, an antispasmodic and 
an anodyne ; in small doses a cardiac, respiratory and spinal stimulant — 
in large doses a paralyzer of the cardiac and respiratory centres, the 
spinal cord, the motor nerves and involuntary muscles. It produces con- 
gestion and dryness of the mucous membrane of the throat, mouth, nose 
and larynx, and at first lessens the gastric and intestinal secretions, but 
soon reproduces these in large quantity. The heart rate is at first slowed, 
but soon becomes very rapid and vigorous, the pulse being doubled in 
rapidity ; the arterial tension being at the same time raised, the circula- 
tion is greatly increased. This is accomplished by stimulation of the 
cardiac sympathetic, and paralysis of the pneumogastric, thus stimulating 
the accelerator apparatus while lessening the inhibitory. [Digitalis in- 
creases both.] The vasomotor ganglia are stimulated all over the body, 
but are afterwards paralyzed by over-stimulation, the heart weakens, the 
vessels relax, and the blood-pressure becomes greatly reduced. Complete 
motor-paralysis follows, delirium, stupor, and finally death, which usually 
occurs by asphyxia. 

The pupils are dilated by either the local or systemic use of the drug, 
it stimulating the end-organs of the sympathetic and paralyzing those of 
the motor oculi, thus increasing the power of the radiating iris fibres and 
lessening the action of its circular ones. Atropine locally also paralyzes 
accommodation and increases the intraocular pressure. The least quan- 
tity of Atropine which will affect the pupil is stated at gr. T^nnnr (Wood), 
g r - 2W00 (Roosa), gr. ^^ (Ely), gr. y^oo (Trousseau), gr. y^Voo 
(Lonng), gr. yooVo o" (Bonders). 

The brain is congested by Belladonna, headache, vertigo, busy delirium, 
hallucinations, etc., being produced, the latter from a selective action on 



BELLADONNA. I 5 I 

the cells of the gray matter. The spinal cord is stimulated from the 3d 
cervical vertebra to the 10th dorsal, resulting in complete motor paraly- 
sis, central and peripheral, power being lost first in the lower extremities. 
Sensation is also impaired somewhat, but the muscular irritability is not. 
Respiration is increased and the body temperature elevated. Metamor- 
phosis is greatly promoted by the increased activity of the circulation. A 
diffused eruption of scarlet color, greatly resembling the eruption of scar- 
let fever, is often produced on the skin and fauces by Belladonna, with 
dysphagia and sore throat, and is sometimes followed by desquamation of 
the epidermis. It is due to capillary congestion caused by the greatly 
increased circulation. 

Belladonna is rapidly diffused and quickly eliminated, particularly by 
the kidneys. The urine of an animal under the action of the drug will 
dilate the pupil of another animal. Herbivorous animals and birds are 
scarcely susceptible to it, and pigeons are not affected by it at all. 

Atropine has the same actions as those above described, being the 
active principle of the plant. Belladonnine was long supposed to be inert, 
but has recently been shown to be identical with Hyoscyamine. It is a 
mydriatic when given internally, but not when used locally. 

Antagonists, Antidotes, and Incompaiibles. 

Opium is the physiological antagonist to the effects of Belladonna on the cerebrum, 
pupil, heart, respiration, arterial tension and kidneys. Physostigtnine , Aconite, Pilocar- 
pine and Quinine are each antagonistic to some of its effects, Muscarine , to most of them. 
In poisoning by this drug, Tannic Acid and emetics should be used, then Morphine, Phy- 
sostigmine or Pilocarpine for the nervous disturbance. Caustic alkalies decompose Atro- 
pine and are therefore incompatible with the preparations of Belladonna. 

Therapeutics. 
Belladonna is one of the most valuable drugs in the Materia Medica, 
ranking with Aconite, Arsenic and Opium in efficacy and wide range of 
use. It is especially useful in the pain of inflammation, particularly that 
of rheumatism, gout, neuralgia due to peripheral disturbance, sciatica, 
cancer and pelvic affections. In cerebral and spinal hyperemia, conges- 
tive headaches, encephalitis, meningitis and myelitis it proves one of the 
very best remedies. In erysipelas of superficial and non-vesicular charac- 
ter and when cerebral, it is really curative locally and internally admin- 
istered. Inflammations of the lungs, iris, bladder, kidneys and breasts 
are all amenable to it. In constipation from atony of the bowels it is re- 
markably efficient, and in the enuresis of children it is equally so if used 
freely, 10 to 20 drops of the tincture thrice daily. In recent cystitis 
from chill, spasm of the urethra, bladder, and sphincter ani, typhus and 
typhoid fevers, acute nasal catarrh, sore throat with fever, inflamed and 
swollen tonsils, in many skin diseases, in asthma and whooping-cough, 
epileptic and puerperal convulsions, spermatorrhoea and seminal losses, 



I<52 BENZINUM BENZOLUM. 

Belladonna is often a highly useful agent. Its local application is effi- 
ciently used in ulcers of the rectum, anal fissure, abscesses, boils, carbun- 
cles, and other superficial inflammations. In scarlet fever it relieves many 
of the symptoms, and is especially indicated in this disease when the rash 
is imperfect, the pulse feeble and the condition one of adynamia. Its 
prophylactic power against scarlet fever is believed in by many of our 
best practitioners, though questioned by many others. 

Atropine is used in poisoning by Opium, Physostigma, and Hydro- 
cyanic Acid; in ptyalism from mercury, pregnancy, etc. ; in the sweats 
of phthisis, in sudden cardiac failure, and by eye-surgeons to paralyze 
accommodation, dilate the pupil, contract the vessels, lessen pain, and 
diminish (?) intra-ocular tension. In opium-poisoning it should be given 
in very small doses, and repeated for effect, as most of the unsuccessful 
cases of its use in this connection were due to overdosing with the antag- 
onist, superinducing belladonna-narcosis upon the opium-narcosis. In 
cases of heart-failure from Chloroform or Ether inhalation, the hypoder- 
mic injection of Atropine has, in the writer's hands, saved several lives 
when all other methods of resuscitation had failed. It is highly efficient 
in lead poisoning, if used in combination with Potassium Iodide ; and 
has given the most satisfactory results as a hemostatic in profuse metror- 
rhagia after abortion, in metrorrhagia of obscure origin, and in phthisical 
hemoptysis. 



BENZINUM, Benzin (Petroleum Ether), — is a purified distillate from American 
petroleum, and consists of a mixture of hydrocarbons, chiefly of the mash-gas series 
(C 5 H 12 ,C 6 H U , and homologous compounds). It is a transparent, colorless liquid, very 
diffusive, highly inflammable, insoluble in water, soluble in alcohol, ether, chloroform, 
benzol and fixed and volatile oils. Its sp. gr. is 0.670 to 0.675, an< i ^ ts boiling point 
122° to 140 F. It should be carefully kept in well-stoppered bottles or tin cans, in a 
cool place, remote from lights or fire. Dose, gtt. v-x, on sugar or in mucilage. 

Benzin taken internally in overdose is known to produce gastro-enteritis, and such a 
case is reported which terminated fatally. In the ordinary medicinal doses it does not 
produce either vomiting or diarrhoea. Benzin poisoning may be produced by its inhala- 
tion, which is becoming quite a practice among glove-cleaners, and alcoholics have been 
known to take to inhaling benzin in place of drinking spirits. It has been used with some 
success externally as a remedy for rheumatic pain, neuralgia, itch and prurigo ; and inter- 
nally as a vermicide against tapeworm. In pharmacy it has many uses on account of its 
power as a solvent for oils, fats, resins, caoutchouc and some alkaloids. In the household 
it is used as a solvent application for removing grease from clothing. 



BENZOLUM, Benzol (Benzene, Phenyl Hydride), C 6 H 6 (Unofficial),— is a con- 
stituent of coal-gas tar, obtained by distilling coal naphtha. It is a thin, colorless, oleagi- 
nous liquid, very inflammable, of agreeable odor, and sp. gr. 0.850. It is very diffusible, 
and the vapor, when inhaled, acts as an anaesthetic. Dose, gtt. v-x, on sugar, in emul- 
sion or capsules, up to ^jss daily. 

Benzol is a reliable pulmonary antiseptic, and has been used successfully in the treat- 
ment of whooping-cough, the vapor being diffused throughout the room, and proximity to 
a light or fire being carefully avoided. It has made quite a reputation in the treatment 
of influenza, and has been found effectual in destroying both head and body lice, for 
which purpose a single application is usually sufficient. It has also been given internally 



BENZOINUM. 183 

for the destruction of trichinae, followed by a brisk laxative ; and, mixed with lard, is 

used externally in parasitic skin diseases, especially scabies ; also in rheumatism and 
neuralgia. 



BENZOINUM, Benzoin, — is a balsamic resin obtained from 
Styrax Benzoin, a tree of the nat. ord. Styraceae, native in Sumatra and 
Siam, by incision of its bark. It occurs in agglutinated tears or a brown, 
mottled mass, is soluble in alcohol and solution of potassa, and is com- 
posed of Resins 80 per cent., Benzoic Acid 10 to 20 per cent., and a 
trace of Volatile Oil. Some varieties of benzoin yield also Cinnamic 
Acid. 

Preparations of Benzoin. 

Adeps Benzoinatus, Benzoinated Lard, — is prepared by suspending the powdered 
Benzoin, tied up in coarse muslin, in melted Lard, in the proportion of 2 parts to 100, for 
2 hours, then removing the residual benzoin, and occasionally stirring the lard as it cools. 
When intended for use in warm weather 5 per cent, or more of the lard should be re- 
placed by White Wax. 

Tinctura Benzoini, Tincture of Benzoin, — has of Benzoin 20 parts, Alcohol 100. 
Dose, 3ss-j. 

Tinctura Benzoini Composita, Compound Tincture of Benzoin, Friar's Balsam, — 
has of Benzoin 12, Aloes 2, Styrax 8, Balsam of Tolu 4, Alcohol to 100. Dose, J^ss-ij. 

Preparations of Benzoic Acid. 

Acidum Benzoicum, Benzoic Acid, HC 7 H 5 2 , — occurs in light, feathery plates and 
needles, and is obtained from Benzoin by sublimation, or prepared artificially, chiefly 
from Toluol. It is soluble in 500 of water, and in 2 of alcohol at 59 F., but its solu- 
bility in water is aided by Borax, one part of each being soluble in 100 parts. It is a 
constituent of Tinctura Opii Camphorata. Dose, gr. x— xxv, in wafers. 

Ammonii Benzoas, Ammonium Benzoate, — is soluble in 5 parts of water and in 28 
of alcohol. Dose, gr. v-xxx. 

Lithii Benzoas, Lithium Benzoate, — soluble in 4 parts of water and in 12 of alcohol. 
Dose, gr. v-xxx. 

Sodii Benzoas, Sodium Benzoate, — is efflorescent on exposure to air, soluble in about 
2 parts of water and in 45 of alcohol. Dose, gr. v-^j. 

Physiological Action. 

Benzoin is decidedly antiseptic and disinfectant, and when used exter- 
ternally is somewhat stimulant to the vessels. Its action is due to its Ben- 
zoic Acid, which taken internally produces slight epigastric heat, increases 
the pulse-rate, and stimulates the action of the skin, the salivary glands, 
and the bronchial mucous membrane. It is principally excreted by the 
kidneys, in part as hippuric acid by combination with glycocoll, and in 
part unchanged. It renders the urine acid and increases its quantity. 
Benzoin is irritant to the fauces, and the powder inhaled excites sneezing 
and coughing. 

Therapeutics. 

Benzoin is principally used as a stimulant expectorant, especially in the 
chronic bronchitis of the aged, and by atomization in laryngeal affec- 
tions. The compound tincture, 3J to ^j in a pint of boiling water, is a 



184 BERBERIS. 

useful sedative inhalation for the irritation and cough of subacute laryn- 
gitis and tracheitis. It has also been used beneficially in chlorosis and 
some uterine disorders. The compound tincture is a good local applica- 
tion (1 part to 4 of glycerin and water) for sore nipples and chaps of the 
hands and lips. For use as a cosmetic, either tincture is mixed with 20 
parts of water, and employed to remove freckles and other skin affections, 
especially urticaria. They are excellent applications to foul-smelling 
wounds, and form the basis of all the proprietary preparations sold for that 
purpose. 

Benzoic Acid and its salts are the only certain means we possess, by 
which to neutralize morbid alkalinity of the urine. In cystitis, with 
phosphatic deposits and alkaline urine, they are extremely valuable, acid- 
ulating the secretion, and stimulating and disinfecting the mucous surfaces 
involved. Phosphatic calculi are said to be dissolved by the long con- 
tinued use of Ammonium Benzoate. 

Sodium Benzoate has been largely used as a substitute for the salicy- 
lates in the septic diseases, being equally antiseptic and antipyretic. 
Though slower in action, its effects are more permanent, and it is capable 
of being used in larger doses (3ij-iij daily). In diphtheria and scarlet 
fever it has been highly efficient, and in acute rheumatism, typhoid and 
the malarial fevers it has rendered good service. In phthisis, its use by 
inhalation to the extent of T oVo" °f tne body-weight daily has seemed to 
be of value. It has also proved very efficient in whooping-cough. 

Lithium Benzoate is intended for use in gout and the uric acid 
diathesis, with the object of forming the very soluble urate of lithium in 
the system, as also on the theory that, as benzoic acid is converted into 
hippuric acid at the expense of nitrogenous material which would other- 
wise become uric acid, the latter product will be lessened. 



BERBERIS, Barberry (Unofficial), is the root of several species of the nat ord. 
Berberidaceae, the one generally used being the Berber is aqui folium, or Oregon grape, 
which grows on the Pacific slope of the United States. Its value is probably due to its 
alkaloid, Berberine, G, H ]7 NO 4 , a yellow, crystalline body, soluble in hot water and 
alcohol, but not in ether, which is found also in several other plants, as Hydrastis, Coptis, 
Podophyllum, Menispermum, Calumba, Xanthoxylum, etc. 

Extractum Berberidis Fluidum, Fluid Extract of Berberis (Unofficial), — Dose, 
TT\v-xxx. 

Tinctura Berberidis, Tincture of Berberis (Unofficial), — 1 to 5. Dose, rr\, x-^j. 

Berberina, Berberine (Unofficial), — Dose, gr. j-x. Usually occurs in commerce as 
" Hydrastin," which is a Berberine Hydrochlorate prepared from Hydrastis. 

Berberis is an astringent bitter, a tonic and stomachic in small doses, but in large 
doses it is cathartic, producing watery diarrhoea with abdominal pain. It is also believed 
to possess considerable alterative powers. It has been successfully used as a local appli- 
cation in conjunctivitis, and internally as a remedy for intermittent, remittent and typhoid 
fevers, diarrhoea and dyspepsia. As an alterative and tonic it is useful in syphilitic and 
strumous affections, and in pain, soreness and burning sensations along the biliary or 
urinary tracts with a tendency to gravel or gall-stones it will be found a useful remedy. 

Berberine has some antiseptic and antiperiodic value, but in large doses is a gastro- 



BERGAMOTT^E OLEUM BISMUTHUM. I 85 

intestinal irritant. The Hydrochlorate is a useful injection in gonorrhoea, in which it acts 
by virtue of its antiseptic and astringent powers. 

BERGAMOTT^) OLEUM, Oil of Bergamot,— is a volatile oil, extracted from 
the rind of the fresh fruit of Citrus Bergamia, an orange-tree of the nat. ord. Aurantia- 
ceae, native in Southern Europe. It is of greenish color, faintly acid, and is soluble in 
alcohol, glacial acetic acid and liquor potassae. It contains several hydro-carbons of the 
formula C ]0 H 16 , together with Bergaptene or Bergamot Camphor. It is an ingredient of 
Spiritus Odoratus, and is exclusively used as a perfume in the manufacture of toilet 
articles. 



BISMUTHUM, Bismuth, Bi.— This metal is represented in med- 
icine by four official salts, and several unofficial ones; — the most import- 
ant of which are the following : — 

Official Salts of Bismuth. 

Bismuthi Citras, Bismuth Citrate, BiC 6 H 5 7 , — a white, amorphous powder, odor- 
less and tasteless, insoluble in water or alcohol, soluble in Water of Ammonia. Used 
only for pharmaceutical purposes. 

Bismuthi et Ammonii Citras, Bis??iuth and A?nmonium Citrate, — is a combination 
of the citrate with aqua ammonise, and has no definite chemical composition. Small, 
pearly scales, very soluble in water, sparingly in alcohol. Dose, gr. j-v. 

Bismuthi Subcarbonas, Bismuth Subcarbonate, — a white or yellowish-white pow- 
der, of somewhat varying chemical composition, tasteless and odorless, insoluble in water 
or alcohol. Dose, gr. v-xxx, in powder or emulsion. 

Bismuthi Subnitras, Bismuth Subnitrate, — a heavy, white powder, of somewhat 
varying chemical composition, odorless and almost tasteless, of slightly acid reaction ; 
insoluble in alcohol, almost insoluble in water. Dose, gr. v-xxx, several times a day, in 
powder, pill, or milk ; often combined with opium, morphine or belladonna. 

Unofficial Salts of Bismuth. 

Bismuthi Salicylas, Bismuth Salicylate, — exists in two forms, the acid salt and the 
basic salt, the latter being the one used therapeutically. It contains 76 per cent, of the 
oxide of bismuth, and 23 per cent, of salicylic acid; and occurs as a white, crystalline 
salt, almost entirely insoluble in water, alcohol or glycerin. It should give no reaction 
with perchloride of iron. Dose, gr. v-xx. 

Bismuthi Subiodidum (Oxyiodidum), Bismuth Subiodide, — a brick -red, heavy, 
amorphous powder, insoluble in water, insoluble in any reagent without decomposition. 
Used locally as an antiseptic dusting powder, and internally in doses of gr. jss-iij. 

Bismuthi Subgallas, Bismuth Subgallate (" Dermatol'' 1 ), — a fine, odorless, saffron- 
yellow powder, insoluble in all ordinary solvents. Dose, gr. v-x, in tablets. 

Bismuthi Oleas, Bismuth Oleate, — a pearly-gray, soft, bland substance. [See under 
Acidum Oleicum, ante, p. 91.] 

Physiological Action. 
The action of the insoluble Bismuth salts is chiefly a local one, they 
being sedative to the end-organs of the nerves, though a minute quantity 
passes into the blood and acts as a tonic, promoting constructive meta- 
morphosis by increasing the appetite and digestion. They are also feebly 
astringent, and produce constipation after a time, coloring the stools and 
tongue a dark clay color, from their conversion in part into the sulphide. 
Toxic effects when occurring are ascribed to Arsenic, with which the 



1 86 BISMUTHUM. 

commercial preparations were formerly contaminated. Lately, however, 
it has been shown that Bismuth salts possess toxic powers of their own, and 
that the symptoms of bismuth poisoning may develop when these prepara- 
tions are applied as a dressing to a large, denuded surface, or taken inter- 
nally in large doses for a long period of time. A black line along the 
margins of the gums, headache, nausea, vomiting, pale face, elevated 
temperature, rapid pulse, oedema of the lower extremities, diarrhoea, and 
an odor of urine on the breath are some of the symptoms observed in 
such cases. Black and gangrenous sloughs may occur in the intestines, 
and the urine may contain albumen. 

Therapeutics. 

The insoluble Bismuth salts are used internally in many forms of dis- 
ordered digestion, gastralgia, vomiting and diarrhoea, especially in chil- 
dren, but large doses are necessary for efficiency. The best vehicle for 
them is milk. Locally they are used with advantage in acne rosacea, 
stomatitis, nursing sore mouth, eczema, intertrigo, ulcers, conjunctivitis, 
coryza, gonorrhoea, gleet and leucorrhcea. 

The Subnitrate is regarded by many practitioners as almost a specific 
in cholera infantum, given in hourly doses of 3 to 6 grains : also in the 
diarrhoea of phthisis, in dysentery and intestinal ulceration, it is highly 
efficient, in doses of 15 grains every hour or two. Externally, it is em- 
ployed as a dusting powder, either pure or mixed with starch (1 to 5) ; 
as a drying application for the nasal, pharyngeal and laryngeal mucous 
membranes; in suspension as an injection in gonorrhoea (4 to 10 per 
cent.) ; and with vaseline (10 to 15 per cent.) as an ointment in eczema, 
burns and wounds. 

The Bismuth and Ammonium Citrate being soluble, is more rapid in 
action, but also more astringent and irritant than the other salts, though 
it is probably precipitated in the stomach by the hydrochloric acid of the 
gastric juice. It is serviceable in diarrhoea without irritation of the intes- 
tinal mucous membrane, but rather with relaxation thereof. 

The Salicylate (basic salt) when pure, is well borne by the stomach, 
and can be used for longer periods than the subnitrate. It has been es- 
pecially serviceable in the diarrhoea of phthisis, in that of typhoid fever, 
and in chronic gastric and intestinal disorders. It is highly praised as an 
internal antiseptic in dilatation of the stomach, and to prevent fermen- 
tation in the intestinal canal after operations. 

The Oleate is credited with mildly astringent and emollient properties, 
having been used with benefit in pustular affections of the skin and in 
acne. The Subiodide is an exceedingly valuable agent in the treatment 
of burns, wounds, ulcers, and similar affections, as a substitute for Iodo- 
form. (See under Iodum.) 



BOLDUS BROMUM. I 87 

Dermatol, Bismuth Subgallate (Unofficial), — is one of the many proprietary substitutes 
for Iodoform, and has been patented in this country. It has great stability, as well as 
valuable drying and bactericidal qualities, and is an excellent vulnerary for wounds and 
burns. It has proven useful in the treatment of moist eczema, ulcers, and other affections 
of the eye, diseases of the middle ear and dental caries. It occasionally produces der- 
matitis, and Dr. Cantrell holds that it is decidedly irritating, is a stimulant rather than an 
astringent, does not check but rather increases discharge, and does not fulfil the claims 
made for it. Efforts are now being made to show value for it as an internal remedy in 
fermentative dyspepsia and gastric catarrh. Dose, gr. v-x, in tablets. 



BOLDUS, Boldo (Unofficial), — the leaves and stems of Peumus Boldus, an ever- 
green shrub of the nat. ord. Monimiacese, found in Chili. It contains a volatile oil and 
a bitter alkaloid, Bo/dine. A tincture is made (I to 5), of which the dose is n\ v-viij, 
gradually increased, but large doses have a somewhat narcotic effect, besides causing 
vomiting and purging. 

Boldo is used in anaemia, rheumatism, dyspepsia and general debility, also in catarrhal 
affections of the urinary passages, and as a substitute for Quinine. In France it is 
employed as a tonic, especially for cases with chronic torpor of the liver ; and in South 
America it is much used in gonorrhoea and in chronic cystitis. 



BROMUM, Bromine, Br, — is a dark, brownish-red, volatile liquid, 
evolving an irritant vapor of peculiar and suffocating odor. It is soluble 
in 30 of water at 59 F., very soluble in alcohol, ether, chloroform and 
carbon disulphide ; is a non-metallic element found in sea-water, and in 
the mother-liquor of certain salt-works, usually in combination. On 
exposure to air or heat it is completely volatilized. It destroys the color 
of solutions of litmus and indigo, and imparts a yellow color to solution 
of starch. It is only used by inhalation and locally as an escharotic. 

Bromides and their Preparations. 

Potassii Bromidum, Potassium Bromide, K Br, — colorless, cubical crystals, soluble 
in 1.6 of water, and 200 of alcohol. Dose, gr. ij-.^j, well diluted. 

Sodii Bromidum, Sodium Bromide, NaBr, — colorless, monoclinic crystals, soluble 
in 1.2 of water, and 13 of alcohol. Dose, gr. ij-^j, well diluted. 

Lithii Bromidum, Lithium Bromide, LiBr, — a white, granular, deliquescent salt, 
very soluble in water and alcohol. Dose, gr. ij-xx, well diluted. 

Ammonii Bromidum, Ammonium Bromide, NH 4 Br, — colorless, prismatic crystals, 
soluble in 1.5 of water, and 30 of alcohol. Dose, gr. ij-xx, well diluted. This Bromide 
is well borne by children in comparatively large doses if epileptic from reflex causes A 
child one year old can tolerate gr. v every 4 hours (Barton). 

Calcii Bromidum, Calcium Bromide, CaBr 2 , — a white, granular, deliquescent salt, 
very soluble in water and alcohol. Dose, gr. ij-.^j, well diluted. 

Strontii Bromidum, Strontium Bromide, SrBr 2 (H 2 0) 6 , — colorless, hexagonal crys- 
tals, very deliquescent, very soluble in water and in alcohol ; insoluble in ether. Dose, 
gr. ij-xxx, well diluted. 

Zinci Bromidum, Zinc Bromide, ZnBr 2 , — a white, granular, deliquescent powder, 
very soluble in water and alcohol. Dose, gr. ^-ij, well diluted. 

Syrupus Ferri Bromidi, Syrup of Iron Bromide (Unofficial), — is a syrupy liquid 
containing 10 per cent, of Ferrous Bromine, FeBr 2 , prepared by acting on Iron Wire 35 
parts with Bromine 75, adding Sugar 600 and Water up to 1000 parts. A translucent, 
pale-green, odorless liquid of sweet, ferruginous taste and neutral reaction. Dose, ^ss-j. 

Bromoformum, Bromoform, Tri-bromo-methane , CHBr 3 , (Unofficial), — is prepared 
by the action of sodium hypobromite on acetone, or by the action of bromine upon a 
solution of equal parts of caustic potash and methyl alcohol. A clear and colorless 



1 88 BROMUM. 

liquid, of pleasant odor and sweet, agreeable taste ; slightly soluble in water, readily 
soluble in alcohol, and in glycerin. Dose, TT^v-xx. If it has color it should be rejected 
as unsafe by reason of decomposition. 

Arsenic Bromide is described on page 165, Aurum Bromide on page 173, Ethyl 
Bromide on pages 99 and 102, Hydrobromic Acid on page 85, and Camphora 
Monobromata under Camphora. 

Physiological Action. 

Bromine is an active and very painful escharotic, a deodorant and an 
antiseptic, setting free ozone. Its vapor is highly irritant to the respira- 
tory mucous membrane and the eyes, producing cough, hoarseness and 
dyspnoea. Internally, it is an active, corrosive poison, causing violent 
gastritis, depression and collapse. 

The Bromides are powerful depressants of the cerebral and spinal func- 
tions, also alterative, antispasmodic and hypnotic. The Potassium salt is 
especially a cardiac and muscular paralyzant. 

They have a saline taste, and are very diffusible, but slowly eliminated. 
They are decomposed in the blood, and re-formed at the points of elimi- 
nation (fauces, bronchi, intestines, skin and kidneys), where they irritate 
the mucous membranes. Continued for some time, they produce severe 
gastric catarrh. They reduce the number of the respirations, and the 
heart's action and force ; and though diminishing the calibre of the arte- 
rioles, they lower arterial tension. They lessen the activity of the brain 
cells, producing somnolence ; and diminish the sensibility .of the periph- 
eral nerves, causing anaesthesia of the skin and mucous membranes. They 
impair motility and the sexual function, cause great pallor and emacia- 
tion, lowered body-temperature, acne on the face and upper extremities, 
fetid breath, dysphagia, sluggish reflexes and defective coordination ; 
and if long continued may even impair the mental faculties, producing 
hallucinations in some cases, in others melancholia with suicidal tendency ; 
also incompetence of the sphincters and paralysis, beginning at the 
periphery and extending to the centres. They sometimes cause maniacal 
excitement, as in the case of a physician who committed suicide in a 
frenzy caused by bromidizing himself for sea-sickness. 

The general result of their action is termed Bromism, and is heralded 
by the acne and lowered faucial sensibility. It is probably due to the 
sedative influence of these agents on the sympathetic system, causing 
general anaemia of the brain, spinal cord, sexual organs, and skin. It is 
believed that a previous prolonged use of opium or morphine renders the 
organism extremely susceptible to the action of the bromides. 

Dr. Hammond mentions several cases of fatal bromide poisoning in one of the last 
chapters of his treatise on Nervous Diseases, and several cases of poisoning by Potassium 
Bromide have been recently published by Dr. Greenless. The first was that of an epi- 
leptic who took 75 grains a day for three weeks, when stupor, coma, and extreme pros- 
tration and death followed. The post mortem showed intense congestion of the meninges. 
In another case, an epileptic, the same amount of potassium bromide, 75 grains a day, 



BROMUM. 189 

was given, and in ten days coma and death followed. Both the brain and meninges 
were congested and the kidneys were in the advanced stage of cirrhosis. The other 
cases were less prominent and clearly from bromidism which was the result of long use 
of the drug. In some cases of inebriety larger doses of bromides produce stupor and 
prostration, from which recovery is slow, and is followed by continued prostration. 

Differences in Action between the ordinary Bromides. 

Potassium Bromide is the most toxic to the heart and the muscular system, and is 
the least hypnotic. It contains 66 per cent, of Bromine. 

Sodium Bromide is the least toxic, but the most hypnotic, and acts most energetically 
on the circulation. It contains 78 per cent, of Bromine. 

Ammonium Bromide resembles the Potassium salt in action, except that it exerts less 
influence on the heart and muscular system, and is somewhat more stimulating. 

Lithium Bromide contains the most Bromine, 92 per cent., and resembles the sodium 
salt in action. It has proved better than the others in some cases of epilepsy, and is by 
several authorities considered to be the best hypnotic of the series. 

Calcium Bromide is an efficient hypnotic, but otherwise much less active than the 
other bromides. 

Strontium Bromide is said to be less apt than the other bromides to produce the 
bromic acne and the other results of bromism. 

Zinc Bromide, in large doses, is violently irritant. It is supposed to combine the 
tonic effects of zinc with the sedative actions of the bromides. 

Ferrous Bromide is not official. It is supposed to combine the actions of iron and 
the bromides, and to produce the effects of a sedative chalybeate tonic. It is not an 
eligible chalybeate. 

Antagonists and Incompatibles. 

Vaso-motor stimulants, as Digitalis, Ergot, Belladonna, antagonize many of the effects 
of the Bromides, but Morphine is the most efficient antagonist, especially for the mental 
symptoms. Nitrous Ether is incompatible with the Bromide of Ammonium, and Acids 
and metallic salts are so with all the Bromides. 

Therapeutics. 
The Bromides are used as sedatives to the nervous system, to lower 
reflex activity, to produce sleep, to subdue excitement of the genital appa- 
ratus, and to antagonize congestion of the brain. Their use in epilepsy 
is that of a specific, but therein they are terribly abused, by patients, 
nurses, and even by physicians. They should not be used in anaemic 
conditions, and never for any length of time without the daily supervision 
of a physician. If Opium be administered in ascending doses for four 
to six weeks before commencing a course of treatment by bromides, the 
latter will be much more effective in smaller doses than otherwise. The 
mixture of Potassium Bromide and Chloral is very unsafe in cases where 
fatty or weak heart exists, both drugs being active cardiac depressants. 
In convulsive and spasmodic affections, the bromides are very efficient, 
and in epilepsy, especially when the seizures are diurnal, the sodium salt 
is used with great advantage over a long period, in sufficient quantity to 
maintain anaesthesia of the fauces. It requires occasional purgation to 
prevent its accumulation, and arsenic to combat the acne. In diabetes 
of nervous origin, the ammonium salt, long used, has proved curative by 
its sedative influence on the medulla; and in acute rheumatism it is an 
excellent alkali. In muscular rheumatism, rheumatic arthritis and myal- 
gia, also in the uric acid diathesis, and various affections due to unde- 



I9O BRYONIA. 

veloped gout, the lithium salt gives good results. In tetanus and strych- 
nine-poisoning the potassium salt, in large doses, is antagonistic. These 
agents are generally efficient in nervous erethism, insomnia with conges- 
tion, infantile colic, cholera infantum, vomiting of cerebral origin, car- 
diac irritability when not due to anaemia, delirium tremens, melancholia, 
whooping-cough and other reflex coughs, seminal losses when plethora 
exists, and nymphomania. The potassium salt is, by some writers, con- 
sidered almost specific in subinvolution of the womb, and in uterine 
hemorrhage not due to a mechanical cause. 

Strontium Bromide has been favorably known for some time for its 
beneficial action in gastric affections, particularly in dyspepsia, acetic 
and lactic fermentation, flatulence from decomposition and vomiting of 
various origin, including the vomiting of pregnancy. In severe cases of 
the latter affection it proved entirely successful, administered in doses of 
gr. xv with meals, twice daily for a month. In epilepsy it has been em- 
ployed with advantage, in doses of gr. xx thrice daily, gradually increased : 
and has been used in the treatment of nervous and sick headaches, sea- 
sickness, insomnia, and other conditions for which the bromides are con- 
sidered suitable. It is said to be less productive of the bromic acne than 
are the other bromides in general use. 

The Syrup of Iron Bromide has been reported by some observers as 
very efficient in chorea, and its usefulness therein is as strenuously denied 
by others. 

Bromine is not much used. Its vapor may be inhaled from hot water 
in acute coryza, hay-asthma, etc., and in chancre and hospital gangrene 
it is the best escharotic. In diphtheria and membranous croup, a solution 
of rr^viij to the §, used internally, and inhalation of the vapor, have been 
used successfully in the most severe cases. 

Bromoform is an analogue of Chloroform, and was discovered in 1832 by Lowig. 
Inhaled, it produces anaesthesia on animals, but of shorter duration than that of ether or 
chloroform. Deep narcosis has been produced in children by overdoses, taken internally ; 
the little patients having been tempted, by the pleasant taste of the medicine, to the sur- 
reptitious ingestion of more than was prescribed. It has proven of special efficacy in 
whooping-cough, administered in daily doses of 5 to 20 minims, administered in glycerin 
and alcoholic solution. It aborts the paroxysms and reduces their number somewhat, 
but has little influence otherwise on the regular course of the affection. Increasing doses 
must not be pushed very far, for fear of toxic symptoms, and the drug must be absolutely 
colorless if pure. 

Inhalations of Bromoform have been used with some success in the treatment of diph- 
theria; and it has been employed locally with benefit, as a deodorizer, disinfectant and 
analgesic, in oz?ena and in tuberculous and other ulcers of the larynx. 



BRYONIA, Bryonia, Bryony, — is the root of Bryonia alba and of 
Bryonia dioica, European perennial plants of the nat. ord. Cucurbitacese. 
Its taste is acrid and bitter, but it is inodorous. The active principle is 
the glucoside Bryonin, C 48 H 80 O 19 , which is intensely bitter, and soluble in 



BUCHU. I9I 

water and in alcohol, but insoluble in ether. Dose, of powdered root, 

gr. x-xxx. 

Preparations. 

Tinctura Bryoniae, Tincture of Bryonia, — a 10 per cent, solution of the root in 
alcohol. Dose, TTLv-^ss. 

Bryonin (Unofficial), — is a violent poison in doses of from 3 to 4 grains. Dose, as a 
drastic purgative, gr. Y(>- l /i- 

Physiological Action and Therapeutics. 

Bryonia is a pure irritant, setting up local inflammation wherever ap- 
plied, with febrile phenomena. It has a vesicant action on the skin, and 
is violently irritant to the serous and mucous membranes. Taken inter- 
nally, it has caused fatal gastritis ; introduced into the pleura, fatal 
pleuritis has resulted with fibrinous effusion. It has a specific determina- 
tion to serous and synovial membranes, especially the pleurae, and is also 
irritant to muscular fibre, and to the bronchial mucous membrane, caus- 
ing dry, continuous, shaking cough, with soreness behind the sternum. 
It produces cerebral congestion, with frontal headache, vertigo, and epis- 
taxis ; also, hepatic and renal congestion, burning pain and tenderness in 
the hepatic region with bilious disturbance amounting sometimes to severe 
jaundice, vesical tenesmus, and depression of the action of the heart. It 
is a drastic purgative and a powerful diuretic. 

Bryonia is a very old medicine, its most ancient reputation having 
been in epilepsy, hysteria and mania, conditions in which it is now 
superseded by other agents. It is a most valuable drug in the second 
stage of serous inflammations, especially in pleurisy, pleuro-pneumonia, 
and pericarditis, after Aconite has reduced pyrexia, to limit the extent of 
the effusion and to promote its absorption. For this, small doses fre- 
quently repeated are required. Also, in rheumatic fever, after the swell- 
ing of the joints has been reduced by other means, Bryonia is extremely 
efficient for the pain and stiffness. It is one of the best remedies for a 
" cold-on-the-chest," with dry, shaking cough, soreness, or shooting 
pains. It has been used with success in common, continued, or "gas- 
tric" fever, relapsing fever, congestive headaches increased by stooping, 
bilious headache with vomiting, gastralgia with pyrosis and soreness of 
the epigastrium, constipation, cholera infantum during dry, hot weather, 
congestion of the liver, croup, and threatened mammitis. Pains of shoot- 
ing or tearing character, which are increased by movement, are often 
quickly relieved by this drug. In dropsies of various forms it is used as a 
drastic purgative and diuretic to remove the accumulated fluid. 

BUCHU, Buchu, — is the leaves of Barosma betulina, B. crenulata, 
and B. serratifolia, S. African shrubs, of the nat. ord. Rutaceae. They 
contain a Volatile Oil, which is probably the active principle, and gives 



192 CACTUS GRANDIFLORA CADMIUM. 

them a peculiar and penetrating odor, resembling that of peppermint; 
also, Barosmin, a bitter extractive, and resin, gum, lignin, etc. Dose, of 
the leaves, gr. xv-xxx. 

Preparations. 
Extractum Buchu Fluidum, Fluid Extract of Buchu. — Dose, TT^x-^j. 
Infusum Buchu, Infusion of Buchu (Unofficial), — t ^j to the pint. Dose, ^ss-ij. 

Physiological Action and Therapeutics. 

Buchu in small doses causes a sense of heat in the stomach, which is 
gradually diffused over the body. It increases the pulse-rate, stimulates 
the appetite, and produces slight moisture of the skin. It increases the 
flow of urine, which becomes of darker color and strongly aromatic odor, 
and deposits a brownish sediment. In large doses it produces vomiting, 
purging, and strangury, with a burning sensation at the stomach. 

Buchu is of especial value in chronic affections of the genito-urinary 
mucous membrane, on which the volatile oil acts topically, being elimi- 
nated by the kidneys. It is a very useful remedy in pyelitis, cystitis, and 
urethritis; also, in lithiasis, chronic bronchitis, and affections of the 
prostate gland. It is recommended in atonic dyspepsia, chronic rheuma- 
tism, affections of the skin, and for dropsy, but it is not so actively 
diuretic as to be very efficient in the latter condition. 

The Infusion makes an excellent vehicle for saline diuretics. 



CACTUS GRANDIFLORA, or Night-blooming Cereus (Unofficial),— is a native 
of tropical America, which has long had a local reputation as a remedy for dropsy, but 
was first brought into notice as a cardiac remedy by Dr. Rubini. Its active principle, 
Cactine, a supposed alkaloid, has been physiologically studied by Dr. Myers, who finds 
it possessed of very decided stimulant action upon the heart, the arterial tension and the 
spinal motor centres. Therapeutically, this drug has been employed as a cardiac stimu- 
lant in the functional disorders of the heart connected with ansemia, neurasthenia, 
dyspepsia, tobacco poisoning, exophthalmos, sexual exhaustion and low fevers, also in 
pseudo angina pectoris. It does not prolong the diastole, as Digitalis does, and on this 
account it has been especially recommended in complicated aortic regurgitation. A 
tincture is prepared of the strength of ^ iv of the fresh stems to a pint of strong alcohol, 
the dose of which is tTLxx-xxx every 4 hours. 



CADMIUM, Cd (Unofficial). — This metal was official in the Pharmacopoeia of 1870, 
but is no longer so. In its physiological action it resembles both Antimony and Zinc, 
being escharotic, astringent, and a very depressant emetic. In over-doses, its salts act as 
irritant poisons, with cerebro-spinal symptoms, such as coma and convulsions. It is never 
used internally. Its salts in general use are — 

Cadmii Sulphas, Cadmium Sulphate (Unofficial), — transparent oblique prisms, efflor- 
escent, and very soluble in water. Used externally in a solution of gr. ss-iv ad £] aq. 
destil., or as an ointment (i to 40 of fresh lard). 

Cadmii Iodidum, Cadmium Iodide (Unofficial), — large, white, pearly crystals, soluble 
in water and alcohol. Used as an ointment, I to 8 of lard. 

The Sulphate has been used almost exclusively as a stimulating astringent in gonor- 
rhoea and diseases of the eye. Corneal opacities are absorbed under the use of a solu- 
tion of gr. ij to the ^ , and in gonorrhoea a mild injection (gr. ^ ad Jj) is very benefi- 
cial. An ointment of the Iodide has been usefully employed for enlarged glands, chronic 
joint affections, cutaneous diseases, nodes and chilblains. 



CAFFEA. 193 

CAFFEA, Coffee, the seed of Coffea Arabica, is officially repre- 
sented only by its active principle, Caffeine. The coffee-plant is a small 
tree of the nat. ord. Rubiacese, 15 to 30 feet high, native of South Arabia 
and Abyssinia, but cultivated in various parts of the world. Its seeds 
contain the alkaloid Caffeine (partly free, partly as a tannate), also tannic 
and caffeic acids, sugar, legumin, etc. By roasting them, part of the 
caffeic acid is converted into methylamin, the sugar is changed into cara- 
mel, and several volatile substances are formed, which give to coffee its 
peculiar aroma and some of its stimulant qualities, and are collectively 
known as Caffeo?ie, one of them being called Caffeol. 

Caffeina, Caffeine (Tri-methyl-xanthiri), C 8 H 10 N 4 O 2 -|-H2O. The U. 
S. Pharmacopoeia of 1890 defines Caffeine (Theine) as " a feebly basic, 
proximate principle, obtained from the dry leaves of Thea Sinensis, . . . 
or from the dried seeds of Coffea Arabica, . . . and found also in 
other plants." In the edition of 1880, Guarana was included by name 
among its sources. Therefore, the principles named Caffeine and Theine 
are now officially declared to be identical, and their identity with Guara- 
nine is left unsettled. That all three are identical was the general opinion 
until recently, their composition being expressed by the formula C 8 H 10 N 4 - 
2 , and the physiological action of one being accepted for the others. 
Some investigators, however, doubt the identity of the first two, and some 
observers maintain that Guaranine also is a separate body, distinct from 
either of the others. The Caffeine of commerce is usually obtained from 
old tea leaves, and is in reality Theine. It contains more nitrogen than 
almost any other proximate vegetable principle. It occurs in colorless, 
flexible, silky crystals, which are soluble in 80 of water and $^ of alcohol 
at 59 F. Dose, gr. j-v. 

Theine is contained in the leaves of Thea Sinensis, the tea-plant, a native of China 
and Japan, and a member of the nat. ord. Ternstromiacese. The tea-plant also contains 
much Tannic Acid, and a volatile oil, the latter being most abundant in green teas. 
Theine is found on the market, Merck's being considered to be the most reliable. Its 
solubility in water is much increased by adding an equal part of Sodium Benzoate, say 
55 j of each to the fluid ^ , with gr. x of Sodium Chloride. Of this, rr\vj equals gr.j^ of 
Theine. Dose, gr. ]/e-], hypodermically, several times a day, for relief of pain. 

Preparations. 

Caffeina Citrata, Citrated Caffeine, — is a very uncertain mixture, and is not considered 
to be a definite compound. It is prepared by dissolving equal weights of Caffeine and 
Citric Acid in double the quantity of hot distilled water, evaporating the solution to dry- 
ness, and powdering the product, which is white, odorless, of acid taste and acid reaction, 
soluble in about 3 parts of water, precipitated as Caffeine on further dilution with water, 
and redissolved with about 25 parts of water. Dose, gr. ij-x. 

Caffeina Citrata Effervescens, Effervescent Citrated Caffeine, — composed of Caf- 
feine I, Citric Acid I, Sodium Bicarbonate 33, Tartaric Acid 30, Sugar 35, triturated, 
mixed with Alcohol to a paste, dried, and powdered. Dose, 3 j-ij, in a glassful of water, 
as an effervescing drink. 

Extractum Caffeae Viridis Fluidum (Squibb), Fluid Extract of Green Coffee (Un- 
official), — is intended as a substitute for the fluid Extract of Guarana. Dose, £ss-ij. 
[Compare the title Guarana.] 

!3 



194 CAFFEA. 

Physiological Action. 

Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a laxative. 
It is decidedly diuretic, and is somewhat antiperiodic and highly anti- 
septic. The green bean produces very different effects from those of the 
roasted one, exhibiting the action of Caffeine alone, unmodified by that 
of the empyreumatic products. A tincture of green coffee, besides being 
an efficient diuretic, has marked anti-lithic powers, and promotes the 
elimination of the poison of gout from the system. 

As a beverage, if used with moderation Coffee assists digestion, pro- 
motes intestinal peristalsis, allays the senses of fatigue and hunger, lessens 
tissue-waste and consequently decreases the formation and excretion of 
urea (?). Used to excess it disorders digestion, and causes functional 
disturbances of the nervous system, shown by headache, vertigo, mental 
confusion, and palpitation of the heart. It increases secretion, blunts 
sensation, exalts reflex excitability, increases mental activity, and may 
produce insomnia and great nervous restlessness. It first briefly stimulates 
the heart and raises arterial tension, but soon depresses both. The wake- 
fulness is usually preceded by a brief period of drowsiness. 

The brief stimulation of the intellect, consequent on drinking a cup 
of good coffee, cannot be obtained from an infusion of raw Coffee, and is 
probably due to the volatile constituents developed in roasting. Caffeone 
opposes Caffeine in its action on the circulation, as it quickens the pulse 
and lowers arterial tension. Its action, however, is of brief duration, and 
soon gives way to the influence of the principal constituent. The Tannin 
is the ingredient which enables it to produce dyspepsia, and is most abun- 
dant in those infusions which are kept a long time on the stove before 
being served. 

The Common Stimulant Beverages Compared. 
The qualities possessed in common by these substances, and for which 
they are so universally esteemed by mankind, are three-fold. They all 
(i) retard the retrograde metamorphosis of the body-tissues (tissue-waste), 
— thereby enabling the work of the individual to be done upon a smaller 
supply of reparative material (food), and with less fatigue. Furthermore, 
when used in moderation, they are all (2) more or less stimulating to the 
mental processes, and (3) sedative to the nervous system. 

This similarity of action they owe to the possession of principles, which, if not iden- 
tical, are so closely related to each other that until very recently they have been so con- 
sidered both by chemists and pharmacologists. Their divergence from each other, in the 
finer shades of their action, depends most probably on the existence in each of differing 
aromatic and volatile principles, which modify the action of the alkaloid in some degree. 
Similar principles are developed in them by the various processes of preparation (as 
roasting, drying, etc.), all of which have some part in determining the general action of 
the beverage containing them. 



CAFFEA. I95 

Coffee ( Coffea Arabica, nat. ord. Rubiaceae), is more stimulating than 
Coca and less sustaining. It is apt to cause severe palpitation of the 
heart in some persons, and may disorder the digestion if long infused be- 
fore ingestion. The coffee-bean contains only from 0.2 to 0.8 per cent, 
of caffeine. 

Tea (Thea sinensis, nat. ord. Ternstromiaceae), is one of the most 
refreshing and stimulating members of the group. Used to excess, it 
powerfully affects the stability of the motor and the vaso-motor nerves, 
the action of the heart, and the digestive function, producing flatulent 
dyspepsia, tremulousness of the limbs, pallor of the surface, irregular 
cardiac action, and feeble impulse, hallucinations, night-mare, anorexia, 
headache, nausea and vomiting, obstinate neuralgias, especially of the 
supra-orbital and occipital nerves; also constipation, and a pain in the 
left side are not infrequent. The condition of chronic tea-poisoning is 
termed Theism, and is very often seen among women of the lower class 
in cities, who do not indulge in alcoholic beverages, but freely accept the 
dominion of the " cup that cheers " and worse than inebriates. Tea con- 
tains much more Tannin than coffee, and that used as a beverage by the 
poorer classes is little more than a decoction of tannin, and a fruitful 
source of dyspepsia and other forms of gastric disorder. 

Mate (I/ex Paraguay ensis, nat. ord. Aquifoliaceae), is supposed to be 
intermediate in its effects between tea and coffee. It contains Theo- 
bromine as well as Caffeine, the latter in the proportion of 1.2 per cent., 
also a little tannin. 

Guarana {Paullinia Cupana of Brazil, nat. ord. Sapindaceae), con- 
tains an alkaloid — Guaranine, in the proportion of 5 percent., which is 
probably identical with Caffeine, though some think it more analogous to 
Theine. It is especially noted for relieving a nervous headache, for which 
purpose the official fluid extract may be used in doses of r^xx, three or 
four times daily, when the basis of that preparation happens to be of good 
quality. [Compare the article on Guarana.] 

Coca, or Cuca (Erythroxylon Coca, nat. ord. Lineae), is probably more 
sustaining than either tea or coffee and less of a direct stimulant, at least 
as used by the Peruvian natives. Its habitual and excessive use produces 
a very serious train of nervous symptoms. [Compare the article entitled 
Coca.] Its alkaloid, Cocaine, is allied in action to Caffeine, but is more 
powerful, and its proportion in the leaves of the plant varies greatly in the 
different samples which occur in commerce. 

Cocoa (Theobrbma Cacao, the Chocolate-tree, nat. order Sterculiaceae), 
pronounced Kah-kow, — is more directly nutritious than any of the group, 
containing a large quantity of fat, Oleum Theobromatis (cacao-butter), 
which makes it difficult of digestion to many persons. Its alkaloid, 
Theobromine, is chemically a Dimethylxanthin, and is closely allied to Caf- 



I96 CAFFEA. 

feine, the latter being considered a Methyl- theobromine. The various 
preparations of this agent are made from the seeds, after the oil has been 
expressed from them. They are ground in a mill, mixed with rice, barley, 
sugar, flour, etc., and put up in powdered form, called Cocoa, — but if 
flavored with vanilla and pressed into a cake, the product is Chocolate. 
The thin husks which envelope the seeds are known as "Shells" and are 
used to make a beverage similar to but milder than cocoa or chocolate. 
[Compare the article entitled Theobromatis Oleum.] 

Kola {Cola acuminata, nat. ord. Sterculiaceae), is the nut or seed of 
the Kola plant, which is a handsome tree growing 30 to 60 feet high in 
the tropical forests of Africa and in the West Indies. It contains both 
Caffeine and Theobromine, the former in larger proportion than any mem- 
ber of the group except Guarana ; also Tannic Acid and a glucoside sub- 
stance named Kolanine, which, in the presence of a ferment, splits up 
into free caffeine and glucose, the yield of caffeine therefrom being 3 per 
cent. The Kola nut is highly valued by the negroes as a stimulant bev- 
erage and food and as an aphrodisiac, the latter quality being ascribed 
to the essential oil, which is not present in the dried nuts. It improves 
the appetite and the digestion, promotes cheerfulness of the spirits and 
inclination to exertion. It is becoming a fashionable stimulant under 
the commercial methods which are employed in pushing the sale of the 
various preparations on the market. 

Physiological Action of Caffeine. 
Caffeine is in general terms a stimulant at first, and subsequently a 
paralyzant, to the nerve-centres in the cerebrum, medulla and cord. In 
small doses it quickens the action of the heart and raises arterial tension ; 
stimulates the cerebral functions, by increasing the supply of blood to the 
brain ; increases the respiration rate and the secretion of urine. Larger 
doses (gr.v-viij) often over-stimulate the cerebral circulation, causing 
thereby great heaviness of the head, flashes of light before the eyes, 
tinnitus aurium, insomnia, restlessness, and even delirium, the pulse be- 
coming rapid, feeble, irregular and intermittent, and the general body- 
temperature elevated, though that of the periphery may be lowered. 
Large doses depress the heart and respiration, and lower the blood-pres- 
sure ; in the smaller animals exalting the reflex excitability of the cord 
and producing tetanic convulsions, and in lethal doses paralyzing the 
cardiac muscle as well as its motor ganglia, but causing death by paralysis 
of respiration. It powerfully affects muscular fibre, both voluntary and 
involuntary kinds, throwing it into a state of tetanic contraction resem- 
bling rigor mortis. If administered in sufficient quantity it would doubt- 
less prove fatal to man, but its lethal dose for him would be very large. 
Caffeine is excreted unchanged in the bile and urine, and is a reliable 



CAFFEA. I97 

hydragogue diuretic ; acting by stimulation of the secreting apparatus in 
the kidney, as well as by generally raising the arterial tension (Brunton). 
The action of caffeine on the kidneys is two-fold ; during the first stage 
it causes a fall of general blood-pressure and constriction of the renal 
vessels ; during the second stage, which persists much longer than the first, 
the blood pressure returns to its normal height, and the kidney undergoes 
great expansion (Murrell). 

Theine, according to Dr. Mays, agrees in most respects with Caffeine in its action upon 
the smaller animals, except that it requires much larger doses to produce the same effects. 
It differs, however, in some important particulars. Theine chiefly affects the sensory, 
Caffeine the motor system. Theine causes spasms and convulsions, and impairs the 
nasal reflex, early in the course of the poisoning process ; while Caffeine does so late, if 
at all. Theine decreases the body-temperature, — Caffeine increases it. Theine causes 
convulsions in frogs, a power now denied to Caffeine, though hitherto ascribed to it. 
Both alkaloids tend to produce muscular contraction, but Theine causes a peculiar rhyth- 
mical contraction in voluntary muscles, which lasts for several hours, and seems to act 
transversely across the fibre, as the muscle is elongated at each contraction. In man, the 
principal action of the hypodermic injection of Theine is the production of a profound 
local anaesthesia at and below the point of injection, — acting therefore outwards along the 
nerve-trunk, and not towards the centre. It does not affect the motor apparatus, nor 
does it seem to produce narcosis. 

Guaranine is generally considered to be identical with Caffeine, though some few ob- 
servers find in its action a closer analogy to Theine. It affects both sensory and motor 
nerves, the sensory first, paralyzing them from the centres outwards. [Cocaine and Brucine 
act from the periphery inwards.] It causes general hyperesthesia, and subsequently con- 
vulsions of spinal origin, — at first increases and afterwards depresses respiration and the 
action of the heart. It seems to have a stronger affinity for the sensory than for the 
motor nerves, and hence resembles Theine more than Caffeine. 

Theobromine has the formula C.H 8 N 4 2 , and is closely allied to Caffeine, both phy- 
siologically and chemically. In fact, Caffeine may be considered a Methyl-theobromine, 
C 7 H 9 (CH 3 )N + 2 . During roasting the cocoa-bean develops an aromatic principle which 
gives to chocolate its peculiar flavor. In large doses Theobromine is fatal to small 
animals. 

Therapeutics. 
Although without a very extensive range of usefulness, Caffeine is a 
valuable stimulant in many forms of nervous and cardiac depression, and 
has proved especially efficacious in headaches of neuralgic or nervous 
type, the pain being general over the head ; gr. j of Caffeine every half 
hour, or the fluid extract of Guarana, in 20-minim doses every 2 or 3 
hours. In choleraic diarrhoea, and that of phthisis, it checks outward 
osmosis by stimulating the depressed nervous apparatus. In cervico- 
brachial neuralgia, Caffeine may be used hypodermically in doses of gr. j, 
increased to gr.v. In lithaemia and gout, a tincture of the green bean 
has marked diuretic and antispasmodic powers, and is very useful in these 
conditions. In the insomnia of chronic alcoholism, gr. ^ of Caffeine 
hypodermically, is often efficient. For adynamic fevers, it may well be 
used in place of alcoholic stimulants. In intermittents, Coffee has a cur- 
ative reputation among the inhabitants of the Philippines, which is corrob- 
orated by the Dutch physicians. In asthma, Coffee is valuable for the 
paroxysm if not used habitually. In opium narcosis, Caffeine hypoder- 



I98 CAFFEA. 

mically, or better still, strong black coffee by the mouth, will antagonize 
the increasing torpor of the nervous centres. 

Although Caffeine is an efficient diuretic in cardiac and renal dropsies, 
there are many objections to its use for this purpose. It sometimes acts 
as a purgative as well as a diuretic, and although at first it produces copious 
diuresis, tolerance is soon established and it loses its diuretic power. 
Moreover, it is a powerful cardiac stimulant, and in many persons it exerts 
a very marked excitant action upon the central nervous system. Lastly, 
and as a minor disqualification, it sometimes sets up considerable smart- 
ing in the penis and produces a mild form of urethritis (Murrell). 

Caffeine is an ingredient of the many proprietary preparations of which 
the active ingredient is Acetanilid (see ante, page 67). Its office therein 
is that of a corrigent, antagonizing the depressant action of Acetanilid 
on the heart. A double Citrate of Caffeine and Antipyrin named Migranin 
is described on page 143. 

Theine, according to Dr. Mays, is a valuable analgesic, especially so by 
reason of its prolonged influence over sensation. Its great field of em- 
ployment is in neuralgia of any kind, cervico-brachial, sciatic, etc., in 
which doses of gr. ^5 to gr. y 2 hypodermicallyare efficient, and may be kept 
up as long as required. To make a cure, however, the nutrition of the 
nerves must be attended to. In locomotor ataxia, lumbago, etc., it has 
been used with prompt benefit, in the same manner, quickly relieving 
pain, without producing any narcotic effect. 

Kola is a useful agent in gastric catarrh and in the dyspepsia of alco- 
holic subjects, as an adjunct to other treatment. After an alcoholic 
debauch it will do much in restoring the nervous system to its normal 
condition. It will counteract the depressing effects of tobacco, and has 
been employed with benefit in asthma, of both the nervous and cardiac 
forms. As it contains a good deal of Tannin, it is especially efficient in 
atonic diarrhoea, and in gastro-intestinal irritation with looseness of the 
bowels, a restricted diet and Kola-wine are frequently all that is needed. 
As an aphrodisiac, it deserves high rank, though it acts in this respect not 
so much by stimulating the sexual appetite as by enabling the organism 
to escape the sense of exhaustion and extreme debility which neurotic 
patients are so apt to complain of (Woodbury). 

Sodio-Theobromine Salicylate, Diuretin (Unofficial), — was introduced under the 
latter title as a proprietary preparation. It occurs as a colorless powder, of sweetish, 
saline and alkaline taste, soluble in y z its weight of water, and should contain 46^ per 
cent, of Theobromine. Being a very unstable compound, it should not be prescribed in 
combination with other drugs, and when dispensed it should be well sealed from contact 
with the air, from which it rapidly absorbs carbonic acid, thereby undergoing decomposi- 
tion. If ordered under its chemical name, and insisted on, the cost should be less than 
y 2 that of the same article under its proprietary title (Squibb). Dose, gr. x-xv, in 
powder or aqueous solution, several times a day, as a diuretic. 

Diuretin was introduced as a soluble preparation of Theobromine, of value for its 
prompt diuretic action, influencing the kidneys without causing serious or dangerous 



CAJUPUTI OLEUM CALAMUS CALCIUM. I99 

results upon the heart, the action of which, however, it strengthens and regulates. Given 
to healthy persons it does not increase the quantity of the urine, but during its adminis- 
tration in morbid conditions of the renal or cardiac apparatus the volume of urine in- 
creases three- and four-fold, and exudations of non-inflammatory character are rapidly 
absorbed. It may give rise to slight diarrhoea, and the author has found the body-tem- 
perature uniformly subnormal in non-febrile patients while under its influence. 

Diuretin has been employed with marked benefit in both cardiac and renal dropsy, in 
hepatic cirrhosis, and in various diseases of the heart and kidneys accompanied by 
oedema. The author has seen a large pleuritic effusion disappear rapidly under its use, 
the fluid having re-accumulated after having been once removed by tapping the pleural 
cavity. It should be administered in aqueous solution, avoiding acids or acid vegetable 
juices, which are chemically incompatible, as they precipitate the alkaloid in the form of 
a thick white sediment. 



CAJUPUTI OLEUM, Oil of Cajuput,— is a volatile oil distilled from the leaves 
of Melaleuca Leucadend'ron, a tree of the nat. ord. Myrtaceae, native of the Molucca 
Islands. It is a bluish-green or colorless liquid, of camphoraceous odor, and neutral re- 
action, freely soluble in alcohol. It contains Cajuputol or Bihydrate of Cajuputene, 
which forms 2 A\ of it, the other y^ being another oil. Dose, TT\j-v. 

Cajuput Oil resembles Oil of Turpentine, and has similar action to that of the other 
volatile oils, being a stimulant carminative, somewhat diuretic and diaphoretic, antiseptic, 
parasiticide and anthelmintic. Externally used, it is irritant to the skin. Swallowed, it 
produces a sense of warmth in the stomach and accelerates the pulse. 

It is not much used internally, though it has been given with benefit in flatulent colic, 
dropsy, hysteria, chronic rheumatism, scrofula, and syphilis, also in elephantiasis and 
other cutaneous disorders. Externally, as a strong, stimulating rubefacient, it is efficient 
in chilblains, muscular rheumatism and nervous headaches. 



CALAMUS, Sweet Flag, — is the rhizome of Acorus Calamus, a plant of the nat. 
ord. Aracese, native in Europe and North America, having an aromatic odor and pungent 
taste. The unpeeled root should only be used, peeled or bleached calamus being almost 
inert. It contains a volatile oil and Acorin, which is a nitrogenous, bitter principle, also 
benzoic acid, starch, etc. Dose, indefinite. 

Extractum Calami Fluidum, Fluid Extract of Calamus, — is made with Alcohol as 
a menstruum. Dose, Tt\, xv-gj. 

Calamus is an aromatic bitter, and stomachic tonic, increasing the appetite and stimu- 
lating digestion. It is one of the constituents of the preparations termed " bitters," and 
is chewed as an appetizer. 

CALCIUM, Ca, — is the metal characteristic of Lime, Chalk, and all 
calcareous substances, and although itself unofficial it is represented by 
several official salts and preparations. Lime (Ca/x) and Chalk {Cretd) 
are respectively the Oxide, CaO, and the Carbonate, CaC0 3 , of Calcium, 
the latter occurring in the native forms called chalk, marble, limestone, 
oystershells, etc., which are converted into Lime by heating to full red- 
ness (calcination), thereby driving off carbonic acid and leaving the oxide 
behind. The latter, in this form, is known as " burnt lime " or " quick- 
lime ; " and, by the addition of j4 to ^ its weight of water, combines 
with one molecule of H 2 to form Calcium Hydrate, Ca(HO) 2 , or 
"slaked lime," the process being termed "slaking" and being accom- 
panied by the evolving of a high degree of heat. 

Lime is one of the four alkaline earths, the other three being Baryta, Magnesia, and 
Strontia. As such, however, it never occurs naturally, though in combination with 



200 CALCIUM. 

various acids it is found in all the three kingdoms of nature ; its base, the metal Calcium, 
being a widely distributed element, forming the basis of all calcareous and cretaceous 
substances. Besides the forms mentioned above, Calcium occurs as a sulphate (gypsum), 
also as a phosphate in bones, shells and various organic tissues, and as a silicate and a 
fluoride in certain minerals and vegetables. 

Official Salts of Calcium. 

Calx, Lime [Calcium Oxide), CaO, — is Lime prepared by burning white marble, 
oyster-shells, or the purest varieties of native Calcium Carbonate. Occurs in hard, white 
masses, gradually resolving to a white powder in the air, odorless, of sharp caustic taste 
and alkaline reaction, soluble in 750 of water and 1 300 of boiling water, insoluble in 
alcohol. Not used internally except in solution. Is a constituent of Potassa cum Calce. 
(See under Potassium.) 

Calcii Hydras, Calcium Hydrate [Slaked Lime), Ca(HO) 2 , — official in the Br. 
Phar. , is prepared by pouring I pint of water over 2 pounds of Lime in a metal pot. It 
should be recently prepared and kept excluded from the air. It is sparingly soluble in 
water (gr. xj in Oj) and less soluble in hot water, but its solubility is greatly increased 
by the addition of sugar. 

Calcii Carbonas Praecipitatus, Precipitated Calcium Carbonate, CaC0 3 , — a fine im- 
palpable, white powder, odorless and tasteless, insoluble in water or alcohol, but soluble 
in mineral acids or acetic acid with effervescence. Creta (chalk) is native Calcium Car- 
bonate. (See below.) Dose, gr. v-^j. 

Calcii Chloridum, Calcium Chloride, CaCl 2 , — hard, colorless masses, deliquescent, 
of sharp, saline taste, soluble in 1^ of water and in 8 of alcohol. Dose, gr. iij-x in 
solution. This salt should not be confounded with Chlorinated Lime. 

Calcii Sulphas Exsiccatus, Dried Calcium Sztlphate {Dried Gypsum), — contains 
about 5 per cent, of water. A fine, white powder, without odor or taste, insoluble in 
alcohol, soluble in 410 of water at 59 F., in 388 of water at ioo F., and in 476 of water 
at 212° F. Used in the preparation of Calx Sulphurata. 

Calcii Sulphidum, Calcium Sulphide, is described under Sulphur ; Calcii Bro- 
midum, Calcium Bromide, under Bromum ; Calcii Hypophosphis, Calcium Hypo- 
phosphite, and Calcii Phosphas Praecipitatus, Precipitated Calcium Phosphate, under 
Phosphorus. 

Preparations of the Oxide. [Lime.) 

Liquor Calcis, Solution of Li?ne [Lime-water), — contains about 0.17 per cent, of 
Calcium Hydrate, Ca(HO) 2 . A clear, colorless liquid, of saline taste and alkaline re- 
action. Dose, 25 ss-iv. 

Syrupus Calcis, Syrup of Lime [Saccharated Solution of Lime), — contains 6^ per 
cent, of Lime, and 40 of Sugar, the latter aiding the solvent power. Dose, TT\,x-3J. 
Is an antidote to poisoning by Carbolic or Oxalic Acid. 

Linimentum Calcis, Lime Liniment [Carron Oil), — contains equal volumes of 
Lime-water and Linseed Oil, mixed by agitation. For local use. 

Calx Chlorata, Chlorinated Lime, is described under Chlorum ; Potassa cum 
Calce, Potassa with Lime, under Potassium, and Calx Sulphurata, Sulphurated Lime, 
under Sulphur. 

Preparations of the Carbonate. [Chalk.) 

Creta Praeparata, Prepared Chalk, CaC0 3 , — is native Calcium Carbonate, freed from 
most of its impurities by elutriation ; a white, amorphous powder, odorless and tasteless, 
insoluble in water or alcohol. Dose, gr. x-3 j. Is a constituent of Hydrargyrum cum 
Creta, and also of the following : 

Pulvis Cretae Compositus, Compotmd Chalk Powder, — has of Prepared Chalk 30, 
Acacia 20, Sugar 50 parts. Dose, gr. v-^j. 

Mistura Cretae, Chalk Mixture, — has of the preceding 20 parts, Cinnamon Water 
40, Water to 100, rubbed together and made fresh as required. Dose, 3 ss-ij. 

Trochisci Cretae, Troches of Chalk,— each contains of Prepared Chalk 4 grains, 
Acacia I, Sugar 6, with a little Nutmeg. Dose, indefinite. 

Testa Praeparata, Prepared Oyster-shell (Unofficial), — contains animal matter inti- 
mately mixed with the Carbonate of Calcium. Dose, gr. x-xx or more. 



CALCIUM. 20I 



Allied Substances. 



Substances allied to Chalk, and derived from the animal kingdom, are — Crabs' - 
eyes, which are concretions obtained from the stomach of the craw-fish, Coral, Cttttle-fish 
Bone, Egg-shells and Oyster-shells (Testa, see above) ; all of which are mainly composed 
of Calcium Carbonate, but also contain the phosphate and sulphate of calcium and other 
metallic salts in small quantity, as well as organic material. In the past special virtues 
have been ascribed to these substances, and even now some authorities maintain that the 
animal carbonates derange the stomach less than the mineral ones, and are to be pre- 
ferred for infants and delicate persons. 



Physiological Action. 

Lime, in its unslaked form (quick-lime), has a great affinity for water 
and readily combines with sulphur, thereby decomposing and destroying 
organic matter. Upon the skin its action is irritant and superficially 
caustic, but more severe on the mucous membranes, and if inhaled or 
swallowed it may produce dangerous local inflammation, followed by 
ulceration. In weak solution it has an astringent and sedative effect 
both locally and internally, and acts as an absorbent and an antacid. 
Chalk possesses the astringent and antacid qualities of lime without its 
irritant property. 

Calcium Chloride is a very diffusible salt, and in small doses has re- 
markably alterative action, being apparently a powerful antagonist to the 
condition known as the strumous diathesis. Full doses produce symptoms of 
muscular poisoning similar to those caused by potassium salts, with lowered 
temperature, slowed pulse, and a tendency to cardiac paralysis. In large 
doses it is an irritant poison. It increases the amount of the urine and 
probably promotes the excretion of urea. It has a great affinity for water, 
and is used in pharmacy to abstract water from other substances, as in 
the preparation of absolute alcohol and ether. In solution it is used as a 
test for tartrates, citrates and oxalates. 

Calcium Salts play an important part in the circulation and in most 
of the other functions of the body. The heart or any other muscle, de- 
prived of calcium, will no longer contract. These salts have a remark- 
able influence on the nutrition of plants and animals, the Phosphate be- 
ing as essential to the nourishment of the organs of locomotion (cartilage, 
bone, tendon and muscle) as Iron is to the blood or Phosphorus to the 
nerve tissue. They possess high coagulating power on the blood, their 
deficiency gives rise to lymphatic and osseous disease, and their absence 
results in emaciation and finally death. They are excreted almost entirely 
by the intestines, a very small portion being absorbed and but little of 
that passes out by the kidneys. Their absence from water renders the 
latter flat and insipid to the taste, but if present in excess (above 20 
grains of the carbonate to the gallon) the water containing them is be- 
lieved to be one of the factors of goitre. The Sulphate, in even so 
small a proportion as 6 grains to the gallon, is unwholesome, as it is liable 



202 CALCIUM. 

to irritate the bowels and produce constipation and diarrhoea alternately, 
according as its astringent or irritant effects predominate. 

Antidotes, Antagonists and Incompatibles. 

In poisoning by Caustic Lime the antidotes are a dilute Vegetable Acid or Lemon- 
juice or Carbonated Water freely, followed by demulcents or fixed oils to protect the mu- 
cous membranes. Opium or Alcohol as antagonists against the vital depression. Potas- 
sium salts and Calcium salts are mutually antagonistic. Poisoning by Calcium Chlor- 
ide is treated by Albumen, mucilaginous drinks, oils, milk, flour and water, but no acids. 

Incompatible with preparations of Lime and Chalk are all the Acids and metallic salts, 
especially the Sulphates and Tartar Emetic ; and borates, alkaline carbonates and astring- 
ent vegetable infusions are also incompatible with the preparations of Lime. 

Therapeutics. 
Lime may be used as a caustic and depilatory, but is better known as 
an agent for hastening decomposition, which it does by its affinity for 
water, the resulting hydrate absorbing many of the products. The 
Chlorinated Lime is an excellent antiseptic and disinfectant, but as it 
owes its energy entirely to its power of evolving Chlorine it will be 
described under the title Chlorum. Lime-water is a favorite remedy 
for vomiting, especially in children, and is added to milk to increase its 
digestibility. A mixture of milk and lime-water will be retained by the 
stomach when no other food can be borne. Lime-water is an efficient 
agent in acid dyspepsia, mucous enteritis and typhoid fever, as an 
astringent and antacid. Locally, it is well employed as an enema against 
thread-worms, as a mouth-wash for aphthse, and as a lotion for cracked 
nipples, eczematous eruptions, and many mucous and purulent discharges. 
For such purposes it may be mixed with oil or glycerin, and if a few 
drops of carbolic acid be added the efficacy of the mixture is much in- 
creased. The Liniment is best known by the name Carron Oil, from the 
foundries at Carron, where it is extensively used. It is one of the best 
applications for burns and scalds, and makes a good dressing for the face 
in small-pox, and for cases of eczema affecting a large area of the skin. 
The vapor of slaking lime, or lime-water in the form of spray, have been 
usefully employed as inhalations in diphtheria. Lime-water is a good 
injection into the bladder in vesical calculus, in which its benefit is prob- 
ably due to its astringent and soothing effects on the inflamed vesical 
mucous membrane, blunting its sensibility, and preventing the further 
growth of the stone by neutralizing the free acid of the urine. 

One of the curiosities of medical history is the fact that in 1 739 the British Parliament 
gave the sum of ^"5.000 to Mrs. Johanna Stephens for divulging the nature of a certain 
lithontriptic remedy. This, she stated, consisted of calcined egg-shells and soap, with 
various aromatic bitters, a combination which had previously been recommended by 
Barbette for the same purpose. The nauseousness of this compound suggested to Whytt 
the use of lime-water as a substitute, and the latter was found to be efficacious in many 
instances. 

The Syrup contains more lime in solution than lime-water does, and 



CALENDULA CALUMBA. 2C>3 

may be used instead of the latter when a strong preparation is indicated. 
It is one of the antidotes in poisoning by carbolic and oxalic acids, while 
lime in any form (wall-plaster, whiting, etc.) is the antidote for any min- 
eral acid. 

Chalk is the basis of all dentifrices, and may be used as a dusting- 
powder on ulcers, burns and excoriations of the skin. Chalk-mixture is 
a common remedy for diarrhoea, and is usually employed in combination 
with other astringents, also with opium and aromatics. It is particularly 
serviceable for the diarrhceas of children with sour-smelling stools and 
other symptoms of gastro-intestinal acidity. 

Calcium Chloride is used with benefit as an internal remedy in the 
various manifestations of the strumous diathesis. It often causes the 
resolution of glandular enlargements, and the calcification of tubercular 
deposits, aids the cicatrization of ulcerating cavities, and has proved 
curative in eczema and lupus. It is highly praised in phthisis, also in 
chorea, and for the colliquative diarrhoea of strumous children. In solu- 
tion used externally as a fomentation it is said to hasten the maturation 
of boils. 

The therapeutics of the other salts and combinations of calcium are 
described under the titles of their more active ingredients, Bromum, 
Chlorum, Phosphorus and Sulphur. 



CALENDULA, Marigold, — is the florets of Calendula officinalis, the common 
Garden Marigold, a plant of the nat. ord. Composite, frequently cultivated for ornament. 
The tincture (20 per cent.) is also official, and is exclusively used as a local application to 
promote the healing process in wounds, ulcers, burns and other breaches of tissue. Ex- 
travagant views of its powers as a vulnerary are promulgated by the so-called " homoeo- 
pathic surgeons," and serve as one of their excuses for professing an exclusive position in 
the art of surgery. 



CALUMBA, Columbo, — is the root of Jateorhiza palmata, a plant 
of the nat. ord. Menispermaceae, native in southeastern Africa, but culti- 
vated in the East Indian Islands. It contains the alkaloid Berberine(szz 
under Berberis, ante, page 184), a bitter principle named Calumbin, 
also Calumbic Acid and Starch, but no Tannin. Dose, gr. v-xxx. 

Preparations. 

Extractum Calumbae Fluidum, Fluid Extract of Calumba. — Dose, TIL v-xxx. 
Tinctura Calumbae, Tincture of Calumba,— I in 10. Dose, sjss-ij. 

Calumba is the first in alphabetical order of the simple bitters, having 
no astringency or aroma, and its action, as herein described, will apply to 
other members of that class (Quassia, Gentian, Cornus). It stimulates 
the nerves of taste, increases the flow of saliva, excites the flow of the 
gastric juice and the gastric circulation, thus increasing the appetite and 
promoting digestion, and so promoting the constructive metamorphosis. 



204 CAMBOGIA CAMPHORA. 

As it also increases the gastric mucus, its continued use will set up catarrh 
of the stomach, and interfere with digestion, though it is one of the least 
irritant of stomachic tonics. 

As Calumba contains no Tannin, it may be administered with the salts 
of Iron, and is often prescribed with the sub-carbonate. It is useful in 
atonic dyspepsia with pain after eating, in the convalescent stage of dis- 
ease to promote appetite and digestion, in diarrhoea and dysentery, vomit- 
ing, sea-sickness, cholera morbus and cholera infantum. An Infusion of 
Calumba with Ginger and Senna is effective in flatulence, and the same 
preparation is a good vehicle for the administration of acids and alkalies, 
tonics, aromatics, and mild cathartics. Having little or no irritant 
quality, it is an excellent tonic in the hectic of phthisis. 



CAMBOGIA, Gamboge, — is a gum-resin, obtained from Garcinia Hanburii, a 
Siamese tree of the nat. ord. Guttifene. It contains 73 per cent, of Gambogic Acid, a 
resinous substance, also 25 per cent, of gum and 2 of water. It is partly soluble in 
alcohol and ether. The only official preparation is the Pil. Cathartics Co. (described 
under CoLOCYNTHls) , each pill containing gr. % of Gamboge. Its dose, as a cathartic, 
is gr. ij-v, — as a diuretic, gr. j at short intervals. 

Gamboge is an irritant purgative, decidedly diuretic, and its powder is sternutatory. 
Its catharsis is accompanied by vomiting and colic, and the stools produced are watery, 
but not so much so as generally believed. It has no cholagogue action. Full doses are 
liable to produce violent gastro-enteritis, and incautiously used (as in Morrison's pills) it 
has frequently caused death. On the other hand, large doses have been given continu- 
ously in some cases, without producing any dangerous symptoms. 

Gamboge was formerly much used as a hydragogue cathartic and diuretic in dropsies, 
but its irritant qualities have caused it to be superseded by other agents (elaterium, digi- 
talis, etc.). However, for dysentery, especially when in young subjects, very small doses 
(gr. y 1 ^) at short intervals, up to gr. £jf in 24 hours, have proven to be remarkably effi- 
cacious. 



CAMPHORA, Camphor, C 10 H 16 O, — is a stearopten (solid volatile 
oil), derived from Cinnamomum Camphora, a tree of the nat. ord. Lauri- 
neae, and purified by sublimation. It occurs in white, translucent, waxy 
masses, of penetrating odor and pungent taste, lighter than water, in 
which it is sparingly soluble (1 to 1300), but dissolves readily in alcohol, 
ether, chloroform, benzin, oils, etc. The camphor-tree is indigenous in 
China, Japan, Formosa and other parts of Eastern Asia. Borneo Camphor 
has the formula C 10 H 18 O, bears the same relation to Japanese Camphor as 
alcohol bears to aldehyde, and is heavier than water. Dose, gr. j-xx. 

Derivatives of Camphor are — Camphor- cymol, which is obtained by its 
distillation with zinc chloride, Camphoric and Camphretic Acids, which 
result respectively from its lesser or greater oxidation, and Safrol, also 
contained in Sassafras oil, but obtained in much larger quantities from 
Camphor oil, a waste by-product in the production of crude camphor. 

Official Preparations. 
Aqua Camphorae, Camphor-water, — Camphor 8, Alcohol 5, Distilled Water to 1000. 
Used externally or as a vehicle. Dose, 3J-iv. 



CAMPHORA. 205 

Spiritus Camphorae, Spirit of Camphor, — 10 per cent, in Alcohol. Dose, ff^v-xx. 

Linimentum Camphorae, Camphor Liniment, — Camphor 20, Cotton-seed Oil 80. 

Ceratum Camphorae, Camphior Cerate, — has of the Liniment 10, White Wax 30, 
Lard 60. Used for itching skin-affections. 

Camphora Monobromata, Mo7iobromated Camphor, C 10 H 13 BrO, — colorless, pris- 
matic needles or scales, of mild camphoraceous odor and taste, and neutral reaction, 
almost insoluble in water, slightly in glycerin, freely in alcohol, ether, oils, etc. Dose, 
gr. j-x, in emulsion. 

Camphor is also an ingredient of Linimentum Saponis, Linimentum Sinapis Com- 
positum, and Tinctura Opii Camphorata. 

Unofficial Preparations. 

Acidum Camphoricum, Camphoric Acid, C 8 H u (COOH) 2 , — is a dibasic acid, ob- 
tained by the action of nitric acid on camphor. Occurs in white, acicular, odorless 
crystals, of feebly acid taste ; insoluble, or nearly so, in cold water, readily soluble in hot 
water, alcohol, ether and fatty oils. Dose, gr. x-xxx, dry on the tongue. 

Rubini's Tincture of Camphor, — is a saturated solution in alcohol, ^j in ^JX> 
of which the dose is from 4 to 10 drops. n\vij have caused toxic symptoms in an adult. 

Raspail's "Eau Sedative," — contains Aq. Ammoniae ^ij,Sodii Chloridum § ij, 
Camphorated Spirits of Wine .^iij, Water Oij. Used externally. 

Camphora Carbolata is a name given to a mixture of 2^£ parts of camphor with one 
each of carbolic acid and alcohol. This preparation, mixed with olive-oil, is a good 
non-irritating and antiseptic dressing for wounds and breaches of surface. 

Camphor- Chloral is a fluid obtained by triturating together equal parts of camphor 
and chloral hydrate. It has decided solvent powers, dissolving sulphate of morphine 
readily (gr. xx in ^ij), and many other salts of alkaloids. It is often a serviceable ap- 
plication in superficial neuralgia, and is said to allay spasmodic cough if painted over the 
larynx. 

Camphora Salicylata is obtained by heating together II parts of salicylic acid and 
14 of camphor. An ointment prepared from this substance has been used with very 
satisfactory results in the treatment of phagedena, spreading syphilitic sores, epithelioma, 
lupus, etc. 

Oleum Camphorata, Camphorated Oil, — strength 10 per cent. , is used for hypoder- 
mic injection, in doses of rihxv-^j. 

Physiological Action. 

Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, a stimu- 
lant expectorant, a cerebral excitant, a gastro-intestinal irritant, and a 
rubefacient. It has an acrid, hot taste, and irritates the skin and mucous 
membranes, in quantity exciting severe gastric inflammation with all the 
effects of an irritant poison. In medicinal doses it stimulates the vaso- 
motor system and the cardiac motor ganglia, and lessens the influence of 
the pneumogastric, — thus increasing the circulation and raising arterial 
tension. It also stimulates respiration and mental activity, even produc- 
ing intoxication ; promotes diaphoresis, allays pain, and increases the 
menstrual flow and the sexual appetite, but its continued use depresses 
the generative function. " Camphora per nares castrat odore mares." 

Large doses cause gastro-intestinal inflammation, depress the heart and 
lower arterial tension, diminish the reflex function of the spinal cord, 
produce coldness of the surface, insensibility, coma, convulsions and per- 
haps death. As many as 200 grains have been taken without fatal result, 
yet 6 or 7 grains have produced extreme drowsiness and weakness of the 



206 CAMPHORA. 

pulse, and 20 grains laid an Alpine guide up for a day. It is eliminated 
by the bronchial mucous membrane, skin and kidneys, and has often 
caused dysuria. 

Monobromated Camphor resembles the bromides in action, but is not 
identical therewith. In mammals it produces muscular weakness passing 
into paralysis, lowered temperature and respiration, stupor and death. In 
some cases its use by man has been followed by epileptiform convulsions. 
It is a nervous sedative and hypnotic, and a gastric irritant. 

Antagonists, Antidotes and Inco??ipatibles. 

Arterial sedatives, coffee, cold, etc. , antagonize its action. Water precipitates it from 
the alcoholic solution, alkalies and earthy salts precipitate even the small quantity which 
is soluble in water. E)netics to remove as much as possible. Opium and Bromides for 
the convulsions. 

Therapeutics. 

Camphor was much used by the older physicians as an antispasmodic, 
and is yet greatly valued in China and Japan. It has a reputation for 
uncertainty of therapeutic action, but is usefully administered in cholera 
and choleraic diarrhoea, summer diarrhoea and that of infants, vomiting, 
gastralgia, cardiac depression, nervousness and nervous headache, nym- 
phomania, capillary bronchitis, typhoid and eruptive fevers, dysmenor- 
rhea, afterpains, chordee, strangury, and catarrhal colds. Locally it is 
effective in myalgia, lumbago, toothache, gangrene, and other conditions 
where counter-irritation or a local anodyne are required. A solution in 
ether has been found to be a beneficial application in erysipelas. 

Subcutaneous injections of camphor dissolved in oil have been employed 
with excellent results in the collapse of pneumonia and in other conditions 
where collapse is imminent. In fibrinous pneumonia these injections 
produce a depression of about one degree in the temperature, and greatly 
ameliorate the general condition. They are also employed with benefit 
in the treatment of phthisis during the period of softening, rendering 
the patient more comfortable and prolonging life. Camphor administered 
in this manner is not well borne by young children, even in minimum 
doses. 

Monobromated Camphor is used as a nerve sedative and hypnotic, but 
is not particularly efficient. It has been employed with advantage in 
whooping-cough, neuralgia, chorea, hysteria, delirium tremens and epi- 
lepsy, but it is taken with difficulty and is very liable to irritate the stomach. 

Camphoric Acid in solutions of ]/ 2 to 6 per cent, strength, has been used with benefit 
as a topical agent in cystitis, and in coryza, acute bronchitis, and other affections of the 
respiratory tract. Internally administered it gives good results as an intestinal disinfectant, 
and has lately come into prominence as one of the most efficient agents against sweating 
from various causes, especially the profuse night-sweats of pulmonary tuberculosis. For 
this purpose it is best administered dry on the tongue, in dose of 10 to 30 grains, not 
more than two hours before the time for the expected sweating to occur, — as it is quickly 
and abundantly eliminated by the urine. 



CANNABIS INDICA. 2C>7 

CANNABIS INDICA, Indian Cannabis, Indian He mp,— is the 
flowering tops of the female plant of Cannabis saliva, grown in the East 
Indies; a coarse, pubescent, somewhat viscid annual of thenat. ord. Urti- 
caceae. Its odor is peculiar and narcotic, taste slightly acrid. 

Cannabis Americana, American Cannabis (Unofficial), — is the same 
plant, Cannabis sativa, grown in the Southern States. 

The two varieties are specifically identical with each other, differing 
only in the degree of their action, that grown in India being the most 
powerful. They contain a resin named Cannabin, and a Volatile Oil, from 
the latter of which are obtained Cannabene, a light hydrocarbon, and 
Cannabene Hydride, a crystalline body. Cannabis should not be con- 
founded with the so-called "Indian or Canadian Hemp," Apocynum 
cannabinum (see ante, page 156). 

Preparations. 

Extractum Cannabis Indicse, Extract of Indian Cannabis. — Dose, gr.^-j, if 
active. Hering's English Extract is one of the best. 

Extractum Cannabis Indicae Fluidum, Fluid Extract of Indian Cannabis, — is an 
alcoholic preparation which in mixtures must be thoroughly emulsified with Acacia, 
otherwise the resinous drug will separate and float to the top or adhere to the sides of the 
bottle. The Dose is put at n\j-v or x, but the author has frequently administered 3J of 
a good fluid extract without untoward results. Whatever may be the reason, it is a fact 
which he has often verified, that if the precipitate, formed when the alcoholic preparation 
is added to water, be of a brownish hue, a dirty, yellow-brown, the sample wdl prove to 
be almost inert ; — but if of a decided olive-green color, the preparation will be active. 
The activity will be found to increase almost in direct proportion to the decided green of 
the precipitate. Samples from the same manufacturer show this difference, often seen 
between two bottles in the same shipment. The active principle seems to be intimately 
connected with the chlorophyll or other coloring matter present, and to be destroyed 
therewith by whatever injures the latter. 

Tincture Cannabis Indicse, Tincture of Indian Cannabis , — strength 15 per cent. 
Dose, rr\xx-gj. The above remark on mixtures containing the fluid extract applies also 
to the tincture of this drug. 

Similar preparations of Cannabis Americana are prepared by the manufacturers and 
may be used in larger quantities. The dosage of all preparations of hemp is uncertain, as 
specimens of the plant vary very much in activity. The best rule is to begin with a small 
dose, gradually testing the activity of the drug and the susceptibility of the patient by 
carefully increased doses. 

Cannabin Tannate (Unofficial), — is a yellowish-brown permanent powder, insoluble 
in water and ether, slightly soluble in alcohol, having a not unpleasant odor and a bitterish, 
astringent taste. No formula has been published for it, but it is claimed to be the tannate 
of a glucoside by Merck, of Darmstadt, who placed it on the market. Dose, as a hyp- 
notic, gr. v-x. 

Preparations used in the East. 

Churrus is an impure resin, prepared by rubbing the leaves of the plant together and 
scraping off the adhering resin. 

Gunjah is the dried leaf and tops as sold in the bazaars for smoking purposes. 

Hashish, Bhang or Siddhi is a confection consisting of the leaves and small stalks 
coarsely broken and mixed with fruits and aromatics. It is employed in the preparation 
of various electuaries and beverages, and is also smoked with or without tobacco. 

Physiological Action. 
Cannabis Indica is antispasmodic, analgesic, anaesthetic and narcotic, 
a eerebro-spinal stimulant and a powerful aphrodisiac. Its increases intel- 



208 CANNABIS INDICA. 

lectual and motor activity, stimulates the vase-motor nerves, raising arterial 
tension, depresses sensation, and strengthens the energy of the uterine 
muscular fibre, but has no power to initiate uterine contractions. In large 
doses it causes a peculiar but generally pleasant form of intoxication, dur- 
ing which the particular traits of the individual are exalted, and the ideas 
follow each other so rapidly as to produce a sense of great prolongation of 
time, minutes seeming as if hours or even days. With this occurs 
increased sexual desire, great uterine activity, and sensations of double 
consciousness and enormous dimensions. The sight and hearing are 
exalted, pupils dilated, anaesthesia sets in, the reflexes are lowered by 
stimulation of inhibition (Setchenow's centre ?), and if the dose be a 
heavy one a cataleptic state is induced. Sleep or coma follows according 
to the size of the dose, but death has never been produced by this drug. 

After-effects are dullness, heaviness, vertigo, headache, and confused 
thought, anaesthesia of the skin, and marked diuresis, — but no nausea, no 
vital depression, no constipation. Repeated use of the drug causes mental 
weakness and impotence, the result of over-stimulation. A ravenous 
appetite is usually one of its effects. 

Antagonists and Incompalibles. 

Strychnine and Faradism are antagonistic. Caustic Alkalies are incompatible. In 
poisoning by it the stomach should be evacuated, stimulants given cautiously, and respira- 
tion maintained. The effects of a large dose last over 24 hours. Lemon-juice is said to 
antagonize its effects. 

Therapeutics. 
Cannabis Indica was formerly much employed as an anodyne and hyp- 
notic, also as an anaesthetic during surgical operations. It is now some- 
what out of fashion. In migraine it is useful to prevent recurrence of the 
attack, and in neuralgia it is often very efficient. Uterine affections, as — 
chronic metritis, subinvolution, menorrhagia, dysmenorrhcea, etc., are 
greatly benefited by its anodyne quality and its power over the uterine 
muscular fibre. It is one of the best hypnotics in delirium tremens, and 
in traumatic tetanus and paralysis agitans large doses of this drug will 
lower the reflex activity. Dysuria and retention of urine are often relieved 
by it, while in spasm of the bladder and other painful affections of that 
organ it will be found a most efficient remedy. It is useful in functional 
impotence, especially if combined with Ergot and Nux-vomica. In gonor- 
rhoea it lessens the discharge, relieves the inflammation, burning pain and 
restlessness, and allays chordee. The tincture of Cannabis Americana is 
the most useful in this affection, being fully as efficient as Copaiba or 
Sandal Oil, and much more agreeable. It should, however, be prepared 
from the fresh plant, and be given in 3 to 5 drop doses 3 or 4 times daily 
after the subsidence of the acute symptoms. Full doses of the tincture of 
the Indian plant are extremely efficient in many cases of headache at the 



CANTHARIS. 209 

menopause, but should be used cautiously until the activity of the sample 
and the susceptibility of the patient are tested. 

Dr. Lees has recently called attention to the fact that aqueous prepara- 
tions of this drug, which contain but little of the resin, are much used by 
the natives of India for intoxicating and stimulating purposes, which in- 
dicates that the volatile oil and not the resin is the active principle. He 
uses a strong aqueous extract, prepared without heat, which gives all the 
beneficial effects of the alcoholic preparations without the extreme ex- 
hilaration bordering on intoxication so often produced by even medium 
doses of the latter. He finds that, in pulmonary affections generally, 
this Liquor Cannabis Indices acts most favorably as an anodyne and hyp- 
notic, while in phthisis pulmonalis it relieves the cough and aids the 
patient by its stimulant and exhilarating qualities to a degree which no 
other drug can accomplish. Dr. Lees has also used it in indigestion with 
constipation, and in many affections of children in which nervous symp- 
toms are prominent it has done good service. The adult dose is gss-j. 

Cannabin Tannate is considered by Fronmuller to be a very useful 
hypnotic, not in any degree dangerous and neither disturbing the secre- 
tions nor leaving unpleasant after-effects. It has been used with benefit 
in acute mania. 



CANTHARIS, Cantharides, Spanish Flies,— is the dried beetle, 
Cantharis vesicatoria, an insect of the nat. ord. Coleoptera, about an inch 
long, of a shining green color, the powder being grayish-brown, with 
green particles, odor very disagreeable. Contains Cantharidin, C 10 H 12 O 4 
the active principle, — also a greenish volatile oil and peculiar fatty bodies. 

Preparations. 

Tinctura Cantharidis, Tincture of Cantharides, — 5 per cent. Dose, TT\J-xx. 

Ceratum Cantharidis, Cantharides Cerate, Blistering Cerate, — Cantharides 32, Yel- 
low Wax, Resin, Lard, of each 18, Oil of Turpentine 15. 

Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
ides 60, Flexible Collodion 85, Chloroform to 100. 

Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
has of Cerate of Cantharides 8 parts, Burgundy Pitch to 100. 

Physiological Action. 
Cantharis applied to the skin is a rubefacient and vesicant, acting more 
slowly than mustard but much more severely. Internally it is also irri- 
tant, causing heat of stomach, gastralgia, nausea, and vomiting, the circu- 
lation is stimulated, temperature elevated, urine becomes scanty and irri- 
tating, is voided with difficulty and pain, and often contains blood and 
albumen. Afterwards the pulse falls, temperature and arterial tension are 
lowered, and depression ensues. A toxic dose produces severe gastro- 
14 



210 CANTHARIS. 

enteritis, abdominal tenderness, tenesmus, mucous or bloody stools, pain 
in the stomach and loins, dysphagia, ptyalism, strangury, priapism, hema- 
turia, swollen genitals, abortion, muscular tremor, convulsions, coma and 
insensibility. Post-mortem shows evidences of violent metritis, gastro- 
enteritis and general peritonitis. Cantharis is aphrodisiac by causing 
vascular turgescence of the genital apparatus, but only in doses which 
produce dangerous symptoms. It is abortive only in toxic doses. In 
small doses it is diuretic and emmenagogue. 

Counter-irritation by rubefacients or blisters acts on disease probably 
through the nervous system. Its influence is explained by the theory that 
the peripheral extremities of the nerves supplying the skin of the part, to 
which the agent is applied undergo some molecular change, which extends 
to the nerve centre and is thence radiated to centrifugal or trophic nerves, 
effecting various changes in nutrition and secretion over the areas to 
which they are distributed. In addition to this method of action, neigh- 
boring parts are affected by direct extension of the inflammation pro- 
duced, and distant parts are also affected by absorption through the ves- 
icated surface of agents having special affinities for certain organs. 

Blisters act primarily as a stimulant to the body generally as well as to 
the organs in its vincinity, but if permitted to remain long enough to pro- 
duce large blebs, the result is depression proportionate to the amount of 
serum abstracted, the serum containing nearly as much albumen as the 
blood itself. 

Antagonists and Antidotes. 

There is no chemical antidote nor physiological antagonist to Cantharis. Evacuation 
of the stomach, mucilaginous drinks freely, Opium for the gastro-enteritis, are the best 
measures in poisoning by this agent. 

Therapeutics. 

As a counter-irritant and vesicant Cantharis is of great value in neu- 
ralgia if applied close to the emergence of the nerve from the spinal 
column, also in sciatica and neuritis, and in acute rheumatism around the 
affected joints. A blister at the nape of the neck controls many head- 
aches, and one behind the ear will modify inflammatory affections of the 
eye. In pleuritic effusions a succession of small blisters (flying-blisters) 
will promote absorption of the pleural contents, and a blister applied to 
the perineum will often cure a rebellious gleet. Though valuable as a 
therapeutic measure in very many conditions, blistering is going out of 
fashion except in hospitals and among people who believe in heroic treat- 
ment. It is invaluable in subacute joint affections. 

As an internal remedy Cantharis must be employed in very small doses 
(ttl j-iij of the tincture) in order to be efficient. When so used it is an 
admirable agent in acute desquamative nephritis after the active inflam- 
mation and fever have subsided to reduce the albumen and blood in the 



CAPSICUM. 211 

urine. Drop-doses are particularly useful in irritable bladder with frequent 
desire to micturate, so often observed in women, also in the incontinence 
of the aged and of children, and in cystitis, gonorrhoea and gleet. The 
same dose thrice daily will generally abate chordee. In spermatorrhoea, 
prostatorrhcea, scanty menstruation and menorrhagia in subjects of lax 
fibre and general want of tone it is often very serviceable. Cutaneous 
squamae and vesiculae are greatly improved by small doses frequently ad- 
ministered and gradually increased, and it is one of the best remedies for 
psoriasis. For alopecia areata it is of the utmost value as an external 
application, and the tincture, greatly diluted, is an ingredient of all the 
hair-renewers in common use. In pleurisy, after effusion has taken place, 
it will be found admirable in i to 2 drop doses every 2 or 3 hours, and in 
the after-prostration of diphtheria it proves a serviceable stimulant. One 
of the best applications to burns or scalds is a cloth dipped in a lotion of 
the tincture one part to thirty or forty of water. The same lotion is an 
efficient application to vesicular erysipelas and herpes zoster. 



CAPSICUM, Cayenne Pepper, African Pepper, — is the fruit of 
Capsicum fastigiatum, a plant of the nat. ord. Solanaceae, native in tropi- 
cal Africa and America. It contains Capsicin, which is a thick, red 
liquid, and is the active principle, — also a volatile alkaloid having the 
odor of Coni'ine. Dose of the powdered drug, gr.v-x. 



Preparations. 
Extractum Capsici Fluidum, Fluid Extract of Capsicum, alcoholic. Dose, TIL, j-x. 
Tinctura Capsici, Tincture of Capsicum, — 5 per cent, strength. Dose, ttLv-xx. 
Oleoresina Capsici, O leo resin of Capsicum , — prepared by ether. Dose, TT\J-v. 
Emplastrum Capsici, Capsicum Plaster, — prepared from the Oleoresin of Capsicum 
and Resin Plaster. An excellent warming plaster. 



Physiological Action. 
Capsicum is irritant to the skin and mucous membranes. Externally 
used for sufficient length of time it will produce vesication, internally in 
quantity it will excite gastritis. In medicinal doses it increases the saliva, 
excites a sensation of warmth in the stomach, promotes appetite and di- 
gestion, and produces more easy and copious alvine evacuations. It 
stimulates the action of the heart, is diaphoretic and diuretic, also decid- 
edly aphrodisiac. It is a general stimulant to the nervous system, but in 
repeated doses produces a slight narcotic effect upon the brain. On the 
vascular system it acts like ergot, powerfully constringing the vessels by 
influencing the unstriped muscular fibre in their walls, either directly or 
through the vaso-motor nerves. 



212 CARBO. 

Therapeutics. 

Capsicum is an excellent stomachic tonic in atonic dyspepsia and in that 
of chronic alcoholism with tremor and insomnia. In acute dipsomania 
and delirium tremens large doses are efficient in producing sleep and 
promoting appetite. It is the best substitute for alcohol and opium in 
attempts to cure those habits. It is well used in intermittents, chiefly as 
an adjuvant to more active drugs, — in flatulent colic, especially when 
occurring in hysterical women and hypochondriacs, — also in low fevers 
and cholera as a stimulant. It gives good results in functional impotence, 
in spermatorrhoea from loss of tone, in chronic parenchymatous nephritis 
to check the waste of albumen, and is beneficial in chronic cystitis and in 
prostatorrhcea. The tincture internally, and a plaster externally over the 
loins, are efficient in cases of renal congestion with habitual pain in the 
back and a trace of albumen in the urine. 

Locally the tincture diluted (3J to ^viij) or the powder with honey, 
form excellent gargles for relaxed throat and its accompanying cough, 
relaxed uvula, inflammatory sore throat, and thecynanche of scarlet fever, 
but they must be used with caution, as such applications are sometimes 
very irritating. 

The Capsicum-plaster is a mild counter-irritant, of great value in lum- 
bago and other muscular rheumatisms as a palliative application. 



CARBO, Carbon, C. — This element is widely distributed through- 
out all the kingdoms of nature. United with oxygen in the form of 
Carbonic Acid gas, C0 2 , it occurs in the air and in many mineral waters, 
while as carbonates, such as limestone, etc., it constitutes a large portion 
of the surface of the earth. [Compare the article entitled Acidum Car- 
bonicum, ante, page 80.] Another compound with oxygen, Carbonic 
Oxide or Carbon Monoxide, CO, is a highly poisonous gas, which is formed 
to a certain extent during the combustion of charcoal, but does not form 
salts. Two forms of Carbon are official, viz. : — 

Carbo Animalis, Animal Charcoal, — prepared from bone, occurring 
in dull black fragments or powder, odorless and nearly tasteless, insoluble 
in water or alcohol. 

Carbo Ligni, Charcoal, — prepared from soft wood, and very finely 
powdered ; is black, shining, brittle, inodorous, tasteless and insoluble. 

Preparations. 

Carbo Animalis Purificatus, Purified Animal Charcoal, — the bone-phosphate and 
calcium carbonate being removed by digesting with Hydrochloric Acid and washing. 
Dose, gr. xx-^j. 

Carbonei Disulphidum, Carbon Disulphide, CS 2 , — is a clear, colorless, diffusive 
liquid, of strong, offensive odor, aromatic taste and neutral reaction ; soluble in alcohol, 



CARDAMOMUM. 213 

ether, chloroform and oils, and in 535 of water ; vaporizes at ordinary temperatures, and 
is highly inflammable. Dose, TT^ss— j . 

Physiological Action. 

Charcoal is an efficient deodorant and disinfectant, at it absorbs and 
condenses many gaseous bodies and vapors. It is evacuated unchanged 
by the bowel and exerts no specific action on the body. 

Carbon Disulphide is largely used in the arts, hence its effects are fre- 
quently observed. Persons exposed to its fumes are affected by headache, 
vertigo, over-excitement of the nervous system, emaciation, incoordination 
of movement, depression of all the special senses with impairment of sen- 
sation and motility and perhaps insanity. Inhaled directly, it excites vio- 
lent coughing, and produces anaesthesia characterized by great muscular 
rigidity. Being a powerful cardiac paralyzant, it is extremely dangerous 
as an anaesthetic. In 3-drop doses it produces severe nausea and vomit- 
ing, with a sense of heat in the stomach and a weak and rapid action 
of the heart. It is a good [solvent for Caoutchouc and many other 
substances. 

Therapeutics. 

Charcoal is used in pharmacy for decolorizing vegetable principles, 
removing alkaloids from infusions of plants, and making several prepara- 
tions, as acidum sulphurosum, potassii iodidum, etc. 

Externally, it makes an efficient disinfectant, absorbent and deodorant 
application to cancerous discharges, foul ulcers and gangrenous wounds. 
Having no odor it is not open to the charge of substitution of one smell 
for another. A small quantity added to water will keep it sweet for a long 
time. It is an excellent dentifrice if finely powdered. 

Internally, it is used for the same purposes, namely, to absorb gases and 
offending products of indigestion. In flatulent dyspepsia, gastralgia, 
pyrosis, diarrhoeas, nausea of pregnancy, epidemic cholera, and constipa- 
tion, it has warm advocates. When' used internally for any time, an 
occasional purgative should be given to prevent its accumulation in the 
intestines. It has been proposed as an antidote for several alkaloidal 
poisons on theoretical grounds, but its efficacy in this respect is doubtful. 

Carbon Disulphide has such a horribly offensive odor that it will never 
be used for any purpose for which another agent can be found. It relieves 
the pain of gastric cancer, and in ^-drop doses will alleviate nausea and 
vomiting, also gastralgia. Locally it has been used as a counter-irritant 
and a local anaesthetic, for deafness due to want of nervous energy, in 
facial neuralgia and various local pains. 



CARDAMOMUM, Cardamon, — is the fruit of Elettaria repens, a plant of the 
nat. ord. Scitamineae, cultivated in Malabar. It contains about \]/ 2 per cent, of a Vola- 
tile Oil, C 10 H 16 , isomeric with Oil of Turpentine, which oil is the active principle, also a 



214 CARDUUS CARUM — CARYOPHYLLUS. 

fixed oil, coloring matter, etc. It is an ingredient of Pulvis Aromaticus and of Ex- 
tractum Aromaticum Fluidum (See under Cinnamomum), as well as of several com- 
pound preparations. 

Tinctura Cardamomi, Tincture of Cardamon, — io per cent. Dose, ^j-ij. 

Tinctura Cardamomi Composita, Compound Tincture of Cardamon, — has of Car- 
damon 20, Cinnamon 20, Caraway 10, Cochineal 5, Glycerin 50, Diluted Alcohol to 
1000 parts. Dose, 3J-ij. 

Infusum Cardamomi, Infusion of Cardamon (Unofficial), — maybe made in the 
strength of 3J to 0)4, an d used in wineglassful doses. 

Cardamon is aromatic, carminative and stomachic, and is used as an agreeable flavoring 
for bitter mixtures in dyspepsia and other stomach affections. It is especially useful when 
combined with purgatives to check flatulence and griping, and it makes the best flavoring 
for saline solutions or mineral waters. 



CARDUUS (Unofficial), — the seeds of Carduus marianus, or St. Mary's thistle, an 
annual European plant of the nat. ord. Composita?. A decoction ( 3 ij ad Oj) is the pre- 
paration usually employed. It is an old remedy recently revived as a hemostatic, and 
reported as very efficient in hemoptysis, uterine hemorrhage, melaena and amenorrhcea 
connected with derangement of the portal circulation. It has proved curative in conges- 
tion of the liver and simple jaundice, and in Germany it has long been popularly deemed 
efficacious in gall stones, and liver affections generally. Dose of the decoction, ^j-^ss, 
of a tincture, rrLx-xx. 

Carduus Benedictus, the "blessed thistle," also called Cnicus benedictus and Cen- 
taurea benedicta, is another plant of the same order, formerly held in high esteem as a 
popular " cure-all." It contains Cnicin, an amorphous bitter principle, which has been 
used as an antiperiodic in doses of gr. v-x, but generally produces burning sensations and 
pharyngeal constriction, with nausea, vomiting, colic, and diarrhoea. It acts chiefly as a 
bitter tonic, resembling Calumba and Taraxacum most closely. 

CARUM, Caraway, — is the fruit of Carton Carvi, a European plant of the nat. ord. 
Umbelliferae. Its odor and taste are aromatic and agreeable. The active principle is 
the Volatile Oil, which is also official. Caraway is an ingredient of Tinctura Carda- 
momi Composita. 

Oleum Cari, Oil of Caraway, — is the volatile oil distilled from Caraway, and is 
resolvable into Caruen, C 10 H 1G , isomeric with Turpentine, and Caruol, C 10 H n O, iso- 
meric with Thymol. It is an ingredient of Spiritus Juniperi Compositus. Dose, tt\j-v. 

Infusum Cari, Infusion of Caraway (Unofficial), — gj-ij ad Oss. Dose, ^ss-ij. 

The Oil of Caraway is fatal to small animals, and in one case ^j produced cerebral 
congestion, delirium and rigors in man. The chief use of Caraway is as a flavoring 
agent, but it is efficient in the flatulent colic of children, and to prevent griping from the 
use of purgatives. 

CARYOPHYLLUS, Cloves,— are the unexpanded flowers of 
Eugenia aro?natica, a handsome evergreen tree of the nat. ord. Myr- 
tacese, cultivated in the East and West Indian Islands. They emit oil 
when scratched, have an aromatic odor, and a pungent, spicy taste, and 
are contained in Tinctura Lavandulae Composita, Tinctura Rhei Aromat- 
ica and Vinum Opii. They contain a heavy Volatile Oil, which is official, 
— also Eugenin, C 10 H 12 O 2 , a crystalline body ; Caryophyllin, C 10 Hi 6 O, a 
camphor; Caryophyllic Acid, and tannin, gum, etc. 

Preparations. 
Oleum Caryophylli, Oil of Cloves,— a volatile oil distilled from Cloves, soluble in 
alcohol, and of sp. gr. 1.060. It consists of a light and a heavy oil, the latter containing 



CASCA BARK CASCARA AMARGA CASCARILLA. 215 

Eugenol, C ]0 H 12 O, a phenol-like compound, and Caryophyllin, C in H 16 0, which yields as a 
product of its oxidation, Caryophyllinic Acid, C 20 H 32 O 6 . Dose of the oil, TT\J-iv. 

Infusum Caryophylli, Infusion of Cloves (Unofficial), may be made of strength I to 
40, and used in doses of one to two fluid ounces. 

Physiological Action and Therapeutics. 

Cloves may be considered as a type of several agents yielding aromatic 
oils, which as a rule consist of terpenes with camphors, resins, fatty and 
other acids, etc., closely allied to phenol and benzoic acid, the balsams 
and gum-resins. Such are Orange, Lemon, Allspice, Cajuput, Caraway, 
Peppermint, etc. Their oils are antiseptic, locally anaesthetic, stimulant 
and irritant, antispasmodic, stomachic and carminative. Internally they 
increase circulation and temperature, promote digestion and nutrition (in 
quantity may cause inflammation), relieve pain and spasm, and are excre- 
ted by the kidneys, skin, liver and the bronchial mucous membrane, 
stimulating and disinfecting their routes throughout the organism. 

These agents are used to flavor pharmaceutical preparations, to correct 
the griping tendency of many purgatives, to correct flatulence, to relieve 
pain in the stomach and bowels, and to promote the flow of saliva and 
gastric juice. As external applications they are efficiently employed for 
anaesthetic and counter-irritant purposes, to relieve pain in chronic rheu- 
matism, myalgia, lumbago, superficial neuralgia, toothache, etc. The 
Oil of Cloves is an effective deodorizer for sponge-tents, a good applica- 
tion to a painful tooth, and is occasionally applied over the course of an 
aching nerve with relief to the pain. 

CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial),— is the bark of Erythro- 
phlceum Guinense, an African tree used by the negroes as an ordeal in trials for witchcraft. 
It contains a poisonous glucoside, Erythrophlein, and when used in quantity produces 
nausea and vomiting, stricture across the brow, severe cephalalgia, narcosis and death. 
It is used as a remedy in Africa for intermittent fever, dysentery, diarrhoea and colic, 
and in England is considered to resemble Digitalis in action and uses. A tincture is 
made ( ^ij ad Oj) of which the dose is TT^x ; or a watery Extract may be used in doses 
ofgr.j. 

Erythrophlcein, the active principle, is a glucoside, and is said to be a local anaesthetic 
of extraordinary power, even surpassing Cocaine. It is found in Africa in a red mass, 
called " Hayah," which is proven to, be identical with an extract of the original plant 
described by CErtel early in this century, and deposited by him in the Berlin Museum. It 
closely resembles Digitalis in action, being a cardiac tonic and a hydragogue diuretic. 

CASCARA AMARGA, Honduras Bark (Unofficial),— is the bark of a Mexican 
tree of the nat. ord. Simarubacese, which has been used with apparent success as an 
alterative tonic and diuretic in syphilis and various chronic skin affections. The use of 
tobacco and alcohol seems to counteract its usefulness. It is certainly a very powerful 
tonic and has been employed by competent observers with uniformly good results in 
syphilis and syphilodermata, chronic liver complaints, chronic eczema, chronic nasal 
catarrh and psoriasis. A Fluid Extract is on the market, of which the dose is 3 ss-j 
thrice daily. 

CASCARILLA, — is the bark of Croton Eluteria, a shrub or small tree of the nat. 
ord. Euphorbiaceae, growing in the Bahamas. It contains Cascarillin, a crystalline prin- 



2l6 CASSIA FISTULA CAULOPHYLLUM. 

ciple, two resinoid extracts, aromatic volatile oils, with tannic acid, etc. There are no 
official preparations, but an Infusion (i to io) or a Tincture (i to io) may be prepared 
and given in doses of 3J-3J- 

Cascarilla is an aromatic bitter. It increases appetite and digestion, the mucous secre- 
tion, the flow of saliva and gastric juice, stimulates the intestinal secretions, and acts as 
a mild astringent by the influence of its tannin. Large doses produce nausea, vomiting 
and diarrhoea, and in medicinal doses continued it will set up gastric catarrh and conse- 
quently indigestion. It has slight antiperiodic power. 

It has been used with success in epidemic dysentery, flatulent dyspepsia, debility, 
chronic bronchitis, intermittents, and low nervous fevers. It is difficult to dispense, as 
the infusion decomposes quickly, and acids precipitate the resin from the tincture. 



CASSIA FISTULA, Purging Cassia, — is the fruit of Cassia Fistula, a tree of the 
nat. ord. Leguminosse, growing in tropical regions of Asia, Africa and America. No 
active principle has been isolated as yet. The pulp is the only valuable part of the drug. 
There are no official preparations, but it is one of the ingredients of Confectio Sennae. 

Cassia-pulp is laxative in doses of 3J-ij, and purgative in large quantities, producing 
nausea, flatulence and griping. It is rarely prescribed alone, owing to its tendency to 
cause colic and flatulence. 



CASTANEA, Chestnut, — the leaves of Castanea dentata, a stately tree of the nat. 
ord. Cupuliferse, which should be collected while green. They contain tannic and gallic 
acids, salts, gum, etc. 

Extractum Castanea Fluidum, Fluid Extract of Castanea. — Dose, ^ss-^ij. 

This drug has not been studied as to its physiological action, if it has any. It is classed 
among the vegetable astringents by reason of its containing tannin. Its only reputation 
therapeutically is as a remedy for whooping-cough, in which it is said to be very effica- 
cious. An infusion or decoction of the leaves has been used, in indefinite doses. 



CATECHU, — is an extract prepared from the wood of Acacia Cate- 
chu, a tree of the nat. ord. Leguminosse, native of the East Indies. It 
occurs in irregular masses, dark brown and brittle, nearly inodorous, but 
of astringent and sweetish taste, soluble in alcohol, and partly so in water. 
It contains Catechutannic Acid 50 per cent.; and Catechuic Acid, which 
is converted into the former by heat. Dose, gr. J-3SS. 



Preparations. 

Tinctura Catechu Composita, Compound Tincture of Catechu, — contains Catechu 
10, Cinnamon 5, Diluted Alcohol q. s. ad 100 parts. Dose, TTLx-^j. 

Trochisci Catechu, Troches of Catechu, — each troche contains of Catechu nearly I 
grain, mixed with Sugar, Tragacanth and Orange-flower Water. 

Catechu is a powerful astringent, acting by virtue of its tannic acid, 
(See ante, page 94, for action and incompatibles). Its uses depend en- 
tirely on its astringency. In the diarrhoea of children the Tincture with 
Chalk-mixture is very serviceable, and with Opium it is efficient in dysen- 
tery. It is also used as a gargle and mouth-wash in relaxed conditions of 
the pharyngeal mucous membrane, as an injection in leucorrhcea, and to 
control passive hemorrhages, spongy gums, etc. 

CAULOPHYLLUM, Blue Cohosh, — is the rhizome and rootlets of Caulophyllum 
thalictroides, a plant of the nat. ord. Berberidaceae growing in Canada and the northern 



CERA CERII OXALAS CETACEUM. 21J 

United States, and contains Saponin a glucoside, and two resins. Dose, gr. v-xx. There 
are no official preparations. The eclectic preparation Caulophyttin is a resinous precipitate 
obtained by pouring an alcoholic extract into water. 

Caulophyllum is a new addition to the pharmacopoeia, and has not yet been made the 
subject of experimental work by reliable observers. It was much used by the aborigines 
of this country in all affections to which their women were peculiarly subject, and was 
known among them by the name " squaw-root." It is said to produce intermittent con- 
tractions of the gravid uterus, to have diuretic, emmenagogue, and antispasmodic powers ; 
and is used as a remedy for deficient labor-pains, spasmodic after-pains, spasmodic pains 
in the uterus at any time, spasmodic dysmenorrhea, and pains in other organs seemingly 
in sympathy with uterine affections. It has somewhat of a reputation in acute rheuma- 
tism of the hands and fingers, and as a preparative medicine for labor. 



CERA, Wax, — a mixture of Myricin, Cerotic Acid, and Cerolein, is 
formed by the honey-bee, and exists in the pollen and leaves of many 
plants, particularly in Myrica cerifera, the wax myrtle. That produced 
by the bee is alone official. 

Cera Alba, White Wax, — is yellow wax bleached. 

Cera Flava, Yellow Wax, — is a peculiar concrete substance prepared 
by Apis mellifica, the honey-bee. It is a yellowish solid, of agreeable odor 
and faint, balsamic taste, insoluble in water and also so in cold alcohol, 
but soluble in 35 of ether, 11 of chloroform, boiling alcohol, fixed and 
volatile oils. 

Ceratum, Cerate, — consists of White Wax 30, Lard 70. 
Unguentum, Ointment, — consists of Yellow Wax 20, Lard 80. 

Wax is also a constituent of the 5 compound Cerates, 2 of the 22 compound Ointments, 
and 2 of the 13 Plasters. 

Wax owes its value to its power of resistance to decomposition and to 
many chemical agents. Its fusibility at a moderate degree of heat, and 
its solidity at the temperature of the body, together with its unirritating 
quality, make it a valuable ingredient of the cerates and ointments to give 
them consistence. 

Ceratum and Unguentum may be used as simple protective applications. 
They form the bases of the most of the compound preparations so named. 



CERII OXALAS, Cerium Oxalate, Ce 2 (C 2 4 ) 3 + 9H 2 0,— is a white, slightly- 
granular powder, odorless and tasteless, insoluble in water or alcohol, but soluble in 
diluted sulphuric or hydrochloric acid. Dose, gr. j-x, in pill or powder. 

Cerium Oxalate is a gastric sedative, and is thought to possess selective action as such 
on the motor distribution of the pneumogastric nerve. It is considered to be particularly 
useful in vomiting of reflex origin, especially in the vomiting of pregnancy, but it often 
fails, probably because not given in sufficient doses. To be effective, at least 4 or 5 grains 
should be given 3 times a day to adults, and no results promised until after it has been 
used several days. It is also recommended in the vomiting of phthisis and bronchitis, 
cough with vomiting, gastralgia, chorea, and diarrhoea. 



CETACEUM, Spermaceti, — is a peculiar, concrete, fatty sub- 
stance obtained from Physeter macrocephalus, the sperm whale. It occurs 
in white, pearly masses, odorless, of bland taste, and neutral reaction, 



2l8 CETRARIA — CHAULMOOGRA OIL — CHELIDONIUM. 

becoming rancid in the air, soluble in ether, chloroform, carbon disul- 
phide and boiling alcohol. Is a constituent of — 

Ceratum Cetacei, Spermaceti Cerate, — has of Spermaceti io, White Wax 35, Olive 

Oil 55. 

Unguentum Aquae Rosas, Ointment of Rose Water, Cold Cream, — has of Sperma- 
ceti ii]/ z , White Wax 12, Expressed Oil of Almond 60, Stronger Rose Water 19, 
Sodium Borate ]/ z . 

Unguentum Cetacei, Spermaceti Ointment (Unofficial), — has of Spermaceti 5, 
White Wax 2, Almond Oil 18. The ointment of the B. P. has Benzoin ]/ 2 in addition, 
rendering an emollient preparation irritant, and therefore unsuitable for eye-ointment, for 
piles, etc. 

Spermaceti consists of Cetin (Cetyl Palmitate) with several other fats 
in small quantities. Its action is solely that of an emollient, and it is 
rarely used internally, though an alcoholic preparation was once a regular 
prescription for coughs, bronchial irritation, and for a recently delivered 
woman. The Cerate is employed as a bland ointment for blisters, abra- 
sions and ulcers, but is too stiff for easy application, and the unofficial 
Ointment is preferred in practice. The latter on lint to broken blisters 
from walking affords great relief, and is employed to prevent injury to the 
feet by smearing on them before starting for a rough tramp over broken 
ground. The Ointment of Rose Water, popularly known as "cold 
cream," is one of the most agreeable emollient and protective applica- 
tions for chapped hands, chilblains and other slight affections of the skin. 

CETRARIA, Iceland Moss, — is the lichen Cetraria islandica, found in northern 
latitudes. Contains Lichenin or lichen starch, which forms as a jelly when the plant is 
boiled in water ; also Cetraric Acid. 

Decoctum Cetrariae, Decoction of Cetraria, — 5 per cent, strength. Dose, ^ ij-iv. 

Cetraria is nutrient, demulcent and feebly tonic. It has a popular reputation in pulmo- 
nary affections, and is of value in chronic catarrhs, chronic bronchitis, purulent discharges 
from mucous surfaces generally, also in chronic diarrhoea and dysentery. 



CHAULMOOGRA OIL (Unofficial),— is a fixed oil expressed from the seeds of 
Gynocardia odorata, an East Indian tree of the nat. ord. Bixacese. It is nauseous and 
bulky, and soluble in alcohol, ether, chloroform, etc. Its active principle, Gynocardic 
Acid, is the best preparation for use, and may be given internally in doses of gr. ss-iij, or 
applied as an ointment, gr. xxad ^ j of Petrolatum. Dose of the oil, gtt. v-x, in capsules. 

Chaulmoogra Oil is credited with a few cures of leprosy, and several cases improved 
by its use both internally and externally. It is recommended as an external application 
in scaly eczema, psoriasis, syphilitic skin-diseases, chronic rheumatism, rheumatic arthritis 
and tabes mesenterica. 



CHELIDONIUM, Celandine, — is the plant Chelidonium majus, nat. ord. Papa- 
veracese, which grows in Europe and N. America, about rocky places. It contains 2 
alkaloids, Chelidonine, C 19 H 17 N 3 3 , and Chelerythrine, the latter being identical with 
Sanguinarine : also Chelidoxanthin, a yellow, crystalline substance, and Chelidonic Acid, 
supposed to be identical with Succinic Acid. Dose of the plant, gr. x-xxx, — of the 
fresh juice rr^v-xx. There are no official preparations. 

Chelidonium used externally is irritant, internally it is a drastic purgative but an unre- 
liable one. It is also perhaps diuretic, diaphoretic and expectorant. In overdoses it is 
considered poisonous. It is an old remedy for jaundice and liver affections, but has 



CHENOPODIUM CHIMAPHILA CHINOLINUM. 2 19 

been obsolete for some time. The fresh juice is a popular application for warts and corns, 
and a tincture in whiskey is used in Indiana as a remedy for phthisis, the menstruum 
being probably the most useful agent. It seems to be of real service in simple jaundice, 
whooping-cough, right-sided pneumonia with hepatic involvement, and the catarrhal 
pneumonia of children. 

CHENOPODIUM, American Wormseed, — is the fruit of Chenopodium ambro- 
sioides, var. anthehmnticuni, a plant of the nat. ord. Chenopodiaceoe, indigenous in the 
United States. Its active principle is a Volatile Oil which is official. 

Oleum Chenopodii, Oil of Chenopodium, — a thin, colorless or yellowish liquid, of 
aromatic odor and pungent, bitter taste. Dose, TTLv-xv. 

The Oil is the only preparation used and that rarely, its odor and taste being very dis- 
agreeable. It increases the cardiac rate, and promotes the secretions of the skin, bronchi 
and kidneys. It is an efficient anthelmintic against the round worm in doses of gtt. x 
three times a day for two days, followed by a cathartic. It seems to possess some tonic 
properties, and certainly is a diffusible stimulant. As such it has been used with benefit 
in chorea, hysteria, flatulent dyspepsia, and chronic malaria. 

CHIMAPHILA, Pipsissewa, — the leaves of Ckimaphila umbellata, or Prince's 
Pine, an evergreen plant of the nat. ord. Ericaceae, indigenous in all parts of the United 
States. It contains Chimaphilin, a yellowish crystalline principle, Arbutin, also crystal- 
line but colorless, with tannic acid, etc. 

Extractum Chimaphilae Fluidum, Fluid Extract of Ckimaphila, — Dose, gss-ij. 

Decoctum Chimaphilae, Decoction of Ckimaphila (Unofficial), — I to 17. Dose, 

Chimaphila is a tonic, astringent diuretic, belonging to the same group as Buchu, Uva 
Ursi, Pareira and Scoparius. It is probably the most active diuretic among them, stimu- 
lating all the excretory organs but especially the kidneys. It is an agreeable tonic, excites 
the appetite and promotes digestion. The fresh leaves, bruised and applied to the skin, 
are rubefacient and vesicant, showing the presence of some irritant principle. 

Chimaphila is a good diuretic in dropsy, and is efficient in several forms of chronic 
kidney disease wilh albuminuria, and in chronic catarrhal affections of the urinary pas- 
sages, as hematuria, ischuria, dysuria and gonorrhoea. It is believed to check the secre- 
tion of uric acid, and should prove useful in gout and rheumatism. Externally, it has 
been applied to ulcers and tumors with benefit. 

CHINOLINUM, Chinolin {Leucolin, Quinoline), C 9 H-N (Unof- 
ficial), — is a constituent of coal-tar oil, but may be obtained from Qui- 
nine or Cinchonine by their destructive distillation with potassium hy- 
drate, and is artificially prepared by heating Anilin or Nitro-benzol with 
glycerin in the presence of a dehydrating agent. Chemically, it is con- 
sidered to be formed by a union of Benzene and Pyridine atoms. (Com- 
pare the article Cinchona.) It is a colorless, oily liquid, strongly re- 
fractive, turning dark on exposure to the air ; soluble in alcohol, ether and 
carbon disulphide, sparingly so in water. It combines, like an alkaloid, 
with acids to form crystalline salts ; all of which, except the tartrate, are 
very deliquescent. 

Chinolini Tartras, Chinolin Tartrate (Unofficial), — a white, micaceous, crystalline 
powder, of pungent odor and sharp taste, stable in the air and soluble in water. Dose, 
gr. v-xx. 

Chinolin is a valuable antiseptic, and antipyretic, being nearly as 
effective in this respect as Quinine, which it closely resembles in chemical 



220 CHIRATA CHLORAL. 

character and physiological action. It is one of the most powerful anti- 
pyretics of the substances which have been discovered in the search for 
an artificial quinine (Hydroquinone, Antipyrin, Pyrocatechin, Resorcin, 
Thallin, Kairin, etc.). Chinolin has a very disagreeable taste and smell, 
and is irritant in action, hence the tartrate is preferred for medicinal use. 
It has been extensively used as an antipyretic in pneumonia, typhus, 
diphtheria, typhoid and other fevers, with varying success. In diphtheria, 
a 5 per cent, solution in weak alcohol is painted on the affected surface 
with great benefit. The tartrate has been used beneficially in neuralgia 
and whooping-cough, and as an antiperiodic in intermittents. 

Quinalgen, Ortho-cethoxy-ana-mono-beiizoyl-amido-qiiinoline, NHCOC 6 H 5 H (Un- 
official),— is a derivative of quinoline (chinolin), and is a reformed and renamed An- 
ALGEN (see ante, page 67), differing therefrom by having the benzoyl instead of the 
acetyl radicle. Its action is similar to that of Antipyrin, except that it is claimed for this 
substance that no unpleasant effect or after-effects are noticed after taking it. It has 
been used in gout, influenza, migraine, sciatica, neuralgia, hay fever and rheumatic pains, 
with asserted benefit. Dose, gr. viij-xv, not to exceed gr. xlv daily. 



CHIRATA, Chirata, (Chiretta), — is the Indian plant Swertia Chirata, nat. order 
Gentianacese, occurring in bundles composed of all but the coarser woody stems. It is 
inodorous but intensely bitter, and contains Chiratin and Ophelic Acid, two amorphous, 
bitter principles, but no tannin. Dose of the powdered plant, gr. xv-xxx. 

Extractum Chiratse Fluidum, Fluid Extract of Chirata, — made with glycerin and 
diluted alcohol. Dose, TTLxv-xxx. 

Tinctura Chiratae, Tincture of Chirata, — 10 per cent. Dose, ^ss-ij. 

The action of this plant is that of a simple bitter, like its congener Gentian. It is an 
excellent tonic, in this respect rivalling Cinchona, and is used in India as a substitute for 
the latter. It is laxative and stomachic, diminishes flatulency and acidity, and is particu- 
larly serviceable in the dyspepsia of gouty subjects. As it contains no tannin, it may be 
administered with preparations of Iron. 



CHLORAL, Chloral, {Chloral Hydrate), C 2 HC1 3 -f H 2 0— is a 
crystalline solid, composed of Trichloraldehyde (Chloral) with one mole- 
cule of water. It occurs in colorless, transparent, rhomboidal crystals, 
slowly volatilizing when exposed to the air; of aromatic, penetrating and 
slightly acrid odor, bitterish, caustic taste, and neutral reaction. It is 
freely soluble in water, alcohol, ether, chloroform, oils, etc.; liquefies 
when triturated with about an equal quantity of camphor, menthol, thymol 
or carbolic acid; melts at 136 F. and is decomposed by alkalies into 
Chloroform and a formiate of the alkaline base. Its aqueous solution 
becomes acid, but the alcoholic solution remains neutral. 

Chloral itself, (Trichloraldehyde, C 2 HC1 3 0), is an unstable, oily, color- 
less fluid, formed by the action of chlorine upon alcohol, whence its 
name, Chlor-al. The Hydrate is the only official preparation. 

The Dose varies much with individual susceptibility and with the presence or absence 
of cardiac and pulmonary disease. Death has been caused in several instances by gr. 
xxx, in one case by gr. x, and in another gr.vijss produced alarming symptoms, all being 
adults. On the other hand, recovery has occurred after the ingestion of an ounce, sev- 



CHLORAL. 22 1 

eral hundred grains have been taken at a time in more than one instance without fatal 
results, and where tolerance has been established by habitual use 3 ij— 55 iij are frequently 
taken without poisonous symptoms. An average dose for a healthy adult is gr. xv, for a 
child gr. j for each year of age up to gr.vj. It is best given in Syrup of Tolu, or in 
Peppermint water. 

Cazction is necessary when prescribing this drug in combination with alcoholic prepara- 
tions, as the Chloral is then very apt to separate as an alcoholate, especially if the Bro- 
mides of Potassium or Sodium are used in the same mixture and if the solutions are at 
all concentrated. In this way great danger is incurred of giving a heavy overdose, as 
the alcoholate floats on the surface of the mixture, and the entire Chloral contained 
therein may be taken at a single dose. 

Unofficial Preparations. 

Chloralamid, — is described under its own title. 

Somnal, — is the suggestive name given to a liquid preparation formed by the union 
of Chloral, Alcohol and Urethan, described as Ethylirtes Chloral-nrethan, represented 
by the formula C 7 H 12 C1 3 3 N, and claimed to be a complex body, not a simple mixture 
of its constituents. It occurs as a colorless liquid, resembling chloroform in its behavior 
with cold water, with which it forms globules and refuses to mix or dissolve. It is solu- 
ble in hot water, in alcoholic solutions, and in alcohol, 3 parts in I. The advantage 
claimed for Somnal is that when administered in 20-grain doses it induces within half an 
hour a quiet sleep lasting from six to eight hours without any inconvenient after- or by- 
effects. Doses of 45 and even 60 minims produced no depression of the circulation or 
respiration. In doses of t ^ss its action is usually very prompt, the dose is well borne 
always, easily taken (in a little syrup of tolu or whiskey), and entirely without deleteri- 
ous effect. The effects are much more striking and certain than those of Urethan, and 
far less depressing than those of Chloral ; and there is no vertigo or depression, as may 
follow the use of Sulphonal. In drachm-doses, this drug is not powerful enough to de- 
cidedly control delirium tremens, maniacal delirium or severe pain. (Dr. Gilman Thomp- 
son.) 

Hypnal is a combination of Chloral and Antipyrin, occurring as tasteless and odor- 
less rhombic crystals, soluble in 6 of water, and credited with simultaneous action as a 
hypnotic and analgesic. Dose, gr. xv-xxx in aqueous mixture with some alcohol, flavored 
with syrup of orange. It is said to cause no gastric disturbance. Although Chloral 
and Antipyrin are incompatible with each other, they form, when heated together, the 
above described compound, which resembles both and yet differs from each. Its chemi- 
cal appellation is Tri-chloraldehyd-phenvl-dimethyl-pyrazolon. 

Official Analogue of Chloral. 
Paraldehydum, Paraldehyde, — is described under its own title. 

Unofficial Analogues of Chloral. 

Amylene Hydrate, C 5 H 12 0, Di-methyl-ethyl-carbinol, — is a tertiary alcohol, occur- 
ring as a clear, colorless fluid, of peculiar odor, soluble in 8 of water and readily misci- 
ble with alcohol. It is one of the most valuable hypnotics, in power standing between 
chloral and paraldehyde, but being much more agreeable to the taste and safer than either 
of those agents. Its action is exerted chiefly on the cerebrum in doses sufficient to pro- 
duce profound narcosis ; and in medicinal doses it leaves behind no unpleasant effects, 
and has no perceptible influence on the heart or respiration. By very large dosage the 
medullary centres are paralyzed, including those governing respiration and cardiac action. 
Dose, 3J-3JSS. 

Chloral Butylicum, Croton-Chloral, — is described under its own title. 

Hypnone, C 6 H.(CO)(CH 3 ), Phenyl-methyl-acetone, — is a member of the Ketones, 
occurring above 70 F. as a colorless, mobile liquid, having a strong almond and orange 
odor. It is insoluble in water or glycerin, and is best given in capsules. It is a hypnotic, 
of only moderate intensity, but said to be especially useful in the insomnia of alcoholism. 
Its use is devoid of danger, and leaves behind no unpleasant effects, except a disagreeable 
odor of the breath, the drug being eliminated by the lungs as well as by the kidneys. 
In very large doses it has induced coma, followed by paralysis of the heart and respira- 
tion. Dose, TTLv-x, in capsule, Tr\vij to rr\viii being usually required. 



222 CHLORAL. 

Methylal, CH 2 (OCH 3 ) 2 , Methylene-di-methyl Ether, — is one of the products of the 
oxidation of Methylic Alcohol, occurring as a volatile, mobile liquid of pleasant, aromatic 
odor and taste, readily soluble in water, alcohol, etc. It is a local anaesthetic, and an 
efficient hypnotic, producing a deep sleep of short duration, with more or less general 
anaesthesia and lowered reflex excitability. It is depressant to the heart, respiration and 
body temperature, but in medicinal doses does not leave any bad after-effects. Dose, 
per orem TT^iv-v, repeated thrice at short intervals. 

Urethan, Ethyl Carbamate, NH 2 C0 2 C 2 H 5 , — occurs in crystals which are readily 
soluble in water, with scarcely any taste or odor, devoid of irritant action, and hence may 
be administered hypodermieally. It is a pure hypnotic, but a mild one at best, and not 
so reliable as Paraldehyde or Chloral. It does not affect the circulation, nor does it de- 
press (but rather stimulates) the respiration. It acts directly on the cerebrum, causing a 
sleep which closely resembles the normal, and has no unpleasant after-effects. In very 
large doses it slows the heart, lowers the temperature, and induces muscular resolution 
and general anaesthesia. In small animals it effectually antagonizes the action of Strych- 
nine. Dose, gr. xv-^j, an average hypnotic dose being gr. xxx ; but it is best given 
in 5-grain doses repeated frequently, as a large dose may cause vomiting. It is a safe 
and efficient hypnotic for children. (Squibb.) 

Physiological Action. 

Chloral is a powerful hypnotic, also an antispasmodic, an antiseptic, a 
preventive of the coagulation of fibrin, indirectly an anaesthetic, and es- 
pecially a depressant of the cerebral, medullary and spinal centres and of 
the cardiac muscle. It is more hypnotic than chloroform but less of an 
anaesthetic. Applied to the skin or mucous membranes a i percent, solu- 
tion (gr. v ad 3) is antiseptic, but strong solutions are irritant and vesi- 
cant, may produce sloughing ulcers, and if taken internally may excite 
gastritis with nausea and vomiting. 

After a brief period of stimulation a medicinal dose depresses the heart, 
dilates the peripheral vessels and lowers arterial tension, dimini:*hes oxida- 
tion and decreases the body temperature. On the brain cells it has a 
selective action, producing a deep sopor very like normal sleep, from 
which the patient may be awakened, but immediately falls asleep again, 
and which is not followed by headache or depression. This effect is con- 
sidered by some authorities to be the result of cerebral anaemia produced 
by the drug. In some persons, instead of sleep it causes headache, in- 
somnia and delirious excitement. It is not an anodyne, as it does not 
affect the conductivity of the sensory nerves, and does not interrupt the 
transmission of pain ; but by overwhelming the centres it drowns the 
consciousness of pain, and is therefore indirectly anaesthetic. A toxic 
dose produces profound narcotism, abolishment of reflexes and sensibil- 
ity, complete muscular relaxation, and a great fall of body temperature. 
Death may result in the chloral sleep from paralysis of the respiratory 
centre or the cardiac motor ganglia, or by sudden failure of the heart- 
muscle in cases of fatty degeneration or in old drunkards. 

On the blood its action is to increase the fluidity, crenate the red cor- 
puscles, and to destroy the leucocytes if used in large quantity. It is 
rapidly diffused and is excreted by the kidneys partly unchanged, but 
chiefly as urochloralic acid, producing some diuresis, — also by the skin, 



CHLORAL. 223 

causing various eruptions if used for any lengthened period. It has been 
held that the blood, being an alkaline fluid, decomposes it, setting free 
chloroform, but there are many facts against this theory. 

The Chloral-habit produces a state of marked anaemia and muscular 
weakness, especially of the legs ; its subject presenting a weak, irritable, 
often irregular heart, deranged hepatic functions, jaundice, bileless stools, 
perhaps purpura and sloughing of a finger from decreased blood-supply. 
Its votaries are on the border of insanity, excitable, uncontrollable in 
speech and action, talking in a silly manner and very volubly, and show- 
ing a marked loss of power of the limbs, so much so as to simulate paralysis 
thereof. Many cases of insanity have their origin in chloralism. 

Chloral and Atropine, though antagonistic in their action on the spinal 
cord, both produce motor paralysis, the former by paralyzing the cord, 
the latter by direct paralysis of the motor nerves. 

Antagonists and Incompatibles. 

Atropine antagonizes its cardiac, respiratory and spinal depression, and should be in- 
jected in small doses frequently repeated, until its effects are apparent. Morphine ad- 
ministered with Chloral antagonizes the tendency to cardiac failure, while synergistic to 
the hypnotism. While Chloral is the antagonist to Strychnine, opposing the spinal action 
of that drug, the reverse is only true to a very limited extent ; yet in a case described by 
Dr. Colenso in the British Medical Journal, Nov. 3, 1894, in which recovery occurred 
after the ingestion of an ounce of Chloral, nine-tenths of a grain of Strychnine was em- 
ployed by hypodermic injection in broken doses. Heat is a necessary application, to 
maintain the body temperature. Artificial Respiration should be employed if required. 
All Alkalies are incompatible with preparations containing Chloral. 

Therapeutics. 
Chloral Hydrate is of great value as a hypnotic and antispasmodic, but 
must be cautiously used if at all in persons with weak or fatty hearts, 
atheromatous vessels or advanced pulmonary disease. In combination 
with Potassium Bromide it is much used in asylum and general practice, 
and equally abused, both drugs being active cardiac poisons. It is by far 
the best hypnotic in acute mania and in delirium tremens, but has been too 
incautiously employed therein. The condition of alcoholic intoxication 
seems, however, to antagonize its depressant action on the heart to a great 
extent, even in old topers, for 30-grain doses, repeated twice within 7 or 
8 hours, are commonly used in inebriate asylums and by police surgeons, 
for the purpose of straightening up a case of acute alcoholism, with no fatal 
effects resulting from its direct action. Chloral possesses marked power to 
relax spasmodically contracted unstriated muscle and to dilate the peri- 
pheral vessels, properties which govern its employment in many morbid 
conditions. Associated with Potassium Iodide it is of service in bronchial 
asthma, and has been used in the form of an enema for checking hemop- 
tysis by the revulsion which it produces in dilating the cutaneous vessels. 
Chloral is exceedingly efficient as a gastric antiseptic and sedative in the 
so-called nervous dyspepsia of neurotic persons, characterized by severe 



224 CHLORAL. 

pain in the cardiac region of the stomach. It is very serviceable in fevers, 
when high temperature exists with excitement, restlessness and a sthenic 
condition, as it lowers temperature and prevents the coagulation of fibrin. 
In the algid stage of cholera and in violent cases of cholera morbus it has 
been injected hypodermically in 15-grain doses with extraordinary efficacy. 
In sea-sickness small doses (gr. v) two or three times a day are generally 
very efficient. In obstetrics it is used to relieve suffering, relax the os 
uteri, palliate convulsions and relieve after-pains. For nocturnal epilepsy 
a full dose at bedtime is a useful palliative. In neuralgia it may be tri- 
turated with Camphor and applied over the course of the affected nerve, 
and the same preparation is efficiently employed as a local application for 
toothache and earache. 

Chloral is well borne by children, and is an excellent remedy for in- 
fantile convulsions and colic, chorea, whooping-cough, laryngismus stri- 
dulus and the first stage of diphtheria, but it should not be used when 
the first sound of the heart becomes dull and weak. It is highly efficient 
for the purpose of calming children in scarlet fever. In these affections 
it may be given with Paregoric, as its combination with Opium enhances 
its value and guards the patient against its dangers. Its hypnotic power 
in adults is much increased by the conjoint administration of Laudanum 
or Morphine, and this combination is an excellent remedy in colic, 
cholera and cholera morbus. Tetanus is well treated by Chloral and 
Potassium Bromide given together in full doses. In Strychnine poison- 
ing Chloral is the antagonist. It is generally given by the mouth in very 
dilute solution with some simple elixir, syrup of tolu, or cinnamon-water, 
but is well absorbed by the rectum. Its hypodermic administration is 
liable to result in great local irritation and even sloughing ulcers. 

Chloral may be applied to the skin as an antipruritic in the eruptive 
diseases, for which purpose it is well combined with Carbolic Acid, ten 
grains of each to an ounce or two of water or oil. It is said to be the 
best of all local applications for boils, 3JSS in giv each of glycerin and 
water constantly applied to the boil by a tampon of cotton. For ulcers 
and cancers a 25 per cent, solution is a good antiseptic and anodyne 
application. 

The chief contra-indication to the use of Chloral is the presence of a 
cardiac affection, although it may be prescribed with much benefit in 
neurotic palpitation of the heart and in pseudo angina pectoris. Other 
contra-indications are rosacea, or a tendency to it, and hysteria of grave 
character. Chloral easily produces congestion of the face, and in hys- 
terical subjects it may excite paroxysms of delirium and hallucinations. 

Somnal (see ante, page 221), — manifests its hypnotic and sedative action to best ad- 
vantage in the insomnia of convalescence from acute disease, but where an adynamic 
condition exists it must be used with caution. In whooping-cough, spasmodic laryngitis, 
asthma, the so-called " nervous cough " and in chorea, it shows decided sedative proper- 



CHLORAL BUTYLICUM CHLORALAMIDUM. 225 

ties. A great element of safety in its use is that its action is never out of proportion to the 
quantity ingested, nor does it act in a cumulative or other unexpected manner. It seems 
to have little or no influence over insomnia due to acute inflammation. (Myers.) It is 
injurious in acute mania and general paralysis, but is of great value in cases of melan- 
cholia, in which it promotes sleep and produces a soothing effect on the mental condition 
by removing depression and gloomy forebodings. It is contra-indicated when the diges- 
tion is out of order. (De Montyel.) 



CHLORAL BUTYLICUM, Butyl-chloral Hydrate, Croton- chloral, C 4 H 5 C1 3 - 
0,H 2 (Unofficial), — is formed by the action of Chlorine upon Aldehyde, then adding to 
the Butyl-Chloral thus produced the necessary water. It occurs in crystalline scales, insolu- 
ble in chloroform, sparingly soluble in water, (i in ioo), but freely soluble in alcohol, hot 
water and glycerin, (i in 4). Dose, gr.v-xx, in syrup or pill ; — but the best method is 
to give 5 grains every half-hour until 20 grains have been taken or relief afforded. 

The action of Croton -chloral closely resembles that of chloral, but it is feebler as a hyp- 
notic, less depressant to the heart, and generally less poisonous, but more disagreeable to 
the taste. It has a specific paralyzant power over the fifth nerve, and over its distribu- 
tion causes an anaesthetic condition long before it produces general anaesthesia (Liebreich). 
It has been used with benefit in various neuralgiae, especially tic-douloureux, also in sci- 
atica and dysmenorrhcea. All statements concerning the action and therapeutics of this 
drug are to be received with hesitation, as wide differences therein are reported by the best 
authorities. 



CHLORALAMIDUM, Chloralamid, Chloral Formidate, (Unof- 
ficial), — is chemically a union of Chloral anhydride (C 2 HC1 3 0) with 
Formamide (CHO.NH 2 ). It is a proprietary drug, having been both 
patented and trade-marked, wherever possible, by its proprietor and ex- 
clusive manufacturer, Schering, of Berlin. It occurs as colorless, faintly 
bitter, odorless crystals, which are decomposed in hot water or warm 
solutions, and are soluble in 20 parts of cold water, or in 1^ of alcohol ; 
rapidly decomposed by caustic alkalies and slowly by alkaline carbonates. 

The Dose is put at from 10 to 60 grains. The average adult hypnotic quantity is about 
30 grains, given in a teaspoonful of whiskey or brandy, or in any alcoholic compound; 
for example, 30 grains in 2 drachms each of Tinct. Cardamom. Co. and Elixir Simplex, 
at one dose. By some observers a 45 -grain dose is considered the limit of safety and 
equal to 30 grains of Chloral hydrate ; by others this amount is considered necessary for 
its certain hypnotic action. Sixty grains have frequently been administered, and in one 
case 140 grains were taken at one dose, without producing unpleasant symptoms ; — but, 
as Dr. Steele has pointed out, the slow solubility of the drug in the watery contents of the 
stomach must be taken into account, and when considering its action, the menstruum and 
the condition of the gastric mucous membrane should be known. 

Physiological Action and Therapeutics. 
The action of Chloralamid is essentially a hypnotic one ; it is exten- 
sively advertised as the least depressant and most efficient sleep-producer 
at our command, — without unpleasant after-effects from ordinary doses, 
except in 2 per cent, of the cases in which used, 1 per cent, having gastric 
and the other 1 per cent, having cerebral symptoms ; while these were 
always slight unless the dose of 30 grains had been exceeded. The more 
severe and unusual effects (from doses above 30 grains) are vertigo, thirst, 
nausea, dry mouth, vomiting, anorexia, slight delirium, cardiac weakness, 
rapid and feeble pulse, and restlessness. The drug does not seem to have 
15 



226 CHLOROFORMUM. 

any cumulative action, nor any tendency to provoke a habit of using it. 
It is also credited with considerable analgesic power in certain conditions 
(see below), as well as with anti-dyspnceic and anti-hydrotic action. 

The main field for the use of Chloralamid is found in the treatment of 
insomnia, particularly the simple or idiopathic form, and when not due to 
excitement or severe pain, but from nervousness, hysteria, chronic alcohol- 
ism, and similar states ; also in that accompanying typhoid fever, asthma 
(both cardiac and bronchial), organic heart disease, the opium habit, and 
diabetes mellitus (Steele). It is less effective in organic nervous affections 
and mental disorders, and is useless in these conditions when the insomnia 
is due to excitement, hallucinations, or severe pain. As an analgesic, it 
has lessened and checked the pains of aneurism, carcinoma of the stomach 
and liver, sarcoma of a rib, erysipelas, rheumatic fever, gall-stone, etc. ; 
and in dysmenorrhea it has given entire relief, used just as the painful 
period approached, in a single dose of 30 grains. It has been reported 
curative of chorea, in doses of 15 grains thrice daily for five days, in a 
boy of eleven years ; and in a girl who had resisted all other treatment 
for the same affection, it was successful in 8 days. 

Compared with Sulphonal, Chloralamid is preferred for all cases in which collapse is 
feared, by reason of its apparent freedom from depressant action on the cardiac centres or 
the respiratory mechanism. In phthisis it has proven efficient against the most obstinate 
night-sweats, while at the same time securing rest in cases in which the cough was not 
very violent. To secure its best hypnotic results, the drug should be given about an hour 
and a half before sleeping-time, in a dilute alcoholic menstruum, and on a stomach con- 
taining little or no watery fluids to interfere with its solution and absorption. 



CHLOROFORMUM, Chloroform, CHC1 3 (or CHC1 2 C1), Ab- 
solute Chloroform, the Terchloride of Methyl, or the Chloride of Bichlor- 
inated J^//y/ (Di-chlor-methyl Chloride), — is formed by the substitution 
of 3 atoms of Chlorine for 3 of Hydrogen in Methyl Hydride (marsh- 
gas, CH 4 ). In practice it is obtained from Ethylic Alcohol or Methylated 
Spirit by the action of Chlorinated Lime, or from Chloral by an alkaline 
hydrate, and is known chemically as Normal Chloroform. If prepared 
from Methylic Alcohol (wood-spirit) it is called Methylic Chloroform, and 
is purified with great difficulty. The object of purification is to remove 
the chlorinated pyrogenous oil. Absolute Chloroform has a sp. gr. of 
1.500, and decomposes easily in sunlight or diffused daylight, but when 
reduced to a sp. gr. of 1.485 to 1.490 by alcohol it will keep well. The 
official form is — 

Chloroformum, Chloroform, CHC1 3 , — a liquid consisting of 99 to 
99.4 per cent, by weight, of absolute Chloroform, and 1 to 0.6 per cent, 
of Alcohol. A heavy, clear, colorless, mobile and diffusible liquid, of 
characteristic, ethereal odor, a burning, sweet taste, neutral reaction ; 
volatile, not inflammable ; soluble in 200 of water, freely so in alcohol or 



CHLOROFORMUM. 2 27 

ether, also in oils, benzol or benzin. Sp. gr. not below 1.490 at 59 F., 
or 1.473 at 77° F. Dose, internally, ni^ij-xx, for inhalation 3J, repeated 
until the desired effect is produced. 

Chloroformum Venale, Commercial Chloroform, (Unofficial), — is a liquid containing 
at least 98 per cent, of Chloroform, and having a sp. gr. not lower than 1.470. It con- 
tains sundry Hydrocarbons, free Chlorine, Aldehyde and Hydrochloric Acid, and is used 
only for external applications, or to make the purified article. 

Preparations. 

Aqua Chloroformi, Chloroform Water, — a saturated solution, prepared by agitating 
an excess of chloroform in distilled water and pouring off the needed quantity of the 
solution. Dose, 3 ss— 3 ij . 

Emulsum Chloroformi, Emulsion of Chloroform, — has of Chloroform 4, Expressed 
Oil of Almond 6, Tragacanth \]/ 2 , Water to 100. Dose, 3J-^ j. 

Spiritus Chloroformi, Spirit of Chloroform, — has of Chloroform 6, Alcohol 94. 
Dose, rrLx-^j, well diluted. 

Linimentum Chloroformi, Chloroform Liniment, — has of Chloroform 30, Soap 
Liniment 70. 

Linimentum Chloroformi Compositum, Compound Chloroform Liniment, (Un- 
official), — has of Chloroform ^ j, Oil of Turpentine ^ j, Tincture of Opium ^ ss, Tincture 
of Aconite £ij. 

Chlorodyne, (Unofficial), — is a celebrated secret mixture, put forth by Dr. J. Collis 
Browne, of London, and since imitated by many others. It contains Morphine, Chloro- 
form, Ether, Cannabis Indica, Hydrocyanic Acid, Capsicum, etc., and is powerfully ano- 
dyne, antispasmodic and narcotic, and therefore highly dangerous in non -professional 
hands. Dose, rr^x-xxx, according to the quantities of Morphine and Chloroform present, 
these being the active agents in the preparation. 

A tabular comparison of the principle formulae which are used in imitation of Browne' 1 s 
Chlorodyne, with the formula of the latter preparation itself, is given in the Appendix 
to this book, and will show the wide differences between them in Morphine strength. A 
list of 25 formulae for Chlorodyne was published in the Therapeutic Gazette for October, 
1883. 

Tinctura Chloroformi et Morphinae (B. P.), — has been recently made official as a 
substitute for Chlorodyne. Each dose of 10 minims contains of Chloroform lr^i^, Ether 
Tit}/}, Alcohol V\f/i , Morphine Hydrochlorate gr. T a s , Dilute Hydrocyanic Acid Tr^, 
Oil of Peppermint nL^, Fluid Extract of Liquorice n\l^, Treacle and Syrup q. s. 

Tinctura Chloroformi Composita (B. P.), — has of Chloroform 2, Alcohol 8, and 
Compound Tincture of Cardamom 10. Dose, \\xx-%'}. 

Anaesthetic Mixtures containing Chloroform, — see under yEther, ante, page 100. 

Some Unofficial Chlorinated Anaesthetic Compounds. 

Ethylene Bichloride, Dutch Liquid, Chloric Ether, C 2 H 4 C1 2 , — is a rapid and power- 
ful anaesthetic, probably safer than Chloroform and less so than Ether. It always paralyzes 
the respiratory centre before the heart, so that its effects may be easily watched and con- 
trolled. This is the substance which Guthrie supposed he had obtained when he discov- 
ered Chloroform. 

Ethylidene Chloride, Chlorinated Muriatic Ether, CH 3 ,CHC1 2 , — is a mixture of 
varying sp. gr. , and is not inflammable. It closely resembles Chloroform both physically 
and physiologically, but is less depressant to the heart, consequently safer, and recovery 
from its effects is very prompt. 

Methyl Chloride, CH 3 C1, — a colorless gas, slightly soluble in water, of sweetish odor 
and taste, inflammable, burning with a greenish flame. Cold liquefies it, and the liquid 
boils at — 7. 6° F. It is used locally in neuralgiae to produce intense cold, and with re- 
markable success. 

Methylene Bichloride, Dichloro-methane, CH 2 C1 2 , — is an effective anaesthetic which 
it was supposed would displace Chloroform as being much safer. Dr. Richardson intro- 
duced it and Sir Spencer Wells advocates its use, but though little used as compared with 



228 CHLOROFORMUM. 

other anaesthetics several deaths have occurred from its employment. It kills by paralyz- 
ing the heart. 

Carbon Tetrachloride, CC1 4 , — is less irritant than Chloroform, but far more danger- 
ous to the heart. 

Physiological Action. 

The action of Chloroform is similar to that of Ether (see ante, page ioo) 
with several important differences. It is more irritant to the mucous 
membranes, and if swallowed undiluted it produces violent gastroenteri- 
tis, which becomes apparent after the subsidence of the profound narcot- 
ism which at first follows its ingestion in quantity. A dose of 3J inter- 
nally may cause death, though recovery has taken place after the ingestion 
of one, two and even three ounces (H. C. Wood). It clots the blood 
outside the body, converting it into a mass resembling sealing-wax. 

The inhalation of Chloroform produces on the whole sensations which 
are rather agreeable than otherwise, and many persons acquire a liking for 
it. After a few whiffs the patient experiences noises in the ears and light 
before the eyes, also a feeling of weight upon the chest ; the heart is felt 
to be beating wildly and a throbbing sensation is felt in the carotid arteries. 
In this first stage hysterical symptoms may become manifest, the patient 
laughing, crying, screaming or swearing. The pulse is at first quite rapid 
from nervousness, but soon falls in frequency and gains in force. In a 
short time all sensation of discomfort passes away, the patient becomes 
quiet, breathes easily, and is evidently comfortable. The consciousness 
becomes affected, questions being heard but not understood, and are 
answered hesitatingly and slowly and in an irrelevant manner. After a 
brief period of repose there may be another spell of excitement, during 
which the patient may struggle and endeavor to get up ; but this soon 
passes away, and the muscles, which were contracted become flaccid, and 
the patient gradually assumes a condition of complete insensibility. In 
this state all reflex action is abolished and pain is not experienced ; the 
pupils are contracted, and the limbs, when raised and let go, fall heavily. 
Dangerous symptoms are — (1) respiration becoming stertorous or shallow, 
(2) sudden dilatation of the pupils, (3) signs of cardiac failure. 

As compared with Ether the inhalation of Chloroform is less stimu- 
lating, much more depressant to the vital functions, and much more 
dangerous on account of its direct paralyzant action on the heart. Its 
vapor is less irritant to the air-passages, uninflammable, more agreeable, 
more prompt in action, produces much less subsequent vomiting, a shorter 
stage of excitement and a more profound degree of narcosis ; and should 
be diluted with g6j4 per cent, of air to produce anaesthesia with safety, 
according to the general teaching on this subject. Its mortality is much 
greater, being about 1 in 3,000, against 1 in 16,000 for Ether; and fatal 
cases continue to be reported, though none of these have occurred in ob- 
stetrical practice. 



CHLOROFORMUM. 229 

The Hyderabad Chloroform Commission's investigations, conducted under the direc- 
tion of Dr. T. Lauder Brunton, led to the conclusion that Chloroform and Ether act in 
the same manner upon the heart and respiration, both paralyzing the respiratory centre 
before the heart, and Chloroform acting more quickly and powerfully than Ether in both 
directions. Prior to this investigation it was taught that death from Chloroform is almost 
always sudden and occurs by cardiac paralysis, while from Ether it is slow and usually by 
paralysis of respiration. The subsequent researches of Gaskell, McWilliam and others 
tend to sustain the latter view, and show that the verdict of the commission cannot be 
accepted as conclusive. There is very little doubt but that Chloroform may paralyze the 
heart without first affecting the respiration ; and it is probable that the paralysis of the 
vaso-motor centre, and the consequent withdrawal of blood from the heart and brain to 
the dilated splanchnic area, may be an important factor of a fatal result. Chloroform un- 
doubtedly exerts a powerful depressant action on the heart. Injected into the jugular 
vein it instantly arrests the cardiac action and destroys its muscular irritability. Its vapor, 
applied to the exposed heart, paralyzes it, and even when artificial respiration is main- 
tained the effect is very apparent. There -can be no doubt but that Chloroform destroys 
the contractile power of the heart muscle (Murrell). 

At a certain stage of chloroform anaesthesia women often exhibit 
marked signs of sexual excitement, and on recovery it is not uncommon 
for them to bring charges of improper conduct against some one present, 
with no false intention but in the belief that impropriety actually occurred. 
It is never safe to administer an anaesthetic to a woman without the pres- 
ence of a third party (Murrell). 

For the modes of dying from anaesthetics, see under the title JEther, 
ante, page 101. 

Treatment of Chloroform Poisoning. 

There is no chemical antidote, and if the drug has been swallowed the stomach should 
be evacuated, and the case treated as one of irritant poisoning. Oxygen or Amyl Nitrite 
may then be given by inhalation, and Strychnine or y^/r^m^hypodermically to sustain the 
heart. Artificial respiration should be used as soon as possible. 

In cases of danger from Chloroform inhalation prompt measures must be taken. The 
tongue should be pulled out with forceps and kept out. The doors and windows should 
be thrown open so as to produce a current of fresh air, but care must be taken that the 
body is not cooled thereby. The face and chest should be slapped with a wet towel, and 
Ai-tificial Respiration should be commenced at once and kept up for some time, not faster 
than 20 to the minute. A succession of quick, sharp blows on the chest, over the 
cardiac region, will sometimes provoke the heart to renewed action after it has apparently 
failed. Venesection is wrongly neglected in such cases; it would relieve the right cardiac 
engorgement, which is so constantl) 7 found at the autopsy. Galvanism may stimulate the 
heart into action. Atropine hypodermically has rendered excellent service in several 
cases in the author's experience. Strychnine is considered antagonistic by many authori- 
ties, and has been used with good results. Oxygen is the best antagonist of all (Sayre). 



Therapeutics. 
Chloroform has a large field of therapeutic action besides its use as an 
anaesthetic. It is frequently employed in liniments as a rubefacient and 
anodyne application, also to promote the passage of other agents through 
the epidermis, and to relieve itching. The vapor may be directed onto 
the raw surface of an ulcer or a superficial burn in order to relieve pain ; 
and that arising from a few drops placed in the hand and held close to the 
eye will relieve photophobia. Internally it is administered with great 



23O CHLOROFORMUM. 

benefit in vomiting, colic, dysmenorrhcea and cholera morbus ; also in 
true cholera, in which it has probably been more efficient than any other 
single remedy, and in gastric ulcer, gastralgia and other painful affections 
of spasmodic character. In three to ten drop doses well diluted it 
markedly improves all the functions of the stomach, and is a valuable 
remedy for many gastric disturbances, especially acute dyspepsia. In 
sciatica, tic-douloureux and other neuralgias of important nerves the deep 
injection of Tt^v-xv of pure Chloroform in the vicinity of the nerve is 
highly recommended, though it may cause dangerous local disturbance. 
In several cases of severe supra-orbital neuralgia, the writer has injected 
two or three minims of Chloroform into the vicinity of the supra-orbital 
nerve just above its foramen of exit, with the most gratifying permanent 
results, though severe local pain and considerable swelling were experi- 
enced for several days. 

The vapor of Chloroform inhaled in small quantities from warm water 
or from a handkerchief is a very useful remedy in many neuroses, as hay- 
fever, spasmodic asthma and reflex cough. It is one of the best palliatives 
in the cough of phthisis, as was long ago pointed out by the then Mr. 
(now Sir) Spencer Wells. It may be used with much benefit as a pul- 
monary antiseptic in many affections of the air-passages, as acute nasal 
catarrh, influenza and bronchitis ; and has promptly checked a severe 
case of catarrh extending into the antrum and causing great pain. Car- 
ried to the production of muscular relaxation it is often used as an aid to 
diagnosis, especially in cases of malingering, in suspected disease of 
the abdominal viscera, and to aid in reducing dislocations and herniae. 
It is used with great benefit in parturition, decreasing the sensibilty to 
pain, relaxing the passages, and easing the labor, while it does not inter- 
fere with the uterine contractions, nor predispose to inflammation, hemor- 
rhage or convulsions. In such cases the quantity needed is very small, a 
few whiffs from time to time being quite sufficient. In some cases, as in 
acute mania, a patient may require to be kept under the influence of 
chloroform for a long time, — for hours, days or even weeks, and this has 
been done in the digital treatment of subclavian and other aneurisms. 
The writer, on one occasion, kept an insane woman continuously under 
its influence for a period of three weeks, except during the time necessary 
for taking food. 

For the production of complete anaesthesia the use of Chloroform is 
steadily decreasing in favor of Ether, except for young children and in 
obstetrical practice. Its vapor being four times denser than air, and the 
rule for its effective use requiring fully 963^ per cent, of air with it, its 
administration according to the orthodox fashion requires most careful 
management, and should never be attempted in any but the recumbent 
posture. An ounce of Brandy and a hypodermic injection of Morphine, 



CHLORUM. 23I 

gr. i, with Atropine, gr. y^-, given 20 minutes before commencing the 
inhalation, are means of great utility in sustaining the heart and respira- 
tion, as well as in rendering the anaesthesia more profound. No opera- 
tion, especially on parts supplied by the fifth nerve, should be undertaken 
during partial chloroform anaesthesia, for the reasons given on page 101. 
Syme administered Chloroform in five thousand cases without a single 
death therefrom. He ascribed this excellent record to his adherence to 
the following rule : " Never mind the pulse, never mind the heart, leave 
the pupil to itself, but keep your eyes on the breathing, and if it becomes 
embarrassed to a grave extent, pull the tongue well out with an artery for- 
ceps." The Edinburgh rule is practically this : "Watch the respiration, 
the heart will take care of itself;" but Professor Stewart suggests that a 
second one should be inculcated, namely — "Watch both the breathing 
and the pulse ; and if the heart threatens to fail for want of blood, fill it 
by raising the legs and compressing the abdomen." 

The elder Sayre administers Chloroform in a manner which is apt to startle an unin- 
itiated observer who is impressed by the orthodox rule of 96^4 per cent, of air with 3 % 
per cent, of the anaesthetic as the only safe proportion. Having been made familiar with 
the practice of Dr. Sayre through observance of his method as employed by some of his 
pupils, the writer sought for more direct instructions from that distinguished surgeon, and 
received from him a letter from which the following paragraphs are extracted : — 

" I have employed no other method for more than twenty years, have used it in this 
manner in some thousands of cases without the least appearance of danger, and can 
therefore speak with confidence as to its safety. 

" My plan is simply to anaesthetize the patient with the smallest amount of Chloroform 
possible : and as Oxygen is the Antidote to the anaesthetic I exclude all air that is not 
impregnated with the anesthetic. 

" In this manner a very few inspirations will produce immediate anaesthesia without 
the muscular struggling which always follows when pure air is admitted with the chloro- 
form. I always measure my dose with the same care as if I were administering Arsenic, 
Strychnine, Corrosive Sublimate, or any other potent agent; and then I know what I am 
doing. If by accident there should be some peculiarity about the patient, making him 
unduly susceptible, a few artificial respirations would soon remove the influence of the few 
drops which had been inhaled, and thus all danger can be avoided. Five, ten, or twenty 
drops of Chloroform administered in this manner is all that is requisite to produce imme- 
diate and profound anaesthesia. I have explained my method hundreds of times at my 
clinical lectures in Bellevue Hospital, many of which have been published at different 
times in different medical journals by various persons who have made stenographic re- 
ports of my lectures. In the ' Transactions of the International Medical Congress,' held 
in Philadelphia in 1876, is a verbatim report of my remarks on this subject made while I 
was performing an exsection of the hip-joint in the hospital before the Congress." 



CHLORUM, Chlorine, CI, — is a greenish-yellow gas having a suf- 
focating odor, belonging to the Halogeti group of elements; and though 
not official itself, it is represented in medicine by several of its compounds, 
as well as by several preparations which furnish it. 

The so-called Halogen Elements derive their title from a/r, the sea, — because the most 
important members of the group are obtained, directly or indirectly, from the ocean, viz. : 
Chlorine, from sea-salt ; Bromine, from sea- water ; and Iodine, from sea- weed. They 
are all noted for their affinity for hydrogen, and consequent power as decomposers of 
organic matter. 



232 CHLORUM. 

Chlorine Compounds, described under the titles of their respective 
metallic bases, are — the Chlorates of Potassium and Sodium ; the Chlorides 
of Ammonium, Calcium, Potassium, Sodium, Mercury, Gold, Iron and 
Zinc, etc. ; — also Hydrochloric Acid, classed with the mineral acids (see 
page 85), and Chloral, Croton-chloral, and Chloroform. 

Preparations. 

Aqua Chlori, Chlorine Water, — is an aqueous solution of Chlorine, containing at least 
0.4 per cent, of the gas; and is prepared by heating together Manganese Dioxide 10 
parts and Hydrochloric Acid 35 parts, then saturating 400 of distilled Water with the gas 
so obtained. It is a clear, greenish-yellow liquid, of suffocating odor and disagreeable 
taste. Dose, 3J-.^ss, well diluted, as a lotion or spray; internally, nT,x-xx, in water. 

Chlorine Water may be extemporaneously prepared by mixing in a mortar Chlorate of 
Potassium 40 grains and Hydrochloric Acid ^ ounce, and adding a pint of distilled 
water by agitation during the evolution of the vapors. If done in a closed vessel danger 
may arise from the explosive gas, C1 2 4 , which is liberated at the same time. It should 
be quickly bottled. 

Calx Chlorata, Chlorinated Lime {Chloride of Lime), — is a compound resulting from 
the action of Chlorine upon Calcium Hydrate, and containing at least 35 per cent, of 
available Chlorine. It is obtained by exposing slaked Lime to the action of Chlorine 
gas as long as the latter is absorbed, and should not be confounded with Calcium Chloride 
(see ante, page 200). It occurs as a whitish, dry powder or friable lumps, gradually de- 
composing in the air, of saline, disagreeable taste and a feeble Chlorine odor, partially 
soluble in water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off 
Chlorine gas. Dose, gr. iij-yj in water ; for external use a I to 3 per cent, solution. 
Liquor Calcis Chlorata:, B. P., is a solution of I pound in I gallon of water. 

Liquor Sodae Chloratae, Solution of Chlorinated Soda (Labarraque's Solution), — a 
pale-greenish liquid, of faint Chlorine odor, and alkaline taste and reaction ; prepared by 
adding together watery solutions of Sodium Carbonate 150, and Calx Chlorata, 75, each 
in water, then adding Water up to 1000. Is an aqueous solution of several chlorine- 
compounds of sodium, containing at least 2.6 per cent., by weight, of available chlorine. 
Dose, \r\x-g j in 20 parts of water. 

Physiological Action. 
In the presence of moisture Chlorine is one of the most powerful of 
disinfectants and deodorants, and an antiseptic and antifermentive agent 
of the highest activity ; its power in these respects being due to its affinity 
for hydrogen, decomposing all bodies which contain hydrogen as a mole- 
cular constituent, forming hydrochloric acid and setting oxygen free in 
its nascent form (ozone). Administered internally, it is converted, on 
reaching the stomach, into hydrochloric acid and chlorides, losing all ac- 
tion on the organism in its own character. Locally applied, it is irritant 
to the skin and mucous membranes, producing a sense of heat, with burn- 
ing sensations and even vesication. Inhaled in any quantity, it causes 
cough, sneezing, and spasm of the glottis, also inflammation of the mucous 
lining of the air-passages and of the lungs. 

Antidotes. 

Ammoniacal Vapors inhaled after Chlorine to form Ammonium Chloride. Ammonium 
Sulphide has a similar reaction, but should be inhaled in great moderation. Albumen is 
the antidote if Chlorine preparations have been taken into the stomach, and a little Aqua 
Ammonia, sufficiently diluted, may also be administered with advantage. 



CHLORUM. 233 

Therapeutics. 

The Chlorinated preparations are used as disinfectants and deodorizers 
of rooms, drains and discharges from the body. They are rarely used 
about the person or clothing of patients by reason of the irritation pro- 
duced by them when inhaled, and their power to destroy the color of 
fabrics. In dilute solution they are well employed as local applications in 
aphthae, gangrene, scarlet fever and diphtheria, in which their principal 
action is to destroy fetor. The same may be said of their use in slough- 
ing ulcers and gangrenous wounds, foul discharges, etc., as they are rarely 
employed about the person in sufficient strength to have any destructive 
effect on disease-germs. A strong solution of Chlorinated Soda is a good 
application to bites of serpents and insects, to wash the hands after con- 
tact with infectious material, and to prevent infection by the syphilitic 
poison. A combination of Potassium Chlorate and Tinctura Ferri 
Chloridi, makes a solution of Chlorine, Euchlorine, Potassium Chloride 
and Ferric Chloride, when diluted with water, and gives one of the best 
and most innocuous solutions of antiseptics. It makes an excellent gargle 
for sore throats, simple or diphtheritic. Glycerin should never be added 
to it, as the resulting mixture will be liable to explode violently. These 
preparations have been administered internally in septic diseases, low 
fevers, etc., but without producing any marked beneficial results, except 
in diphtheria, for which disease the internal administration of Chlorine 
Water diluted has many advocates among practicing physicians. 

Chlorine gas is a powerful local stimulant, and has been used with great 
benefit to promote healing in old ulcers. Absorbent cotton may be ex- 
posed to the gas extemporaneously prepared as directed above, and ban- 
daged on the surface of the ulcer. Chlorine inhalations were used forty 
years ago, by Sir James Simpson and others, in phthisis, with apparent 
benefit. 

Chlorinated Lime, freshly prepared, in solutions of various strength, 
from 1 in 12 to 1 in 60, are used by hypodermic injection in Australia as 
an antidote to serpent venom. The solution is injected into several points 
above the wound, 20 to 100 minims being inserted at each place. In 
some cases this procedure causes great pain, but it does not seem to in- 
duce any local inflammation, and it is highly efficient for the purpose for 
which it is used. 

A common method of disinfecting a sick-room is to place a pound of 
Chlorinated Lime into a canvas bag and immerse it in a mixture of com- 
mon Muriatic Acid, 1% pint, and Water 4^ pints, allowing it to remain 
for 24 hours. A still better method is to mix common salt, Manganese 
Dioxide and Sulphuric Acid in a saucer. The Chlorine generated is 
heavier than atmospheric air, so that the vessel should be placed on a high 
shelf and not on the floor, in order that it may be diffused throughout the 
room. 



234 CHONDRUS CHRYSAROBINUM CIMICIFUGA. 

CHONDRUS, Irish Moss, Carragheen, — consists of two sea-algae, Chondrns cris- 
pus and Gigartina mammilosa, dried and bleached. Is horny, translucent, pale yellow- 
ish-white, swelling in water, of sea- weed odor and mucilaginous, saline taste. On boil- 
ing with 30 parts of water for ten minutes it yields a solution which gelatinizes on cooling. 
It contains 90 per cent, of mucilage with traces of Iodine and Bromine, also I per cent, 
of Nitrogen. There are no official preparations. A jelly or blanc mange may be pre- 
pared by boiling 3 ij in t ^ xxxiv of water for an hour, straining and adding 3 iij of sugar 
while hot. Dose, indefinite. 

Irish Moss is a demulcent and nutrient substance of some slight value in bronchial and 
catarrhal affections. Having no starch in its composition it is not so valuable as Iceland 
moss (Cetraria) as an article of food for the sick. 



CHRYSAROBINUM, Chrysarobin, — is a mixture of proximate principles ex- 
tracted from Goa-poivder, a substance found in cavities formed by decay in the wood of 
the trunk of Andira Araroba, a Brazilian tree of the nat. ord. Leguminosae. It is com- 
monly misnamed " Chrysophanic Acid" (which is one of the constituents of Rheum) — 
though easily converted into that substance. Occurs as an orange-yellow powder, odor- 
less and tasteless, nearly insoluble in water and alcohol, but readily soluble in ether, solu- 
tions of alkalies and sulphuric acid. Dose, gr. j^-gr. xx. 

Unguentum Chrysarobini, Chrysarobin Ointment, — Chrysarobin 5, Benzoinated 
Lard 95 parts. Should be diluted for average use from I to 3 times. 

In 20-grain doses Chrysarobin is a gastro-intestinal irritant, producing large, watery, 
bilious stools, with repeated vomiting but not much nausea. Locally it produces diffuse 
dermatitis, often followed by follicular and furuncular inflammation. It stains the skin a 
dark yellowish-brown color, which may be removed by a weak solution of chlorinated 
lime. The use of this remedy is confined to superficial parasitic skin diseases of vegetable 
origin, and for psoriasis, in the latter affection being the best remedy known. It may be 
used in weak ointment locally, and internally in ^-grain doses. 



CIMICIFUGA, Black Snake-root, Black Cohosh,— is the rhizome 
and roots of Cimicifuga racemosa, a plant of the nat. ord. Ranunculacese, 
native in the United States. It contains a Volatile Oil when fresh, resin, 
tannic and gallic acids, also an acrid, crystallizable, neutral principle. 
Cimicifugin or Macrotin is an impure resin obtained by precipitation from 
a concentrated tincture by the addition of water. The active principle 
has not been isolated. 

Preparations. 
Extractum Cimicifugse, Extract of Cimicifuga. — Dose, gr. j-v. 
Extractum Cimicifugae Fluidum, Fluid Extract of Cimicifuga . — Dose, TT^v-xx. 
Tinctura Cimicifugae, Tincture of Cimicifuga, — 20 per cent. — Dose, tt\x-3J. 
Macrotinum, Macrotin, (Unofficial). — Dose, gr. ss-ij. 

Physiological Action. 
Cimicifuga is stomachic, antispasmodic, aphrodisiac, diaphoretic, diu- 
retic and expectorant. Its taste is bitter and nauseous, resembling that 
of Opium. It acts on the heart and circulation similarly to Digitalis, and 
on unstriped muscular fibre like Ergot, but is much feebler in activity 
than either of these agents. Small doses stimulate digestion and secre- 
tion, the generative function and the menstrual flow, and especially the 
secretions of the bronchial mucous membrane and the kidneys. Full 
doses slow the heart while increasing its force, raise arterial tension and 



CINCHONA. 235 

stimulate uterine contraction. Large doses dilate the pupils and produce 
dimness of vision, vertigo, intense headache, nausea, vomiting, and in 
some persons soporific and anodyne effects. 

Therapeutics. 

Cimicifuga closely resembles Digitalis in action, but it is safer, and 
should be more frequently used when the latter drug is indicated. In 
cardiac diseases it is very efficient, especially in weak or fatty heart where 
Digitalis would be dangerous. It is a good stomachic tonic, particularly 
in the irritable dyspepsia of alcoholism. As an expectorant it is used in 
acute and chronic bronchitis. It is a good nerve-tonic in delirium tre- 
mens, and in functional impotence it is remarkably efficient. In rheuma- 
toid arthritis and rheumatism of the localized muscular variety, as lum- 
bago, torticollis, pleurodynia, intercostal rheumatism, etc., it is one of the 
most efficacious remedies, having a strong affinity for the muscular system. 
Neuralgias of various kinds are benefited by it, particularly ovarian neu- 
ralgia. Chorea about the age of puberty is one of the affections in which 
it is most efficient, and the same maybe said of the hysterical form of this 
disease. 

Many uterine disorders are remarkably benefited by Cimicifuga, such 
as amenorrhcea, neuralgic and congestive dysmenorrhcea, subinvolution, 
spinal irritation due to some obscure sympathetic or neuralgic affection 
of the womb, sympathetic pains and neuralgiae arising from the so-called 
iFritable womb, passive menorrhagia, etc. In obstetrics it gives excel- 
lent results when used to initiate uterine contractions, to check hemor- 
rhage, and to allay afterpains and nervousness after delivery. In puer- 
peral mania and peritonitis its good effects are frequently remarkable, and 
in puerperal hypochondriasis it is strongly recommended by very high 
authority. 



CINCHONA, Peruvian Bark. — The Cinchona tree belongs to the 
nat. ord. Rubiaceae and is a native of the eastern slope of the Andes, but 
has been largely planted in India, Ceylon, Java and Burmah, with the 
result of improving the quinine-yielding value of many species by culti- 
vation. In late years the test of appearance has given way to that of 
assay in judging of the various barks of commerce, and only those are 
official which yield 5 per cent, of total alkaloids of which at least 23/2 V ev 
cent, must be Quinine. Yellow bark contains most Quinine (as high as 
9 per cent, having been obtained from one specimen), pale bark contains 
most Cinchonine and least Quinine, while red bark contains these alka- 
loids in about equal proportions. The Columbian varieties afford the 
largest percentage of Cinchonidine. 



236 CINCHONA. 

The principal varieties of the sub-order Cinchonese, the barks of which 
are found in commerce and used by manufacturers of the alkaloids, are — 

Cinchona Calisaya, Cinchona Flava, Yellozv Bark, — from Peru, Bolivia and India. 
Cinchona Succirubra, Red Bark, — from Ecuador, Java and Ceylon. 
Cinchona Condaminea, Pale Bark, — from Ecuador and Peru. 
Cinchona Pitayensis, Pitaya Bark, — from New Granada. 
Cinchona Micrantha, Gray Bark, — from Peru and Bolivia. 

Altogether there are some 31 species acknowledged by botanists, and 
the list is constantly increasing, from the tendency of the different trees 
to hybridize. Several trees formerly acknowledged as Cinchonas are now 
placed in the genus Cascarilla, but their barks are to be found on the 
market. Cuprea bark is from trees of the genus Remijia, growing in 
Columbia; it contains Quinine and a peculiar alkaloid, Cinchonamine, 
but no Cinchonidine. The official species are two, viz.: — 

Cinchona, Cinchona, — the bark of Cinchona Calisaya, Cinchona 
officijialis, and of hybrids of these and of other species of Cinchona, 
yielding, when assayed by a prescribed process, not less than 5 per cent, 
of total alkaloids, and at least 2]/ 2 per cent, of Quinine. 

Cinchona Rubra, Red Cincho?ia, — is the bark of Cinchona Succi- 
rubra, containing not less than 5 per cent, of its peculiar alkaloids. 
From it is prepared the Compound Tincture of Cinchona. 

Bark may be administered in doses of gr. x-^j, but it is never used now 
in substance, being too bulky and disagreeable. 

Cinchona bark contains 21 natural alkaloids (of which 4 are official), 
8 artificial alkaloids, 2 simple acids, 2 tannic acids, a resinoid and color- 
ing matter, as follows : — 

Quinine, C 20 H 24 N 2 O 2 , — a strong base, fluorescent, the most valuable of all the alka- 
loids ; heated with glycerin to 374 F. , it is converted into the isomeric base, Quinicine. 

Quinidine, C 20 H 24 N 2 O 2 , — isomeric with Quinine, fluorescent, probably the most power- 
ful as an antiperiodic, but existing in very small quantity. 

Cinchonine, C 20 H 2+ N 2 O, — the least active of the official four, having about half the 
therapeutic power of Quinine. Not fluorescent. 

Cinchonidine, C 20 H 24 N 2 O, — isomeric with Cinchonine, not fluorescent, one of the 
most powerful of the alkaloids. 

Kinic and Kinovic Acids, — are combined in the bark with the alkaloids. The for- 
mer is used to make a Kinate of Quinine, and the latter occurs in non-official pharmacy 
as Kinovate of Lime, an ingredient in Deloudre's Extract, which is used in Europe and 
India for dysentery. 

Kino-tannic and Kinovo-tannic Acids, — give to bark its peculiar and powerful 
astringent qualities. They have not been fully studied. 

Kinovin, — is a bitter amorphous resinoid, which is resolvable into Kinovic Acid arid 
sugar. It is soluble in alcohol, but not in water. 

Cinchona Red, — a reddish-brown, insipid, inodorous substance. 

[The other alkaloids are of no interest medicinally.] 

Preparations of the Bark. 
Extractum Cinchonae, Extract of Cinchona. — Dose, gr. j-v. 
Extractum Cinchonae Fluidum, Fluid Extract of Cinchona. — Dose, rr^x-^j. 



CINCHONA. 237 

Tinctura Cinchonse, Tincture of Cinchona, — 20 per cent. Dose, gss-ij. 

Tinctura Cinchona? Composita, Compound Tincture of Cinchona, — made from 
Red Cinchona — strength 10 per cent. Contains Bitter Orange-peel 8, and Serpentaria 
2 per cent. Dose, 3J-iv. 

Infusum Cinchonae, Infusion of Cinchona, — has of Cinchona 6, Aromatic Sulphuric 
Acid I, Water to 100. Is the only official infusion containing this acid. Dose, 3 j — 5 j- 

Huxham's Tincture of Bark, 1788 (Unofficial), is still used. Red Cinchona 3 iv, 
Orange peel 3 i i j , Serpentaria gr. lxxx, Spanish Saffron gr. clx, Cochineal gr. lxxx, 
Brandy ^xl, digested for 4 days, expressed and filtered. Dose, 5jss-ij. 

■Quinine and its Salts. 

Quinina, Quinine, C, H. H N 2 O o -f- 3H 2 0, — a white, amorphous or minutely crystalline 
powder, of alkaline reaction and very bitter taste, soluble in 1670 of water and 6 of alco- 
hol at 59 F. , in 23 of ether, 5 of chloroform, and readily in dilute acids. Dose, gr.j-xx, 
or xl in special cases. Is insoluble in saliva. 

Quininae Sulphas, Quinine Sulphate •, (C, H 24 N 2 O 2 ) 2 .H 2 SO 4 -\- 7H 2 0, — very light, 
snow white, fragile crystals, of very bitter, persistent taste, soluble in 740 of water and 
65 of alcohol at 59 F. , in 30 of boiling water, 3 of boiling alcohol, also in acidulated 
water. Dose, gr.j-xx, or even gr. xl in special cases. 

Quininae Bisulphas, Quinine Bisulphate, C 20 H 24 N 2 O.,.H. 2 SO i -j- 7H,0, — clear, color- 
less, efflorescent crystals or small needles, of very bitter taste and strongly acid reaction, 
soluble in 10 of water with blue efflorescence, and in 32 of alcohol, at 59 F. Dose,gr. 
j-xxx, or even gr. lx in special cases. 

Quininae Hydrobromas, Quinine Hydrobromate, C 20 H 24 X 2 O 2 HBr -j- H 2 0, — color- 
less needles, of very bitter taste, soluble in 54 of water and in 0.6 of alcohol at 59 F., 
very soluble in boiling water and in boiling alcohol. Dose, gr. j-xx. 

Quininae Hydrochloras, Quinine Hydrochlorate, C 20 H 24 N 2 O 2 HCl + 2H 2 Q, — white 
needles in tufts, of very bitter taste, soluble in 34 of water and 3 of alcohol at 59 F., in 
I of boiling water or alcohol. Is used hypodermically. Dose, gr. j-xx. An excellent 
salt which should be more generally used ; 5 to 10 gr. doses are antipyretic. 

Quininae Valerianas, Quinine Valerianate, C 20 H 24 N 2 O 2 C 5 H 10 O., + H.,0, — white 
pearly crystals, of valerianic odor and bitter taste, soluble in 100 of water and in 5 of 
alcohol at 59 F. Dose, gr. j-iij. It is the only salt of Quinine supposed to be affected 
by the constituent acid. 

Quininae Hydrochloras Carbamidata, Quinine Carbamide Hydrochlorate (Unoffi- 
cial), — is a new compound salt of Quinine and Urea, soluble in equal parts of water and 
therefore admirably adapted for hypodermic administration in a 50 per cent, solution. It 
is almost unirritating to the tissues, and is given subcutaneously in doses of gr. j-iij. 

Chininum Amorphum Boricum, Amorphous Quinine Borate (Unofficial), — is a 
new preparation, soluble in an equal quantity of water, and claimed by its introducers to 
be equally as satisfactory as any other Quinine salt, and much better borne by the stomach 
than any other one. It is also said to cause little or no congestion of the membranatym- 
pani. 

Tinctura Pyrexialis, Warburg's Tincture (Unofficial), — is a celebrated preparation, 
formerly secret, but published in 1875 by the originator, whose formula is as follows : — 
R. Aloes soc. lb j ; Rad. rhei (chinens), Sem. angelicae, Confec. Damocratis,* aa Jiv; 
Rad. helenii (s. enulae), Croci sativi, Sem. fceniculi, Cretae prep., aa^ij ; Rad. gentianae, 
Rad. zedoariae, Pip. cubebae, Myrrbae elect., Camphorae, Bolet. laricis, aa 5J. Digest 
the whole with 500 oz. of proof spirit in a water-bath for 12 hours, express, add £x Bi- 
sulphate of Quinine, dissolve by aid of a water-bath, cool, and filter. Dose, 25 j, in two 
doses 3 hours apart. Hager's modification of the original formula is — Be • Quininae sulph. 
part j, Spt. camphorae, part ij, Elix. proprietatis (Tinct. aloes etmyrrhae) part xxij, Alco- 
holis part xvj. The evidence published in favor of this preparation goes to show that its 
power does not wholly lie in the quinine, camphor, aloes or rhubarb, but in some of the 
aromatic plants contained in it. 

* For the formula for this ingredient see the article on Confections in the section on 
Extemporaneous Pharmacy, Part II. 



238 CINCHONA. 

Other Official Alkaloids and their Preparations. 

Cinchonina, Cinchonine, C 19 H. 22 N 2 0, — white, lustrous pi-isms or needles, of bitter 
after-taste, almost insoluble in water, readily so in dilute acids and 1 16 of alcohol at 59 
F. Dose, gr. j-xxx or more. 

Cinchoninae Sulphas, Cinchonine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 -f- 2H 2 0, — white, 
shining prisms, of very bitter taste, soluble in 66 of water and in 10 of alcohol at 59 F. , 
and readily soluble in dilute acids. Dose, gr. v-xxx or more. 

Cinchonidinae Sulphas, Cinchonidine Sulphate (C 19 H 22 N 2 0) 2 H 2 S0 4 + 3H 2 0, — 
white, silky crystals, of bitter taste, soluble in 70 of water and in 66 of alcohol at 59 
F., freely soluble in acidulated water. Dose, gr. j— xx or more. 

Quinidinse Sulphas, Quinidine Sulphate (C 20 H M N 2 O 2 ) 2 H 2 SO 4 -f- 2H 2 0, — white, 
silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, readily in acidu- 
lated water, at 59 F. Dose, gr. j-xx or more. It is not so bitter as Quinine, is less 
expensive, and is a valuable antipyretic and antiperiodic. 

Unofficial Preparations. 

Chinoidinum, Chinoidin, Quinoidin, — a mixture of alkaloids, mostly amorphous, 
obtained as a by-product in the manufacture of the crystallizable alkaloids from Cinchona. 
A black solid when cold, plastic when warmed, of bitter taste, almost insoluble in water, 
freely soluble in alcohol and in dilute acids. It contains the 4 alkaloids in amorphous 
condition, and has about j^ the therapeutic power of Quinine. Dose, gr. v-xxx or more. 

Quinquinina, Quinetum, — is an Indian preparation containing the total alkaloids 
extracted from bark by, acidulated water, then precipitated by soda and dried. In India 
it is called ' ; febrifuge. " 

Cinchonidinae Salicylas, Cinchonidine Salicylate, — has anti-malarial power only 
inferior to that of the salts of Quinine. 

Substitutes for Quinine. 
The synthetical production of Quinine has been the " philosopher's 
stone " of the modern chemists, who have prosecuted with untiring energy 
the search for an artificial product possessing all its properties. Though 
in this they have as yet been unsuccessful, they have discovered several 
organic bodies, which closely resemble each other and also quinine, both 
in chemical constitution and physiological action. These substances 
belong to the aromatic series of carbon compounds, all of which are de- 
rivatives of Benzene or Benzol, C 6 H 6 , the Hydride of the organic radical 
Phenyl, C 6 H 5 . The distinctive action of the lower members of this series 
is their antiseptic and antipyretic powers, — as that of the fatty series of 
carbon compounds is stimulant and anaesthetic (Brunton). Many of these 
agents are obtained from coal-tar oil (petroleum) by fractional distilla- 
tion, etc., — and they are all derivatives of Benzene (Benzol), either 
directly or from some of the products formed therefrom, by substitution ; 
various radicals replacing the different constituent atoms of H and C. 

Thus by the ring-arrangement of atoms peculiar to this series, there are formed from 
Benzene (C 6 H 6 ), the following substances, viz. : — 

Phenol, or Carbolic Acid, C 6 H 5 OH — by replacing H by OH, (hydroxyl). 

Pyrocatechin, or Ortho- \ C 6 H 4 (OH) 2 . 

Resorcin, or Meta- V dioxybenzol, — by replacing 2H by 2OH. 

Hydroqiiinone, or Para-) C 6 H 4 (OH) 2 . 

Pyrogallol, Pyrogallic Acid, Tri-hydroxybenzene , C fi H 3 (OH) 3 , — 3H by 3OH. 

Amido-benzene , or Anilin, C 6 H 5 .NH 2 — by replacing H by NH 2 (amidogen). 

Nitro-benzene, C 6 H 5 .N0 2 — by replacing H by N0 2 (nitroxyl). 



CINCHONA. 239 

Benzoic Acid, C 6 H 5 CO.OH— by replacing H by CO. OH (carboxyl). 
Salicylic Acid, HC 7 H 5 3 — by replacing 2H by OH and CO. OH. 
Naphtalin, C 10 H 8 — by uniting two Benzenes in an over-lapping ring. 
Pyridin, C 5 H 5 N — by replacing tetrad C by triad N. 
Chinolin, C 9 H 7 N — by uniting Benzene (C 6 H 6 ) and Pyridin (C 5 H 5 N). 
Derived from Chinolin is the hypothetical base — 

Chinicin, or Quinicin, C 9 H 9 N 2 , — represented in Antipyrin. 
Also Kairin, Thallin, and other compounds. 

The most important of these are Antipyrin, Acetanilid, Resorcin, 
•Chinolin and Naphtalin, which are respectively described in separate 
articles. Others of the same class are the following, viz. : — 

Some Unofficial Antipyretics. 

Kairinum, Kairin {Hydrocklorate of Oxy-ethyl-chi?iolin-hydride), C 10 H 13 NO.HC1. 
H 2 0, — is an artificial alkaloid prepared from Chinolin, belonging to the phenol group 
of carbon compounds, and a powerful antipyretic in 8-grain doses hourly. It stains the 
urine a deep green, and has not proven fatal though 220 doses have been administered 
in one case. In some cases of typhus it has caused cyanosis and collapse. It produces 
profuse sweating and vomiting, and the subsequent rise of temperature after its antipyretic 
influence has worn off is generally ushered in by a severe rigor. It is by many authorities 
considered to be the most certain, most powerful and most rapid antipyretic drug we 
possess, though this claim is now disputed by the advocates of Antipyrin. It occurs in 
white crystals, which are freely soluble in water, but is best given in wafer paper, or 
capsules. Dose, gr. iij-xxx. 

Kairolinum, Kairolin {Sulphate of Tetra-hydromethyl-chinolin), — is antipyretic, but 
much less efficient than Kairin. 

Thallin, Parachinanisols, — is a synthetically prepared substance, having the chemical 
name Tetra-hydro-paramethyl-oxy-chinolin. It occurs as a colorless powder which is 
soluble in water, and enters into combination with acids, forming salts, of which the tar- 
trate and sulphate are the most eligible, especially the latter. The dose of Thallin or its 
Sulphate ranges from gr. ij to gr. xv, a mean average dose being about 5 grains, given in 
the form of compressed tablets. Thallin is an antipyretic of very great power, doses of 
5 to 12 grains lowering the temperature in typhoid fever 4 to 5 in 2 hours' time, the 
effect lasting nearly 3 hours. In tuberculosis similar results were obtained. Large doses, 
however, produce very profuse sweating and a dangerous degree of depression ; so that 
this agent is not a favorite remedy for hyperpyrexia. 

Hydroquinone, Para- di- hydroxy -benzene, C 6 H i (OH) 2 , — is isomeric with Resorcin 
(see ante, page 238). It crystallizes in rhombic, colorless prisms which are slightly sol- 
uble in water, readily so in alcohol and in ether, and is obtained from Arbutin, a glucoside 
constituent of Uva Ursi and other Ericaceae. It is an efficient antipyretic, without in- 
jurious effects so far as observed, but its influence is only temporary. The action of this 
drug on animals is summarized in the A r . Y. Medical Record 'for August 15th, 1885, and 
its influence on pyrexia elucidated in the same journal for May 30th, 1885. Dose, as an 
antipyretic, gr. xv-xx, best given in alcohol. Gr. xl have been given without disagree- 
able effects. 

Pyrocatechin, Catechol (Ortho-di-hydroxy-benzene), C 6 H 4 (OH) 2 , — is also isomeric 
with Resorcin, and is one of the acid constituents of coal tar, also obtained from wood-tar 
and from kinic acid. It is a good antipyretic, but much inferior to Quinine or Resorcin. 

Physiological Action. 
The action of Cinchona in sufficient dose is generally that of its alka- 
loid Quinine, except that bark is decidedly astringent, more of a gastric 
irritant, and by reason of its bulk its active principles are more slowly 
absorbed. In large doses (gij) the powdered bark has produced flatu- 
lence and eructation, and in many well-authenticated instances has appa- 
rently produced a well-marked febrile paroxysm, beginning with chill, then 



24O CINCHONA. 

fever and headache, which gradually subsided in slight perspiration. So 
also, Quinine, while incapable of producing intermittent fever in a healthy 
person, may, if taken in large doses unnecessarily, throw the nervous 
system into high commotion, and if untimely used by a malarial subject 
may reproduce the paroxysm with greater or less severity. 

Cinchona is an astringent bitter and a stomachic tonic. At first it 
promotes appetite, digestion, the flow of saliva and of gastric juice ; 
long-continued it sets up a gastric catarrh, impeding digestion and caus- 
ing constipation. 

Quinine is a bitter tonic, antiseptic, antiperiodic, antimiasmatic and 
antipyretic, a diminisher of reflex action, a protoplasmic poison, a cardiac 
depressant and perhaps an oxytocic. It is rapidly diffused and slowly ex- 
creted, being found in the urine in 15 minutes after its administration and 
for two or three days afterwards. Its action on the stomach is similar to 
that of cinchona. It arrests the movements of the white blood-corpuscles 
though increasing their number, and prevents acetification and decay of 
the blood. It is actively destructive of lowly organized life, a solution 
of 1 to 500 being fatal to infusoria and fungi, while one of double this 
strength prevents alcoholic fermentation and checks putrefactive decom- 
position. The heart and arterial tension are somewhat stimulated by 
small doses, but depressed by large ones (gr. xl-lxxx), which slow and 
enfeeble the pulse by direct action on the cardiac ganglia. The brain is 
rendered hyperaemic and exhilarated by small or moderate doses, but 
large ones produce a sense of fulness and constriction in the head, cere- 
bral anaemia, pallor, tinnitus aurium, vertigo, staggering gait, amaurosis, 
and deafness, great headache, dilated pupils, delirium, coma, and in ani- 
mals convulsions. The eyes and ears are very rarely injured permanently. 
These symptoms collectively are termed Cinchonism. Quinine reduces 
the size of the spleen when enlarged, and lowers the temperature of py- 
rexia by lessening oxidation, though it does not depress the body tem- 
perature in health. Large doses lower the reflex function of the spinal 
cord. In some subjects it produces sexual excitement, in others cutane- 
ous eruptions sometimes followed by desquamation. It lessens the excre- 
tion of uric acid, but not that of urea, and is a uterine stimulant in labor, 
but its power to initiate uterine contractions is a much debated question. 

A remarkable case of poisoning by six drachms of Quinine Sulphate is reported by 
Surgeon-Captain A. E. Roberts, M. B., of Aligahr, India, in The Lancet of March 9, 
1895. The patient, an Eurasian woman, aged 35, married, no children, in comfortable cir- 
cumstances, had always enjoyed good general health, but had been troubled for nearly two 
years with menorrhagia associated with slight uterine retroflexion. About an hour after 
swallowing the large dose mentioned above, Captain Roberts first saw her. In his own 
language "she was lying upon her bed totally unconscious — an inert, paralyzed mass. 
The whole surface of her body was deadly cold and blanched, or, rather, livid ; her 
temperature (axilla) was 95 F., breathing almost imperceptible, shallow, and slow, and 
the pulse was 45, thin and small. Her eyes were closed, and the pupils were consider- 
ably dilated, there being no response to light ; no tendon reflex was obtained and there 



CINCHONA. 24I 

was no response to external stimuli, and save that she at long intervals uttered a low 
groan she appeared to her friends to be dead. . . . There was little, if any, change 
in her condition for several hours, during which she vomited ' coffee-ground substance ' 
several times. Indeed, definite and obvious signs of rallying were deferred until the 
early hours of the next day, and it was then ascertained that, in addition to slight deaf- 
ness, she was ' stone blind,' even to total non-appreciation of strong sunlight. The deaf- 
ness gave no trouble ; perfect hearing was restored within a week, with the gradual re- 
turn of general functional activity, but it was long ere all traces of the tremendous shock 
to the general system had disappeared. . . . The blindness was the dense, uncom- 
promising darkness of atrophy, . . . and . . . lasted, I believe, for fully two 
weeks ; the first perception after that was the flash of light from the ophthalmoscopic mirror, 
but there was no perception of external objects until the third or fourth week, when certain 
things — a small bright metal time-piece, the looming figure of an individual — were seen 
at a distance of four to eight yards. This distant vision was a marked feature of the case 
for two or three months, and though it gradually gained in distinctness of outline, the 
detail was a blurred impression on a dim and hazy background. ... I have re- 
cently heard from my patient that, although much better in most respects, there is much 
left to be desired in her visual powers ; she gets about, reads and writes, and uses her 
mirror satisfactorily for toilet purposes, but her color vision is defective, red and yellow 
being still most easily distinguished, and these at a distance, nearness of approach caus- 
ing objects to appear black, the general hazy blur of the background of the visual field 
being also a trouble to her." 

Quinidine and Cinchonidine correspond in action with Quinine both 
qualitatively and quantitatively, the latter however producing less severe 
head symptoms. Cinchonine also corresponds in effect, but is much the 
least active of the four alkaloids. It is said to produce greater headache, 
and much precordial pain and muscular weakness, but to have little effect 
on sight or hearing. 

Aittagonists and Iucompatibles. 

Morphine antagonizes its cerebral action, Atropine its nervous, cardiac and antipyretic 
powers. Free Tannic Acid is incompatible with the Infusion of Cinchona. Iodine 
preparations, Alkalies, Alkaline Carbonates and Earths, are incompatible with solutions 
of the alkaloids, the first-named forming insoluble compounds therewith and the latter 
precipitating them. 

Therapeutics. 

Cinchona is used as a tonic, and has many applications. The Infusion 
or Compound Tincture with a mineral acid is extremely serviceable in 
atonic dyspepsia, gastric catarrh of alcoholics, adynamia, convalescence, 
asthma, chronic bronchitis, and generally in weak subjects of flabby flesh 
and perspiring skin. 

Quinine finds its principal field of action in the malarial diseases, over 
which its influence is specific, by reason of its power to prevent the 
development of the plasmodium to which malaria is due. In intermit- 
tents, a ten-grain dose of the sulphate should be given in the sweating 
stage and again 5 hours before the expected time of the next paroxysm. 
In the intervals Arsenic is better used, as Quinine may cause a daily 
exacerbation of temperature if long continued. In remittents 20- to 30- 
grain doses should be administered once or twice a day until the tempera- 
ture is reduced to the normal point. In pernicious remittents large doses 
(gr. xxx to lx) are necessary to the safety of the patient. In chronic 
malarial poisoning Quinine has considerable power, but Chinoidin is 
16 



242 CINNAMOMUM. 

more effective. Small doses of Quinine (gr. ij-iij per diem) are efficient 
as a prophylactic against malaria. 

As an antipyretic Quinine is used with the best results, especially in 
septic fevers, typhus, typhoid, variola, pneumonia and acute rheumatism. 
Inflammations may, at their inception, be aborted by 15- or 20-grain doses, 
combined with Morphine, which in this respect is synergistic to Quinine. 
Acute tonsillitis and acute catarrh may sometimes be aborted by a full 
dose. In surgical fevers, pyaemia and exhausting suppurative conditions, 
also in septicaemia, hectic fever, and before surgical operations, Quinine 
is much employed. Neuralgias of malarial origin are amenable to it, as 
also neuralgia of the ophthalmic division of the fifth nerve. In eruptive 
fevers, especially scarlet fever, erysipelas and measles, it is advantageously 
administered throughout their course. In some skin diseases, particularly 
erythema nodosum, it is quite efficient, also in whooping-cough and hay- 
fever. In the latter affection a solution of gr.vj to the 3 of the neutral 
hydrochlorate is a very useful local application. Antipyresis has of late 
received considerable attention, particularly in the German hospitals. 
The most certain and safe of all antipyretics is undoubtedly the cold bath, 
but it is not always the most practicable, especially in private practice. 
Internal antipyretics are therefore of great value, and of these the safest 
and best is Quinine, next in order being Phenacetin. 

Warburg's Tincture has obtained a very high reputation in the hands 
of Indian army-surgeons in the treatment of remittent and other malarial 
fevers of the most malignant types, in malarial neuralgiae, acute nervous 
exhaustion and sudden collapse without organic disease. The most pro- 
nounced testimony to its value is that of Dr. Maclean {Med. Times and 
Gazette, Nov., 1875), whose authority will not be questioned by the most 
captious. He affirms that the influence of this combination to arrest an 
exacerbation of remittent fever is far more powerful than that of Quinine 
alone. The remedy has become much less of a favorite since its origina- 
tor was induced to make public the secret of its composition. 

A dm in istration . 

The persistently bitter taste of Quinine and its salts is best obviated by administering 
them in pill form, made with glycerin as an excipient, or by using Liquorice, Eriodyc- 
tion or Chocolate to cover the taste if given in solution or powder. The taste is ex- 
tremely well covered by using as a vehicle a combination of Glycynhizin and Fluid Ex- 
tract of Eriodyction, named " Velatine" but the Quinine must be suspended therein by 
the aid of mucilage, for when an acid is used to dissolve it the bitter taste cannot be dis- 
guised. 

For hypodermic use the best salt is the Carbamide Hydrochlorate, by reason of its 
ready solubility and freedom from irritant quality. 



CINNAMOMUM, Cinnamon, — is official under the three following titles, viz. : — 
Cinnamomum Cassia, Cassia Cinnamon, — is the bark of the shoots of one or more 
undetermined species of Cinnamomum. (nat. ord. Laurinese) , grown in China. Is a 
constituent of the compound tinctures of Cardamon, Catechu and Lavender. 



COCA. 243 

Cinnamomum Saigonicum, Saigon Cinnamon, — the bark of an undetermined 
species of Cinnamomum. 

Cinnamomum Zeylanicum, Ceylon Cinnamon, — the inner bark of the shoots of 
Cinnamomum Zeylanicum . 

The latter occurs in light, yellowish-brown quills, consisting of several pieces rolled 
together, each very thin, while the Chinese variety comes in single quills of irregular 
form and rougher texture. The taste is warm and aromatic, and the odor very fragrant. 
The active principle is a Volatile Oil, and they also contain a resin, and tannic and cin- 
namic acids. Dose, gr. x-xx. 

Preparations. 

Oleum Cinnamomi, Oil of Cinnamon, Oil of Cassia, — a volatile oil distilled from 
Cassia Cinnamon. A yellowish-colored liquid, of sp. gr. 1.055 to l -°^>5 > soluble in an 
equal part of alcohol or of glacial acetic acid. Becomes darker and thicker by age and 
exposure to air. Dose, gtt. j-v. 

Aqua Cinnamomi, Cinnamon Water, — has of the Oil 2, triturated with Precipitated 
Calcium Phosphate 4, and Distilled Water to 1000. Dose, indefinite. 

Spiritus Cinnamomi, Spirit of Cinnamon, — has 10 per cent, of the oil in Alcohol 
to 100. Dose, rt\v-xxx. 

Tinctura Cinnamomi, Tincture of Cinnamon, — has of Ceylon Cinnamon 10, Gly- 
cerin 5, Alcohol and Water to 100. Dose, ^ss-ij. 

Pulvis Aromaticus, Aromatic Powder, — has of Ceylon Cinnamon 35, Ginger 35, 
Cardamom 15, Nutmeg 15, triturated together to a fine powder. Dose, gr. x-xxx. 

Extractum Aromaticum Fluidum, Aromatic Fluid Extract, — has of Aromatic 
Powder 100 per cent, in Alcohol. Dose, TTlx-xxx. 

Cinnamon is an agreeable carminative, somewhat astringent and stimulant, also highly 
aromatic and antiseptic. The Oil is not astringent but is a pleasant stimulant to the 
nervous and vascular systems, and is by some believed to exercise a specific action on 
the uterus, particularly as a hemostatic. In overdoses it acts as an irritant and narcotic 
poison. 

The various preparations are in general use as flavoring excipients, and the Aqua is a 
pleasant vehicle for extemporaneous mixtures. The Bark and its preparations are used 
to check diarrhoea in combination with opium, chalk, or some vegetable infusion. 

Cinnamon was formerly used with success in uterine hemorrhage, generally in com- 
bination with sulphuric acid, which is itself an efficient uterine hemostatic. The Oil is a 
good remedy for flatulence, paralysis of the tongue, cramp of the stomach, enteralgia and 
similar complaints, and is sometimes used to check nausea and vomiting. It has an an- 
cient reputation for healing properties, and its antiseptic powers have long been known, 
especially on the mucous membranes, being utilized as an injection for gonorrhoea. It 
has lately been employed in France as an internal germicide, with great satisfaction ; and 
has given particularly good results in the treatment of typhoid fever, against the bacillus 
of which disease it is believed, by its advocates, to have specific and destructive powers. 



COCA, Coca, Cuca, — the leaves of Erythroxylon Coca, a small shrub 
of the nat. ord. Linear, indigenous to the mountains of Peru and Bolivia, 
and extensively cultivated in those and other S. American states. Its 
odor is tea-like, its taste slightly bitter and aromatic. It contains a crys- 
talline alkaloid, Cocaine, C 17 H 21 N0 4 , which when heated with HC1 is split 
up into Benzoic Acid, Methylic Alcohol and another alkaloid, Ecgoni?ie. 
Other constituents are a volatile, liquid alkaloid of herring-brine odor, 
alkaline reaction and burning taste, named Hygrine, an aromatic Oil, 
and Coca-tannic Acid. Coca should not be confounded with Cocoa, 
the seed of the chocolate- tree, Theobroma Cacao. Dose of the leaves, 



244 COCA. 

Preparations. 

Extractum Cocae Fluidum, Fluid Extract of Coca, — Dose, Ijss-ij. Leaves of good 
quality are often so difficult to be obtained that Dr. Squibb, the well-known pharmaceu- 
tist, has more than once omitted the fluid extract from his trade list, with the explanation 
that " it is impossible to get Coca of proper quality for medical use." 

Cocaina, Cocaine, C 17 H 21 N0 4 (Unofficial), — crystalline, colorless and of bitter taste, 
very soluble in ether, almost insoluble in water or alcohol, and of decided basic proper- 
ties, combining with acids to form salts. It exists in the leaves in very small quantity, 
viz. — from 0.02 to 0.04 per cent. Dose, gr. }i-]. 

Cocainae Hydrochloras, Cocaine Hydrochlorate, C ]7 H 21 N0 4 HC1, — also called Co- 
caine Muriate, but is more properly Cocaine Chloride, — occurs in colorless crystals, odor- 
less, of saline, slightly bitter taste, producing on the tongue a tingling sensation followed 
by numbness. Soluble in 0.48 of water, and in 3 / I/ 2 of alcohol. Is used in aqueous solu- 
tions of 2 to 10 or more per cent, hypodermically or locally to mucous surfaces as a local 
anaesthetic. Dose, internally, gr. yi~) ; by hypodermic injection, gr. yi-]4,. 

Cocainae Oleas, Oleale of Cocaine (Unofficial), — a 10 per cent, solution of the alka- 
loid in Oleic Acid, for external use. 

Wines, Lozenges, Elixirs, Glyceroles, Pastes, etc., of Coca are being manufactured 
and marketed in great variety. The Citrate and Salicylate of Cocaine are recent products 
of the laboratory and may be obtained in the shops. 

Celerina, (Unofficial) , — is a proprietary preparation which is said to contain in each 
fluid-drachm gr. v each of Coca, Celery, Kola and Viburnum, with aromatics. Dose r 

3HJ- 

Physiological Action. 

Coca is an aromatic bitter tonic, a diuretic and a cerebral and nervous 
stimulant, though locally used one of the most efficient nerve sedatives. 
Small doses improve digestion, stimulate respiration, increase the heart's 
action after a brief depression, raises the arterial tension, and increase the 
excitability of the sensory nerves. It stimulates the brain by increasing 
its blood-supply, producing wakefulness, a sense of well-being, and a 
marked diminution of the senses of fatigue, hunger and thirst. Under its 
daily use a considerable amount of labor and want of sleep can be borne 
without suffering. Though diuretic, it lessens the quantity of urea elim- 
inated by checking the processes of waste. Large doses produce im- 
paired coordination, hallucinations and delirium. 

Cocaine acts upon the lower animals similarly to Caffeine. It tetanizes 
frogs, and in large doses paralyzes their sensory nerves and the posterior 
columns of the spinal cord. It kills rabbits and dogs by paralysis of the 
respiratory centre. In proper doses it raises arterial tension by stimulat- 
ing the vaso-motor centres and the cardiac motor system. 

On man, in small doses Cocaine is a cerebral, cardiac, respiratory and 
nervous stimulant, and a prompt diuretic. It improves digestion, stimu- 
lates respiration, increases the heart's action, raises the arterial tension, 
and exalts the irritability of the sensory nerves. It stimulates the brain 
by increasing its blood-supply, producing wakefulness and marked dim- 
inution of the senses of fatigue and hunger. Though decidedly diuretic, 
it lessens the quantity of urea by checking the processes of waste, thus 
acting as an indirect nutrient, and enabling the body to maintain its 



COCA. 245 

energy on a lessened supply of food. It first decreases and then increases 
the cutaneous circulation, flushing the surface, exciting perspiration and 
a sense of heat, and does actually raise the body-temperature. It dilates 
the pupil, — both when locally applied and when taken systemically,— and 
stimulates intestinal peristalsis as well as the evacuation of the bladder in a 
few minutes after its ingestion. 

An overdose produces symptoms of cardiac and respiratory embarrass- 
ment in a very short time. The pulse, at first quick and forcible, becomes 
small, rapid and intermitting ; — the heart apparently standing still in 
systole once in every 10 or 12 beats. Respiration is slow and shallow, 
and a sense of tightness about the chest is often very marked ; — the skin 
grows cold and clammy, and the subject is seized with a sense of impend- 
ing dissolution. Death occurs in animals by paralysis of the respiration, 
but in man a tetanoid spasm of the cardiac muscle seems to occur, which 
is equally dangerous to life. Maurel has shown that, as the capillaries 
contract powerfully under the influence of cocaine, thromboses and 
embolisms, particularly pulmonary embolisms, capable of causing fatal 
accidents, may be produced thereby. It profoundly affects the leucocytes, 
which become spherical and rigid, increase in size, and no longer adhere 
to the walls of the vessels. Other symptoms are impairment of coordi- 
nation, hallucinations and delirium. Lethal doses paralyze the intra- 
cardiac motor ganglia, the posterior columns of the cord, the sensory 
nerves, and the respiratory centre. 

Nearly five years ago, Satterwhite, as a result of the study of one hundred cases of 
poisoning by this alkaloid, called attention to the dangers attending the use of even very 
small doses, and at about the same time another author, after summarizing the records of 
fifty cases, made a similar announcement. A case is reported by Broughton in which 
unconsciousness, an irregular, slow respiration, and a slow pulse, followed the application 
of three minims of a twenty per cent, solution within the cavity of a tooth. Whistler, 
after the application of a four per cent, solution to the nasal cavity, noted vertigo and 
threatening syncope. In a case of glossitis, Ricket states that the patient became mori- 
bund after the use of a similar solution. Myrtyle dropped three minims of a three per 
cent, solution in each eye, which immediately caused a sense of numbness in the back of 
the tongue and throat, palpitation, threatened syncope and nausea. Bettleheim records 
that in one case the hypodermatic injection of one-sixth of a grain induced alarming 
symptoms ; and in another, one-eighth of a grain similarly injected caused unconscious- 
ness, congestion of the face, irregular breathing and trismus. Baker mentions a case in 
which one grain injected into the gums by a dentist produced death in a few minutes, 
and Haenel records the case of a man in whom the injection of i l /$ grain was followed 
by a fatal result. 

As a Local Aruzsthetic the power of Cocaine is very great over a limited 
area. Applied to such structures as the Schneiderian membrane, and the 
mucous covering of the glans penis ; or injected hypodermically in other 
locations, it blanches the structures and causes a profound but temporary 
anaesthesia throughout a small space. Applied to the tongue it tempor- 
arily destroys both taste and tactile sensibility ; — to the ocular conjunctiva, 
it produces profound anaesthesia of that membrane, together with dilata- 
tion of the pupil, partial paralysis of accommodation, enlargement of the 



246 COCA. 

palpebral fissure, slight lachrymation, and sometimes temporary ptosis. 
This profound degree of anaesthesia is thought by some to be caused by 
its paralyzing the terminal twigs of the sensory nerves, — by others to be 
due to'vaso-motor stimulation rendering the nerves bloodless and there- 
fore unable to transmit sensory impressions. It produces mydriasis by 
stimulation of the ends of the sympathetic in the iris, and does not affect 
the third nerve or the sympathetic centre. 

In general action, Cocaine resembles Atropine very closely, especially 
in its influence upon the pulse and blood-pressure, the respiration, pupils, 
salivary- and sweat-glands and intestinal peristalsis. In its symptoms, 
both from large and small doses, it exactly parallels Sparteine, another 
cardio-inhibitory depressant. 

Antagonists. 

Ammonia and Amyl Nitrite combat the earliest swnptoms of cardiac depression, — then 
Alcohol and Opium as stimulants to the heart, also Artificial Respiration. The most di- 
rect antagonist is Chloral, so also are Chloroform and Ether. Morphine is also directly 
antagonistic at almost all points. 

The Cocaine- Hain't. 

COCAINISM, the Cocaine-habit, is now presenting itself to observation, numerous in- 
stances of persons addicted to its excessive use being met with. Loss of digestive power, 
absolute insomnia, enfeeblement of the intellect, great emaciation, ascites, general maras- 
mus, nausea, decay of the teeth, an excessively fetid breath, amblyopia, visual hallucina- 
tions and complete anorexia, form a consensus of symptoms which rival the worst effects 
of the opium habit. A peculiar set of hallucinations is characteristic of the action of 
Cocaine. One patient was always scraping his tongue to extract from it little black 
worms ; another made his skin raw in the endeavor to draw out cholera microbes ; a third 
was constantly looking for cocaine crystals in his skin. Two of these subjects suffered 
from epileptic attacks and the third from cramps. (Magnan and Saury.) Some observers 
report the most extraordinary mental changes resulting from Cocainism, and exceeding 
those produced by any otber drug. The most intense selfishness, utter disregard of all 
social and domestic duties, the most debasing habits, complete destruction of all noble 
qualities, and a general condition of depravity, are some of the results which are charged 
to this drug. The author's experience of a large number of such cases convinces him 
that a cocaine habitue who has used the drug daily for a month is practically an insane 
individual while under the influence of the drug; but that the mind soon resumes its 
normal condition after withdrawal thereof, which can be done, in nearly all cases, at once, 
without involving any serious suffering. 

Many of the proprietary catarrh-snuffs contain cocaine, and their use may cause the 
cocaine-habit, which, however, is in most cases acquired by morphine habitues who go to 
cocaine in the expectation of finding help in their struggle against the tyranny of the for- 
mer drug. In this hope, however, they are always disappointed when the drugs are in 
their own hands. The victim soon finds that one of these agents antagonizes the other 
to a great extent, while, at the same time, it sets up peculiar troubles of its own ; and 
that there is a constant need of more Morphine to counteract the Cocaine-symptoms, and 
of more Cocaine to antagonize the symptoms due to the increased amount of Morphine. 
The result of any such attempt will be that one who is only using a moderate daily 
amount of Morphine, will, if Cocaine be added, soon be using a very great amount of 
Morphine, as well as of Cocaine, and " the last state of that man is worse than the 
first." 

As the stimulant effect of a single hypodermic injection passes off very quickly, within 
about 15 or 20 minutes, the cocaine habitue is under the necessity of constantly injecting 
the drug, so that, as one such expressed it, " I had no time to go home, — no time to do 
anything except to prepare and take one ' shot ' after another/' The effect of such re- 
peated puncturing of the skin is very disastrous to that tissue, causing great induration 
and numerous sloughing sores. 



COCA. 247 

Therapeutics. 

Coca-leaves are chewed by the Peruvians for the purpose of sustaining 
them during arduous labors and long journeys, and were so highly 
esteemed as to have been represented on the coat-of-arms of that nation, 
by whom they are used much as we do tea, coffee or tobacco. This 
example was imitated by Weston, the pedestrian, who is said to have been 
detected chewing the coca-leaf during one of his protracted walks. Co- 
caine is a useful stimulant to the brain and the nervous system in many 
morbid conditions, particularly cerebral and spinal anaemia, neurasthenia, 
melancholia, hysterical and hypochondriacal insanity, and in protracted 
mental depression with suicidal tendency. It may be employed with 
benefit in wasting diseases to retard waste and to stimulate digestion, in 
convalescence from fevers and other acute maladies, and in migraine and 
neuralgia due to depression of the nervous system. It is very beneficial 
in some cases of the vomiting of pregnancy, in stomatitis and gastralgia, 
and in functional impotence due to general atony of the system. 

A wine of the leaves is thought by singers and speakers to relieve hoarse- 
ness, to tense the vocal cords and improve the timbre of the voice. Coca- 
leaves may be smoked in cigars or cigarettes to obtain the exhilarating 
effects of the drug, and for the relief of asthma, hay-fever and many irri- 
table throat affections. The Oleate of Cocaine is an efficient palliative 
application to painful hemorrhoids, fissures of the anus, burns, boils, and 
irritable ulcers ; also in pruritus pudendi et ani and skin diseases attended 
with intolerable itching. 

Cocaine Hydrochlorate has achieved notoriety as a local anaesthetic, 
and promises to be of the greatest value in many operations on the eye 
and ear, nasal passages, uterus and urethra. A 2 to 4 per cent, solution 
is brushed lightly over the mucous surface or injected into the urethral 
canal, the application being repeated within 5 or 10 minutes if profound 
local anaesthesia is required. After about fifteen minutes any superficial 
operation may be performed without giving the slightest pain. Its anaes- 
thetic action is so entirely local and generally free from unpleasant after- 
effects that it is considered the most efficient and desirable agent of the 
kind which is known. It has been used in the same manner with decided 
benefit in congestion of the nasal passages from acute catarrh and hay- 
fever ; and has been applied to the cervix uteri to relieve the first pains 
of labor, to the ear for tinnitus aurium, and by inhalation to strengthen 
the vocal cords, relieve hoarseness and cough, and to improve the quality 
of the voice. It is injected hypodermically around the prepuce to pre- 
vent pain during circumcision, into the vicinity of the supra-orbital and 
infra-orbital foramina to cut short neuralgia of those nerves, and into 
hemorrhoids previous to their ligation. It may be injected into the bladder 
before lithotrity, into the urethra before the passage of sounds or catheters 



248 coccus. 

or to relieve chordee, and it is an excellent application to the gums of 
teething infants. To be efficient it must reach the terminal filaments of 
the sensory nerves in sufficient concentration. Rhus poisoning, by either 
the oak or ivy, is promptly controlled by the application of a 5 per cent, 
solution or oleate, freely over the affected surface. It gives instant relief 
from the burning and itching, and speedily reduces the dermatitis. 

The rapid accumulation of cases in which alarming symptoms followed the local appli- 
cation of small quantities of cocaine, together with the fact that these untoward effects 
are due to individual idiosyncrasy and do not invariably occur immediately, is a positive 
warning to the profession that this powerful substance should not be used in any case for 
the first time without proper antidotes directly at hand and the patient being kept under 
surveillance for at least a half hour. There seems to be no doubt that cocaine is absorbed 
with extraordinary rapidity and that the stronger the solution which is locally applied, 
the greater the danger of toxic symptoms, but whether the latter are to be attributed 
merely to the larger dose or to some obscure action, is not apparent. Falk has found 
that the rapidity of absorption varies in the different tissues — absorption taking place 
most rapidly through the conjunctiva, then in the following order ; nose, larynx, mouth, 
and ear. It is generally conceded that a 5 per cent, solution is sufficiently strong for 
most purposes, besides being free from many of the dangers attending the use of stronger 
ones. Dr. F. de Havilland Hall employs a solution containing 10 per cent, of Resorcin 
and 20 per cent, of Cocaine Hydrochlorate, for the production of local anaesthesia, apply- 
ing it by means of cotton on a suitable holder, and not by the spray. He claims that the 
Resorcin diminishes the toxic effect of Cocaine, increases its anaesthetic effect, prevents 
it crystallizing out and acts as an antiseptic in the solution ; and says that with this 
double solution even the slight toxic symptoms have been of rare occurrence. 

As a mydriatic for ophthalmological use, Cocaine has peculiar qualities 
which make it the most serviceable of the class. The dilatation produced 
by it is great, is quickly attained, lasts only 12 to 20 hours, is promptly 
overcome by the application of Eserine, and is not accompanied by much 
photophobia. The latter is due to the fact that the cocainized pupil is 
not rigidly dilated (as with Atropine), but reacts to light. The accom- 
modation, moreover, is greatly reduced, but not entirely paralyzed, and 
is quickly regained. 

As an antagonist Cocaine is of especial value in narcotic poisoning by 
Chloral or Opiates, where depression of the cardiac and respiratory cen- 
tres exists. It is also indicated in chronic depressant poisoning from the 
Bromides, and in spinal paralyses. In these cases it has all the advan- 
tages of Strychnine without its poisonous character. It has no value in 
the proper treatment of Morphinism except to antagonize certain heart 
symptoms, for which purpose it should be administered only by the phy- 
sician in charge of the case; but never as a regular remedy, at regular 
intervals of time, even by him. 



COCCUS, Cochineal, — is the dried female of Coccus cacti, an insect of the order 
Hemiptera, which feeds on the cactus plants of Mexico and Central America. It is of 
ovate, plano-convex form, of a purple-gray or purple-black color, yielding when crushed 
a dark-red powder, which contains Carminic Acid, or Carmine, the red coloring-matter, 
which is soluble in water and alcohol, but not in oils. Cochineal is an ingredient of 
Tinctura Cardamomi Composita, and is used in pharmacy solely as a coloring material. 



COLCHICUM. 249 

The only therapeutic use of Cochineal is in whooping-cough and neuralgia, in which 
affections it is supposed to have considerable influence, especially in the former. Its 
dose to an infant is about gr. '< thrice daily. 



COLCHICUM, Meadow Saffron, — is the corm and seed of the 
Colchicum auiumnale, a European plant of the nat. ord. Liliacese. It 
contains an intensely bitter, poisonous alkaloid, Colchicine, C 17 H 19 N0 5 , 
which by the action of acetic and mineral acids is converted into Col- 
chicine and a resin, — also tannic and gallic acids, resin, starch, sugar, 
etc. It is official in two forms, namely — 

Coichici Radix, Colchicum Root, — the corm, about an inch long, 
white internally, grooved on one side, inodorous, taste sweetish, bitter 
and acrid. Is less active than the seed. Dose, gr. ij-viij. It contains 
of Colchicine, 0.45 per 1000. 

Coichici Semen, Colchicum Seed, — about -^ inch thick, sub-globular, 
resembling black mustard seed but larger, very hard and tough, inodor- 
ous, of bitter and acrid taste. Dose, gr. j-v. It contains of Colchicine, 
3.35 per 1000. 

Preparations. 

Extractum Coichici Radicis, Extract of Colchicum Root, — made with Acetic Acid 
35 parts to 100 of the root, and sufficient water. Dose, gr. y z — ij. 

Extractum Coichici Radicis Fluidum, Fl. Extract of C. Root. Dose, n\, ij-x. 

Extractum Coichici Seminis Fluidum, Fl. Extract of C. Seed. Dose, TT\,j-v. 

Vinum Coichici Radicis, Wine of Colchicum Root, 40 per cent. Dose, rt^ v-xy. 

Vinum Coichici Seminis, Wine of Colchicum Seed, 15 per cent. Dose, T\ x-xxx. 

Tinctura Coichici Seminis, Tincture of C. Seed, 15 per cent. Dose, Y\ x-xxx. 

Colchicina, Colchicine, C 17 H ]9 N0 5 (Unofficial), — a white or yellowish, amorphous 
powder, of saffron-like odor and bitter taste, soluble in water and in alcohol. Dose, gr. 
T 2o ~ eV I s suitable for hypodermic injection. 

Laborde and Houde condemn all preparations made with acetic acid, also those made 
from the tubers and all wines. The best preparation is Colchicine, in granules or in a 
wine ; or a strong tincture made from fresh seed with the shell on, the latter containing a 
very volatile but active oil. Of this seed 3 j to y z pint of highest proof alcohol, standing 
for 2 weeks. Of this Jv to water q. s. ad 0*4, of which the dose is !|ss every 4 hours 
night and day, avoiding acids, until nausea, vomiting and purging set in. 

Colchicine Salicylate (Unofficial), — is marketed in capsules, each capsule containing 
Colchicine, gr. ^^ and natural Methyl Salicylate (Oil of Wintergreen), gr. iij. Dose, 
I capsule even' 2 hours, up to 10 or 15 daily. 

Physiological Action. 
Colchicum is emetic, diuretic and diaphoretic, a drastic purgative, a 
gastro-intestinal irritant and a cardiac depressant. In small doses it 
increases secretion, especially the urine and the sweat. In full doses its 
action is emeto-cathartic, producing profuse watery discharges, great 
nausea and extreme muscular feebleness. In large doses it is a powerful 
irritant of the gastro-intestinal tract, causing severe griping, choleraic 
discharges, lowered arterial tension and depression of the heart by reflex 
action over the distribution of the pneumogastric, — then great prostration, 



250 COLOCYNTHIS. 

convulsions and collapse, death occurring from exhaustion, with con- 
sciousness preserved until carbonic acid narcosis sets in. On the excretion 
of uric acid and urea its influence is very much disputed, but it probably 
increases the flow of bile, and certainly unloads the portal circulation. 

Antagonistics and Incompatibles. 

Tannic Acid to retard absorption. Emetics and cathartics, also warm demulcent drinks 
freely. Morphine hypodermically to antagonize the cardiac depression, also Alcohol. 

Therapeutics. 
Colchicum is a specific palliative in gout of acute form, in which it 
should be given with an alkali, and kept short of emeto-catharsis. It 
does not prevent relapses, and its power in this disorder is weakened by 
repetition. In ascites from obstructive disease of the liver it is most 
effective, given in full doses to establish a profuse drain, with opium to 
sustain the heart. In acute cerebral congestion and in portal congestions 
it is well given as a drastic purgative. It is often used with marked 
success in acute rheumatism, but frequently fails, and in no case should 
it be continued long in this affection. It has been used with good results 
in the treatment of gonorrhoea and chordee. The alkaloid is probably 
the best preparation for general use, and is admittedly superior to the 
other preparations in acute gout. The preparation known as Colchicine 
Salicylate is a solution of colchicine in oil of wintergreen. It should 
prove to be a reliable remedy for gout and rheumatism, and also for 
many disorders in which the rheumatic diathesis is a factor. 

COLOCYNTHIS, Colocynth,— is the fruit of Ciirullus Colocyn- 
this, deprived of its rind. The plant is a native of Spain and Asiatic 
Turkey and belongs to the nat. ord. Cucurbitaceae, the fruit being of the 
size of a small orange, white, light, spongy, inodorous, very bitter, con- 
taining many flat, brown seeds which should be rejected before the pulp 
is used. Its active principle is Colocynthin, C 56 H 8i 23 , an amorphous but 
crystallizable bitter glucoside, readily soluble in water. It also contains 
Colocy7ithein, a resin, and Colocynthitin, which is a tasteless, crystalline 
powder, soluble in ether but not in water, and devoid of purgative action. 

Prepa ratiojis. 

Extractum Colocynthidis, Extract of Colocynth. — Dose, gr. yi-\). 

Extractum Colocynthidis Compositum, Compound Extract of Colocynth, — con- 
tains of the preceding 16 parts, Aloes 50, Cardamom 6, Resin of Scammony 14, Soap 14, 
Alcohol 10. Dose, gr.v-xx. 

Pilulae Catharticae Compositae, Compound Cathartic Pills, — have of the preceding 
8, Calomel 6, Extract of Jalap 3, Gamboge 1^, Water to make 100 pills. Dose, j-iij. 

Pilulae Catharticae Vegetabiles, Vegetable Cathartic Pills, — have of Compound 
Extract of Colocynth 6, Extract of Hyoscyamus 3, Extract of Jalap 3, Extract of Lep- 
tandra \]/ z , Resin of Podophyllum 1)4,, Oil of Peppermint 0.8, Water to make 100 pills. 
Dose, j-iij pills. 



CONIUM. 251 

Laville's Anti-Gout Remedy, — is a proprietary medicine prepared in France and 
purporting to be " a mixture of prepared Kino-colocynthine." The published formula 
is as follows : Active principle of Colocynth 2]/ 2 , Quinine and Cinchonine 5, Spanish 
Wine 800, Alcohol 100, Water to 1000 parts; but there is good reason for believing that 
it contains Colchicine instead of Colocynthin. 

Physiological Action and Therapeutics. 

Colocynth is classed among the tonic-astringent and resin-bearing pur- 
gatives. In moderate doses it increases peristalsis and the intestinal 
glandular secretions, producing bilious, watery evacuations with much 
colicky, griping pain. Its purgative action is specific, and may be ob- 
tained by its application to the skin over the abdomen. In large doses 
it is a violent irritant of the gastro-intestinal tract, and has frequently 
produced fatal gastro-enteritis. It is popularly supposed to be abortifa- 
cient, but this is only true of quantities sufficient to endanger life. It is 
an indirect diuretic. 

Colocynth is too severe an agent to be administered alone for consti- 
pation, but it makes a useful factor in compound purgatives, as the com- 
pound cathartic pills. In cerebral congestion it may be used to produce 
rapid derivation, and in ascites to set up a profuse drain from the intes- 
tinal canal. In certain cases of chlorotic amenorrhcea it stimulates the 
pelvic nerves and vessels with excellent results. There seems to be abun- 
dant evidence that in very small doses (XyV - tV of a tincture) Colo- 
cynth is an efficient remedy in colic, sciatica, ovarian and other neural- 
gige, as well as in the pain of glaucoma. These actions may be due to 
its two non-purgative principles, which may prove to possess powers not 
heretofore suspected, an example of which is seen in the recently-discov- 
ered cardiac influence of Convallaria, a drug until lately known only as 
a purgative and a diuretic. 

CONIUM, Hemlock, — is the full-grown fruit, gathered while green, 
of Conium maculatum, the spotted hemlock (nat. ord. Umbelliferse). It 
contains 3 alkaloids, namely, — Coniine, C 8 H 15 N, liquid and volatile, 
Methyl-coniine, C 8 H U NCH 3 , and Conhydrine, C 8 H 17 NO, solid and vola- 
tilizable ; — also Coniic Acid and a volatile oil. Paraconi'ine is an artifi- 
cial substance produced by the reaction between Butyric Aldehyde and 
an alcoholic solution of Ammonia, and is isomeric with Coniine but not 
identical with it. The leaves of Conium are no longer official. 

Preparations. 

Extractum Conii, Extract of Conium, — each grain represents a grain of the crude 
drug. Dose, gr. ij-v-xl. 

Extractum Conii Fluidum, Fluid Extract of Conium, — has the same strength as 
the extract. Dose, TTVij-v-xl. 

Coniina, Conii'ne, C 8 H 15 N (Unofficial), — an oily, limpid, volatile liquid, of acrid taste, 
alkaline reaction, and an odor compared to that of the urine of mice. It is quickly de- 



252 CONIUM. 

composed by heat, and if exposed to the air soon becomes inert. 
in minim-doses, WVro _ iJ- ^ s to ° irritant for hypodermic use, unless carefully neutralized 
by acetic acid. The Hydrobromate in watery solution of gr. viij to the ^ , of this ff^x^r 
gr. */£, is a good form for subcutaneous or stomachal administration, and may be given 
in doses of gr. ^ to § r - j, as it is not actively toxic. 

All the preparations of Conium are uncertain in action, particularly the extract, as the 
active principle is very volatile. Any specimen must be carefully tested before deciding 
on its dosage, and if the powerful mouse-like odor of the drug be absent, it is probably 
worthless. 

Physiological Action. 

The special action of Conium (and Coni'ine) is the production of motor 
paralysis without loss of consciousness or sensation. It paralyzes the 
motor nerves, the action commencing at the peripheral end-organs and 
extending upwards, involving the nerve-trunks and finally the centres, 
but the muscular irritability remains unaffected. Methyl-Coniine, on the 
contrary, stimulates the spinal cord, and produces the convulsions often 
seen in Conium poisoning. The sensory nerves are not affected, but the 
general sensibility is, a feeling of numbness being experienced in the ex- 
tremities. 

Gastric irritation is usually the first sensation produced by a full dose 
of Conium, nausea and vomiting being its symptoms. Then weakness 
of the legs, numbness and fatigue, drooping eyelids, diplopia, slightly 
dilated pupils, vertigo, impaired utterance, slow and labored breathing, 
and if the dose be a lethal one, paralysis of the voluntary muscles those 
of the lower limbs being first affected, speech and vision are lost, and 
finally death occurs from paralysis of the muscles of respiration. The 
heart is not affected and the mind remains clear, but torpid and indiffer- 
ent, until carbonic acid narcosis sets in. Muscular movement counter- 
acts the effects of the drug to a very great extent. 

Conium is believed to have been the state poison of the Athenians, by 
the juice of which Socrates and Phocion died. It is closely allied in its 
physiological action to Curare. 

Antagonists and Incompatibles. 

Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antagonistic. 
Tannic acid and caustic alkalies are chemically incompatible. 

Therapeutics. 
Conium is especially indicated in diseases characterized by excessive 
motor activity. Large doses are required, as some physiological action is 
necessary. Children bear it well, their constant activity preventing its 
full action. In chorea and paralysis agitans it palliates, by depressing the 
motor nervous system. In acute mania and delirium tremens, to quiet 
motor excitement and prevent exhaustion, it is remarkably efficient, 
especially when given conjointly with Morphine. When pain and spasm 
are present, it will prove a useful agent ; and in tetanus, blepharospasm, 
asthma, whooping-cough, and other spasmodic affections it is frequently 



CONVALLARIA. 253 

used with very great benefit. The pain of cancer seems to be especially 
amenable to its influence when locally applied, and Coni'ine-vapor is an 
admirable palliative of the tickling cough of phthisis and the irritability 
of the air-passages in acute bronchitis. In pneumonia and pleurisy the 
hypodermic use of Coniine to afford the organs rest by inducing a paretic 
state of the respiratory muscles has been followed by a marked decrease 
in the temperature and pulse-rate. 

CONVALLARIA, — is the rhizome and roots of Convallaria majalis, 
Lily of the Valley, a stemless perennial of the nat. ord. Liliacese, indig- 
enous to Europe, Northern Asia and the Southeastern portion of the 
United States. The preparations in the market vary in action, according 
to the quantity of the Resin present, it being emeto-cathartic. Conval- 
laria contains two glucosides, namely, Convallamariii, on which the car- 
diac action depends, and Convallarin, a crystalline, purgative principle, 
insoluble in water ; — also an acrid Resin which probably contains the 

latter glucoside. 

Preparations. 

Extractum Convallariae Fluidum, Fluid Extract of Convallaria, — is the only offi- 
cial preparation, and probably contains Convallarin, which is not present in aqueous 
preparations, being insoluble in water. Dose, tryj-x. 

Extractum Convallariae (Unofficial), — from the flowers and stalks with ^ of the 
leaves and root ; is freely soluble in water and in alcohol. Dose, gr. ij-x. 

Infusum Convallariae (Unofficial), — prepared from the flowers, leaves and stems 25 
parts, in water 75. Dose, ^ss-ij. 

Convallamarinum, Convallamarin, C 23 H 44 12 (Unofficial), — an amorphous, white, 
bitter powder, freely soluble in water and in alcohol. Dose, gr. %-\). 

Physiological Action. 
Convallaria has long been known as a decided cathartic and a prompt 
and powerful diuretic, but its cardiac action has only lately excited atten- 
tion, and it is now considered a close analogue of Digitalis, while free 
from the cumulative action which makes the latter drug so frequently a 
dangerous remedy. Preparations of the root have a powerful emeto- 
cathartic action, probably due to a preponderance of the resin. Those 
freed from this ingredient correspond in action with Convallamarin, 
stimulate the appetite, without impairing digestion, increase peristalsis 
without producing catharsis, slow the heart and raise the arterial tension 
also slowing and deepening respiration. Lethal doses at first produce 
irregularity of the cardiac action and spasm of the respiratory muscles, 
high arterial tension and a very rapid pulse, — followed by lowered blood- 
pressure, very slow and deep breathing, and finally arrest of the heart in 
systole. Its mode of action is by direct stimulation of the pneumogas- 
tric, the motor and sensory nerves retain their irritability, the muscles 
preserve their contractility, and the cerebral functions and the pupil are 
unaffected. 



254 COPAIBA. 

Convallarin is a drastic purgative in 3-grain doses. Convallamarin is 
an emetic even in small quantity, and the powdered root is sternutatory. 

Therapeutics. 
Convallaria is a heart-tonic like Digitalis, and is indicated in the same 
class of cases as is that drug, with the advantage that having no cumula- 
tive action it is not dangerous to the heart in medicinal doses, and does 
not disturb the stomach or the functions of the cerebro-spinal axis. In 
doses of gr. xv-xxv of the extract it slows the action of the heart and in- 
creases the force of its contractions, raises arterial tension, augments the 
force and volume of the respiration, and produces prompt diuresis with- 
out altering the composition of the urine. It is often a valuable remedy 
in mitral stenosis or insufficiency with venous stasis, dilatation of the heart, 
palpitation, vehement cardiac action or disordered rhythm, and in all 
valvular affections accompanied by dropsy and a weak heart. It has also 
been used with benefit in pneumonia, typhoid fever and renal dropsy. 
Its action is maintained for several days after its use has been suspended. 



COPAIBA, Copaiba {Balsam of Copaiba), — is the oleoresin of 
Copaifera La?igsdorffii, and other species of Copaifera, a S. American 
tree of the nat. ord. Leguminosae, growing chiefly in the valley of the 
Amazon. It is a translucent, viscid liquid, of yellow color, aromatic 
odor, acrid and bitter taste, not fluorescent, soluble in alcohol and benzol. 
It is not a balsam as it contains no cinnamic acid. Its constituents are 
a Volatile (9// and a Resin in about equal proportions, the latter contain- 
ing nearly 99 per cent, of Copaibic Acid. Dose, flbx-^j. 

Preparations. 

Oleum Copaibae, Oil of Copaiba, C 10 H 16 , — the volatile oil, a pale yellow liquid, of sp. 
gr. 0.890, of bitter taste and neutral reaction, soluble in 10 volumes of alcohol. Dose, 
n\^x-xv. 

Resina Copaibae, Resin of Copaiba, — is the residue left after distilling off the vola- 
tile oil from Copaiba ; a yellowish, brittle body, of acid reaction, soluble in alcohol, 
benzol or amylic alcohol. Consists mainly of Copaibic Acid, which is crystallizable, also 
\y z per cent, of a viscid resin. Dose, gr. j-v. 

Massa Copaibae, Mass of Copaiba, Solidified Copaiba, — consists of Copaiba 94, fresh 
Magnesia 6, triturated with water and set aside to concrete into a pilular mass. Dose, 

Mistura Copaibae Composita, Compound Mixture of Copaiba, Lafayette 's Mixture 
(Unofficial), — H . Copaibae 3vij, 01. Cubeba? gj, Glyceriti Vitelli ^vij. Triturate and 
add gradually while triturating Syrupi Aq. Menth. Piperita? 3 ijss. Then add with con- 
stant stirring Liq. Potassae ^ss, Tr. Cardamomi Co. 3 ij , Spt. Etheris Nitrosi 5SS, Aq. 
Mentha; Pip. q. s. ad ^ viij. Dose, 3J-5SS. 

Physiological Action and Therapeutics. 
Copaiba is a stimulant diuretic, diaphoretic, expectorant, and a gastro- 
intestinal irritant. Its taste is bitter and nauseous. In the stomach it 



CORJANDRUM CORNUS COTO. 255 

causes heat, unpleasant eructations, heaviness, frequently anorexia and 
diarrhoea, and if continued for any length of time gastro-intestinal 
catarrh and desquamative nephritis may result. The oil and resin diffuse 
into the blood and are excreted by the bronchial mucous membrane, 
skin and kidneys, producing increased secretion at the points of elimi- 
nation. The various secretions have the odor of the drug, especially the 
urine. In medium doses it increases the quantity of urine and its solid 
constituents, but large doses will cause scanty urine, containing albumen, 
casts and blood, with pain in the loins and other signs of renal conges- 
tion. On the skin it often produces itching and several forms of erup- 
tion. 

Copaiba has been largely used in gonorrhoea after the acute symptoms 
have subsided, also in chronic cystitis, acute and chronic bronchitis, and 
in dropsies, particularly ascites. In all these affections it is a useful 
remedy, but its nauseous taste and irritant effects on the stomach are 
driving it out of fashion, especially in private practice. One eminent 
surgeon declares that not only is it useless in gonorrhoea but that it does 
more harm than good, often prolonging the disease beyond its natural 
limit. In psoriasis and urticaria, and in cutaneous affections character- 
ized by torpid peripheral circulation, this drug has been administered in- 
ternally with excellent results. In long-standing cystitis in the female 
Copaiba has been injected into the bladder with great benefit. The resin 
is the most active ingredient, especially for diuretic purposes. 



CORIANDRUM, Coriander, — is the fruit of Coriandrum sativum, a European 
plant of the nat. ord. Umbelliferce. It contains a volatile and a fixed oil. Dose, gr. 
x-xx. 

Oleum Coriandri, Oil of Coriander, — a volatile oil distilled from Coriander. A 
colorless liquid, of aromatic, bitter and pungent taste ; soluble in 10 volumes of alcohol, 
forming a slightly turbid liquid, neutral to litmus paper. Dose, fnjj-v. 

Coriander is stimulant, aromatic and carminative. It is used almost wholly as a 
flavoring to other remedies, or as a corrective against the griping effects of certain purga- 
tives. Its flavor covers the taste of Senna and Rhubarb, and it is an ingredient of the 
official Confectio Sennse. 



CORNUS, Dog-wood (Unofficial), — is the bark of the root of Comas florida,*. 
small tree of the nat. ord. Cornacea?, indigenous in the U. S. It contains a bitter prin- 
ciple named Cornin, which is crystallizable and soluble in water and in alcohol ; also a 
resin and tannic acid. 

Cornus is a simple bitter, having stomachic and other qualities similar to those of 
Calumba (which see). In addition it is possessed of considerable antiperiodic power, 
and has a good deal of reputation in the Southern States as a remedy in malarial fever, 
the physicians of that section considering it as next to quinine in efficiency. Heat de- 
stroys its active principle, consequently a decoction is a useless preparation. A fluid 
extract is on the market, the dose of which is TT^x-^j. 



COTO, Coto Bark (Unofficial), — is the bark of some unknown tree growing in 
Bolivia. It contains an acrid, bitter principle, of yellow color, crystalline and soluble in 



256 CREOSOTUM. 

hot water and alcohol, named Cotoin, C 22 H 18 6 ; also Piperonylic Acid, C 8 H 6 + , and a 
volatile oil, resin, etc., but no tannin. Dose, gr. j-xv. 

Paracoto Bark, or False Colo. — Its principle, Faracoloin, C 19 H 12 6 , has a strong 
similarity to Cotoin therapeutically, but is less active. 

A fluid extract of the official strength is prepared, also a tincture (10 per cent.), which 
may be administered in doses of from mj-xx. Cotoin is used in doses of gr. j-iv, and 
Paracotoin in somewhat larger quantities. 

The physiological action of Coto has not been studied, all that is known about it being 
that it is decidedly irritant to the skin and mucous membranes. After its internal admin- 
istration the urine takes a dark-red color with Nitric Acid. Ferric Chloride blackens a 
dilute solution of Cotoin, but has no reaction with Paracotoin. 

The bark and both principles are highly recommended in diarrhoeas of various forms, 
especially those of phthisis, typhoid fever, and cholera. In Asiatic cholera Paracotoin 
has been used hypodermically in 3-grain doses with success. Where there is any ten- 
dency to acute inflammation of the gastro-intestinal tract this agent must be used with 
caution. Small doses of the tincture (tt\j-v) are said to be very effective in the diarrhoea 
of children. 



CREOSOTUM, Creosote, — is a mixture of phenols, chiefly Guaia- 
col and Creosol (also Melhylcreosol and Phlorol), obtained during the 
distillation of wood-tar, preferably of that derived from the Beech. It 
occurs as an almost colorless, or pinkish, inflammable, oily liquid, of 
smoky odor, caustic taste, and neutral reaction; soluble in about 150 of 
water, and in all proportions in absolute alcohol, ether, chloroform, ben- 
zin, carbon disulphide, acetic acid, and fixed and volatile oils. It does 
not coagulate albumen (?) or collodion while Carbolic Acid does. It 
was named from its remarkably preservative power over meat (creas, flesh, 
sohzoh, preserve). Much of the commercial Creosote is an impure Car- 
bolic Acid, or a heavy oil distilled from coal-tar and containing Carbolic 
and Cresylic Acids. Dose, tuj-iij, well diluted, in wine or whiskey. 
Morson's beechwood creosote is the best for internal use. There is only 
one official preparation, viz. : — 

Aqua Creosoti, Creosote Water, — is a I per cent, solution, containing nearly 5 minims 
of Creosote in each fluid-ounce. Dose, 3J~3J- 

Unofficial Derivatives. 

Guaiacolum, Guaiacol {Methyl Fyrocalec/iin) , CgH^HOC^ (Unofficial), — is the 
most active ingredient of Creosote, of which it constitutes from 60 to 90 per cent. It 
occurs as a colorless liquid, highly inflammable, of a powerfully aromatic odor, very 
slightly soluble in water, readily soluble in alcohol. Dose, TT\,j-xv, in capsules, pills, or 
alcoholic solution. 

Guaiacoli Carbonas, Guaiacol Carbonate (Unofficial), — is a tasteless and odorless, 
crystalline powder, insoluble in water. Dose, gr. j^-j, gradually increased to a maxi- 
mum of 90 grains. 

Benzosolum, Benzosol, Benzoyl Guaiacol (Unofficial), — is prepared by heating Guaia- 
col with Benzoic acid, and occurs in small, colorless, odorless, and almost tasteless crys- 
tals, practically insoluble in water. Contains 54 per cent, of Guaiacol. Dose, gr. v-xv. 

Physiological Action. 
Creosote is expectorant, astringent, antiseptic, styptic, escharotic, an- 
aesthetic and narcotic. Its action is practically the same as that of Car- 



CREOSOTUM. 257 

bolic Acid (see ante, page 75), especially upon the heart, respiration and 
nervous system, but differs from that of the latter in not causing convul- 
sions, and in increasing the coagulability of the blood. It is eliminated 
by the kidneys and the bronchial mucous membrane, which it stimulates, 
being quite a good expectorant. In small doses it seems to have a selec- 
tive sedative influence on the terminal nerve-filaments in the gastric 
mucous membrane. In large doses it is a powerful poison, resembling 
Carbolic Acid in its symptoms, except that its nervous effects are even 
more marked. It explodes when combined with Oxide of Silver in pill, 
unless previously diluted with an inert powder. 

Guaiacol, locally applied, is rapidly absorbed by the skin, and appears 
in the urine fifteen minutes after its application. Applied by painting it 
over the skin of the thigh, abdomen or chest, in quantity of 20 to 50 
minims, it causes a rapid reduction of body temperature, and thereby the 
temperature in malarial fever, typhoid fever and pneumonia falls as much 
as 7 in the course of an hour or two, but soon rises again (Da Costa). 
This rapid antipyretic action is not accompanied by any marked disturb- 
ance of the nervous system or any signs of collapse, not even by a very 
profuse sweat, neither does there occur any active chill, though slight 
chilliness is sometimes experienced. 

Internally administered, the action of Guaiacol is similar to that of 
Carbolic Acid, and overdoses may prove equally fatal. Professor O. Wyss, 
of Zurich, reports the case of a girl nine years of age who had been acci- 
dentally given 75 drops of guaiacol. In a short time she became uncon- 
scious, the conjunctivae became injected, the corneal reflexes diminished, 
and the pupils no longer reacted to light ; there were frequent attempts 
at vomiting, and the saliva flowed from the mouth in large quantities. 
The pulse became rapid and the sensibility of the skin much diminished. 
Finally, the patient began to vomit, — the physician detecting the odor 
of guaiacol the stomach was washed out, but she did not rally. The 
cyanosis gradually diminished, and instead of it a deadly pallor was 
observed and the respiration became frequent. Three and a half hours 
after the guaiacol had been swallowed the patient passed one hundred 
cubic centimetres of brownish-red urine. The spleen and liver soon 
enlarged, the temperature fell to 96 F., and small hemorrhages were 
observed upon the skin of the arms and legs. The urine contained albu- 
min, blood, and casts, and Ehrlich's carbolic-acid test was positive. 
Jaundice soon appeared, the stupor increased, and the patient died on 
the third day. The autopsy revealed an acute gastritis and enteritis, 
parenchymatous degeneration of the liver, acute hemorrhagic nephritis, 
parenchymatous degeneration of the heart-muscle, and ecchymoses in the 
pleurae, peritoneum, endocardium, and pericardium ; the spleen was much 
enlarged. 

17 



258 CREOSOTUM 

Guaiacol is said to be a powerful local anaesthetic, equal in this respect 
to cocaine and much safer, as it can be injected in ten times larger doses 
without producing ill effects. For this purpose it is used in sterilized 
olive oil (1 in 10 or 20) hypodermically, and it is claimed that thereby 
perfect local anaesthesia is obtained for the extraction of teeth, the 
removal of small tumors, and similar operations. 

Therapeutics. 

Creosote, being a very complex substance of varying composition, 
has been almost entirely supplanted in therapeutics by Carbolic Acid for 
external use, and by Guaiacol for internal administration. As an astrin- 
gent it has been employed in intestinal hemorrhage, gonorrhoea and 
gleet, and generally in the same affections as Carbolic Acid. Externally 
it is a good application in eczema, pruritus, ulcers and scaly skin diseases, 
and it effectually relieves the pain of an exposed dental nerve if applied 
thereto. It is a good agent by inhalation in chronic bronchitis and 
gangrene of the lung, and it has been administered internally with 
decided benefit in abnormal fermentative processes in the stomach and 
intestines, in reflex nausea and vomiting, (as from sea-sickness, pregnancy, 
etc.) ; also as an aseptic expectorant in chronic basilar cavity, in which it 
seems to have greater efficacy than any other remedy ; and in bronchitis, 
pulmonary gangrene, carcinoma of the stomach and diabetes. 

In pulmonary tuberculosis, when well borne by the stomach, and con- 
tinued over a long period of time, it has probably proved more efficient 
than any other remedy. Its employment in this disease is based on the 
statement of Guttmann, that tubercle bacilli are destroyed by blood 
which contains ^ per 1000 of Creosote, while even one-half that propor- 
tion arrests their growth. The commencing daily dose, of Creosote (or 
Guaiacol), is 2 or 3 minims, largely diluted to prevent irritation, taken 
after meals, and increased by the addition of one minim daily until a 
maximum daily dosage of 15 to 18 minims is reached, at which rate it 
should be continued for several months. Under this treatment cough is 
relieved, expectoration diminished, night-sweats are stopped, the fever 
lowered, while body-weight and appetite are increased in most cases ; 
and in many even the local conditions are decidedly improved, as evinced 
by the physical signs. Recent researches indicate that the good effects 
of this treatment are due to the formation of soluble compounds between 
the remedy and the toxic albuminous by-products of the tubercle bacillus, 
which products are then eliminated from the blood. 

Creosote was advocated for phthisis by Reichenbach in 1833, and revived by Bouchard 
and Gimbert in 1877, since which time it has been tried in this disease and approved by 
a long list of authorities, including Jaccoud, Dujardin-Beaumetz, Dieulafoy, Germain 
See, Sommerbrodt, Von Brun, Guttmann, Douglas Powell, Burney Yeo, J. Solis-Cohen, 
and many others, who all agree as to its utility, though differing as to its mode of action, 



CREOSOTUM. 259 

dosage, and the methods of administration. The number of cases dealt with by some of 
these observers is so considerable that there is at least strong prima facie evidence in 
favor of this drug and its derivatives. Bouchard reported on 93 cases at first, and on 
more subsequently ; Sommerbrodt's report included over 5,000 cases, treated during more 
than nine years ; and Von Brun dealt with 1,700 cases. Professor Sommerbrodt con- 
tends that it is possible to administer the quantity necessary to inhibit the growth of the 
bacilli, and believes that he did so in many cases. He had the most gratifying success 
with this medication, and states that the more creosote the patient could bear the better 
was the result. Of late years the tendency has been to administer Creosote (or Guaiacol) 
by hypodermic injection. Lepine uses creosote dissolved in oil, and finds that a much 
larger quantity can be used hypodermically than the stomach will tolerate. Picot injects 
a mixture of sterilized olive oil containing I per cent, of Iodoform and 5 per cent, of 
Guaiacol, beginning with I ccm. of the mixture and increasing the dose to 3 ccm. He 
states that no swelling or other local reaction follows this injection. Burney Yeo has 
used the same method with a more concentrated formula for the injection. 

Guaiacol is preferred by many, for internal administration, instead of 
Creosote, being the principal ingredient of the latter, and of more definite 
chemical composition, though nearly or quite as irritant to the stomach. 
It may be given in mixture with wine or brandy, in capsules, or hypoder- 
mically in combination with cod-liver oil. When neither of these agents 
agree with the patient, a useful and efficient substitute therefor is Guaia- 
col Carbonate, in doses of 6 to 8 grains, gradually increased to gjss daily. 
This preparation is well borne, as it does not- irritate the gastric mucous 
membrane or disturb the digestion. 

The antipyretic power of Guaiacol, when painted on the surface of the 
body, has recently been utilized in the treatment of several diseases ac- 
companied by hyperpyrexia. In typhoid fever Dr. Montagnon applied 
10 or 15 drops with a brush whenever the temperature exceeded 102 , 
and the application was followed by a profuse perspiration, the tempera- 
ture fell, and in a few hours a large quantity of urine was passed. The 
action lasted about two hours, and the treatment was renewed about every 
three or four hours with excellent results, none of the patients suffering a 
relapse. Similar results have been obtained in the pyrexia of malarial 
fever and pneumonia, and this employment of the drug is claimed to pro- 
mote the absorption of pleuritic effusions in a remarkable manner. Only 
pure guaiacol should be used, as an inferior quality produces a very grave 
cutaneous irritation. By other clinicians it is mixed with glycerin before 
application, in the proportion of 1 part to 8 of the latter, or even in 
equal quantity, and it is claimed that thereby no inconvenience is expe- 
rienced. This application of Guaiacol is also decidedly anaesthetic in 
effect, and has been utilized in orchitis, in the chest-pains of tuberculous 
subjects and in other painful affections, especially sciatica and rheuma- 
tism. 

Benzosol contains Guaiacol in the proportion of 54 per cent. In the 
intestinal canal the latter is probably set free by the action of the alkaline 
secretions, as Benzosol is excreted by the urine in the form of guaiacol 
and benzoic acid combinations. Compared with guaiacol, this agent has 



26o CROCUS — CUBEBA. 

the advantage of being almost tasteless ; hence it can be given in large 
doses without the digestive disturbance and disagreeable eructations pro- 
duced by the parent substance when administered in liquids, and without 
the local irritant effect caused by the latter in capsules. In doses of 4 
grains, gradually increased to 12 grains thrice daily, results are claimed 
to have been obtained from this agent, in the treatment of phthisis, equal 
if not superior to those produced by Creosote. 



CROCUS, Saffron, — the stigmas of Crocus sativ us, a plant of the nat. ord. Iridete, 
cultivated in Europe, containing a volatile oil and coloring matter. So-called American 
Saffron is not Crocus but the flowers of Carthamus tinctorius. True Saffron is expen- 
sive, as it requires about 60,000 flowers to furnish one pound of the stigmas. Dose, 
gr. v— xx, in infusion. 

Tinctura Croci, Tincture of Saffron, — 10 per cent. Dose, £j-ij. 

Saffron Tea, so much used in domestic practice, is an infusion of Carthaimis tinc- 
torius, the Safflower. 

Crocus is a stimulant aromatic, having some antispasmodic and anodyne qualities. 
The hot infusion produces diaphoresis, probably by virtue of the hot water alone. It is 
said to have caused death with narcotic symptoms. On the continent of Europe it is 
employed as a stimulant and emmenagogue, but in this country its only use is as a color- 
ing agent. The miscalled Saffron Tea noted above is used in domestic practice for 
measles and other exanthemata. 



CUBEBA, Cubeb, — is the unripe fruit of Piper Cubeba, a plant of 
the nat. ord. Piperaceae, cultivated in Java. It contains a Volatile Oil, 
which is official, an acrid resin composed in part of Cubebic Acid, also a 
fatty oil, gum, and Ctibebin, which is an insoluble, neutral, odorless and 
tasteless body. The volatile oil may be separated into Cubebene a cam- 
phor, and Cubeben a liquid portion. The active principles are the vola- 
tile oil and the cubebic acid, both of which are contained in the oleoresin. 
Cubeb should be kept whole and not pulverized until wanted for use. 
Dose of the powdered drug, gr. x-^ij. 

Preparations. 

Extractum Cubebae Fluidum, Fluid Extract of Cubeb. Dose, TT\v-xxx. 

Tinctura Cubebae, Tincture ofCiibeb, — 20 per cent. Dose, TT^x-^iij. 

Oleoresina Cubebae, Oleoresin of Cubeb, — extracted by ether. Dose, rr\,v-xxx. 

Trochisci Cubebae, Troches of Cubeb, — each contains of the Oleoresin 4, Oil of Sas- 
safras 1, Extract of Glycyrrhiza 25, Acacia 12, and Syrup of Tolu q. s. to form 100 
troches. Dose, j-iij. 

Oleum Cubebae, Oil of Cubeb , C ]5 H 24 , — is the volatile oil, a colorless or pale green- 
ish-yellow liquid, of sp. gr. 0.920. warm, aromatic taste, odor of cubeb and neutral re- 
action. Is soluble in an equal volume of alcohol. Dose, TTLv-xx. 

Cubeb belongs to the pepper family, and like black pepper is an aroma- 
tic stomachic and a stimulant diuretic in small or medium doses, but 
large doses derange digestion and may act as a gastro-intestinal irritant. 
Its constituents are eliminated by the bronchial mucous membrane, the 
skin and the kidneys, stimulating and disinfecting the genito-urinary 



CUPRUM. 26l 

passages, increasing the bronchial mucus, sweat and urine, and frequently 
causing an urticarial or vesicular eruption. It increases the action of the 
heart and of the vascular system, stimulates the venereal appetite, and 
promotes the menstrual discharge. 

Cubeb is particularly useful in affections of the bladder and urethra. 
It is used in the acute stage of gonorrhoea, in chronic cystitis, prostator- 
rhcea and chronic bronchitis with excellent results. The powder is a 
good application in hay-fever, chronic nasal catarrh and follicular pharyn- 
gitis, blown on to the mucous membrane by an insufflator. It may also 
be smoked in cigarettes with temporary relief in cases of acute nasal 
catarrh with "stuffed" nasal passages. In some subjects the continued 
use of cubeb produces nausea, hemorrhoids, hematuria, and severe head- 
ache. The troches are a useful preparation in chronic irritability of the 
fauces, pharynx and air-passages, and are much employed by singers and 
public speakers for their tonic effect on these parts and for the relief or 
prevention of hoarseness. 



CUPRUM, Copper, Cu, — is not official, but one of its salts is, 
namely the Sulphate. The metal itself is inert, but in combination it is 
actively poisonous. Copper has been found in the normal human blood 
in very minute quantity. 

Salts and Preparations of Copper. 

Cupri Sulphas, Copper Sulphate, CuSC^ + 5H 2 0, — blue, translucent crystals, efflor- 
escent, of nauseous, metallic taste and acid reaction, very soluble in water, insoluble in 
alcohol. Its solution is blue by transmitted light, green by reflected light. Dose, as an 
emetic, gr. ij-v, every 10 or 15 minutes, — as a tonic, gr. ye— l /z- 

Alkaline Cupric Tartrate Volumetric Solution, Fehling' s Solution, — the official 
reagent for glucose, is prepared as follows. (1) Dissolve 34.64 grammes of pure Cupric 
Sulphate in water, to measure exactly 500 cubic centimeters. (2) Dissolve 173 grammes 
of Potassium and Sodium Tartrate and 125 grammes of Potassium Hydrate in water to 
measure exactly 500 cubic centimeters. Keep the two solutions in small, rubber-stop- 
pered bottles, separate ; and for use, mix exactly equal volumes of the two at the time 
required. One cubic centimeter of the mixed solution is the equivalent of — 

Cupric Sulphate, crvstallized, CuSO^ -f- 5H 2 0, Gramme, 0.03464 

Cupric Tartrate, CuC 4 H 4 6 + 3H 2 0, " 0.03685 

Glucose, anhydrous, C 6 H 12 6 , " 0.00500 

Cuprum Ammoniatum, Ammoniated Copper (Unofficial), — is made by triturating 3 
parts of Ammonium Carbonate with 4 of Cupric Sulphate until effervescence has ceased, 
then drying. A deep azure blue powder, of ammoniacal odor, a styptic, metallic taste, 
and alkaline reaction, soluble in water. Dose, gr. l /e>-). 

Cupri Arsenis, Copper Arsenite, — is described under Arsexum, ante, page 165. 

Physiological Action. 

The salts of Copper are gastro-intestinal irritants, producing a metallic 

taste, nausea with greenish vomited matter, purging of blood and mucus, 

constricted fauces, depressed heart action, hurried respiration and fever. 

Or, as with Arsenic, gastro-enteritis may not occur, but instead profound 



262 CUPRUM. 

nervous symptoms, as headache, defective coordination, coma and con- 
vulsions. The symptoms of chronic poisoning are bronchial irritation 
and catarrh, gastro-intestinal catarrh, colic with diarrhoea [Lead produces 
colic with constipation], dysentery, nausea, emaciation, anaemia, saliva- 
tion, and a green line (sulphide) along the margin of the gums in those 
who do not clean their teeth. The nervous symptoms above mentioned 
are also usually well marked. The liver becomes atrophied from irrita- 
tion of its connective tissue and fatty degeneration of the hepatic cells. 
The lungs are congested, even pneumonic consolidation may be set up, 
the metal seeming to have affinity for the parenchyma of these organs. 
These effects are often produced by the inhalation of cuprous fumes, and 
by eating acid fruits cooked in a copper vessel. Brass-founding is known 
to cause various forms of disease, as gout, chronic nephritis, progressive 
paresis of the legs, tremor, muscular wasting, and locomotor ataxia. A 
group of symptoms spoken of as "brass founders' ague" has also been 
noticed. The fit of ague is ushered in by languor and depression, then follow 
prostration with pallor, cold sweats, and chills, that even may amount to 
rigors, with chattering of the teeth, precordial anxiety, headache, nausea 
and muscular pains. The onset of vomiting arrests the symptoms and 
usually is followed by sleep, from which the patient arouses almost well. 
It is not clear whether these symptoms are due to copper or to zinc, both 
of which enter into the composition of brass. 

Copper Sulphate is a simple, irritant emetic, producing prompt and 
continued vomiting with but little nausea or depression. In small doses 
it is a nerve-tonic, and is astringent to the gastro-intestinal tract. Ex- 
ternally applied in solution it is a useful stimulant and astringent to dis- 
eased mucous surfaces, and is mildly caustic if used in substance. The 
Acetate is possessed of the same general action as above described. Its 
local action is stimulant and escharotic. The impure acetate (verdigris) 
is a violently irritant poison. Ammoniated Copper has no special action 
other than above noted. 

Antidotes, Antagonists aizd Incompatibles. 

Potassium Ferrocyanide is the antidote in poisoning by the Copper salts, but Albumen 
or Magnesia may be used. Any chemical antidote should be followed by prompt evacua- 
tion of the stomach, then Opium and demulcents for gastro-enteritis, and Potassium 
Iodide even to saturation of the system. Alkalies and their Carbonates, Lime-water, 
Iodides, and Mineral Salts (except the sulphates), are all incompatible. 

Therapeutics. 
The Sulphate is a prompt and efficient emetic, and is so used in croup 
and narcotic poisoning. In phosphorus poisoning it forms a compara- 
tively insoluble phosphide of copper besides producing emesis. Fifteen 
or twenty grains may be dissolved in 3iv of water, and a teaspoonful or 
more, according to age, given every ten minutes until vomiting is pro- 



CURARE. 263 

duced. In acute diarrhoea and chronic dysentery it is the best metallic 
astringent in doses of gr. T \j to -^ with Opium, and in gastro-intestinal 
catarrh it is equally efficient. Locally, it is used with benefit in throat 
affections, gonorrhoea, granular lids and corneal ulcers, indolent granu- 
lations and chronic inflammations of mucous membranes. In most of 
these affections weak solutions (gr. yfa to fy to the g) are best, but in 
granular conjunctivitis the smooth crystal may be rubbed quickly over 
the surface once daily. 

In various nervous diseases, as epilepsy, chorea, hysteria, etc., the salts 
of copper are sometimes beneficial, the Ammoniated Copper being con- 
sidered the most efficient preparation in these cases. In Germany a 
tincture of the Acetate was official and has been used successfully in the 
treatment of pneumonia. Ammoniated Copper has lately been highly 
recommended for facial neuralgia, but requires pushing to the production 
of some physiological action. Ointments or lotions of the Acetate are 
useful applications in eczema, herpes, tinea sycosis, mentagra and herpes 
circinatus. 

Villate' 's Solution has been successfully used as a local injection for the 
cure of caries. It is composed of Copper Sulphate, Zinc Sulphate, of 
each 15 parts, Liquor Plumbi Subacetatis 30, Vinegar 200. The solu- 
tion is thoroughly injected into the sinuses leading to the carious bone. 



CURARE, Woorara (Unofficial), — is a vegetable extract obtained 
from various members of the Strychnos family, also from Paulinia curare 
and other plants. It is used in S. America as an arrow-poison under 
various names, as Caroval, Vao, etc. Its active principle is the crystal- 
lizable alkaloid Curarine, which contains no oxygen. 

The dose of Curare is gr. ^— \ hypodermically, — of Curarine, gr. 2"oo~T^o hypoder- 
mically, or gr. yiy—iV by the stomach, but as the samples vary greatly in activity they 
should first be tried on some inferior animal before being administered to man. 

Physiological Action. 
Curare is a paralyzer of the voluntary muscles, affecting them through 
the end-organs of the motor nerves. It does not at first act upon the 
brain or spinal cord, but if life be prolonged by artificial respiration the 
cord, sensory nerves and even the muscular tissue all become affected. 
The heart, at first quickened, becomes depressed, and the blood-pressure 
is lowered, the eyelids droop, the eye-balls protrude, vision is disordered, 
intestinal peristalsis and sensibility to stimuli are greatly increased, and 
an artificial glycosuria (curare-diabetes) is set up. The limbs are para- 
lyzed first, death occurring by paralysis of respiration. The absorption 
of the drug by the stomach is very slow, as its active principle passes with 
difficulty through animal membranes, and its elimination, which takes 



264 CUSSO CYDONIUM. 

place by the kidneys, being more rapid and complete than that of any 
other agent, no marked effect may be produced when it is administered in- 
ternally. When hypodermically injected its action is very prompt. The 
urine of a curarized animal will poison another, and that of the second 
animal will paralyze a third. 

As compared with other motor depressants Curarine and Coniine 
paralyze the end-organs of the motor nerves, and Gelsemine paralyzes 

the motor centres. 

Antagonists and Incompatibles. 

Strychnine, though from a member of the same family, is antagonistic as to the action 
on the heart and respiration. So also is Atropine. Artificial Respiration is the most 
efficient antagonist, maintaining life until elimination occurs. Evacuation of the bladder 
repeatedly is important to prevent reabsorption. The caustic alkalies destroy Curarine 
as they do all other alkaloids. 

Therapeutics. 
Curare is chiefly used for experimental purposes on the lower animals. 
It has an historical interest from its having been the means by which 
Bernard demonstrated the existence of muscular contractility as an essen- 
tial endowment of that tissue. It has been used with some success in 
spasmodic nervous affections, particularly in tetanus, both idiopathic and 
traumatic, in hydrophobia, chorea and epilepsy. It does not promise 
well as a therapeutic agent, but undoubted cases of hydrophobia are 
reported by high authority as cured by this drug. 



CUSSO, Kousso, Brayera, — is the female inflorescence of Hagenia abyssinica, an 
Abyssinian tree of the nat. ord. Rosacea?. It contains tannic acid, a volatile oil, and a 
crystalline principle named Konssin, which by itself is apparently inert. Dose, of Cusso, 

oiJ-SJ- 

Extractum Cusso Fluidum, Fluid Extract of Kousso. — Dose, ^ij-.^j. 

Cusso has little or no effect except the nausea, vomiting, colic and slight diarrhoea pro- 
duced by large doses. Its chief action is anthelmintic against both varieties of tape- 
worm, but it rarely expels the head of the parasite, and is very nauseous to the taste and 
difficult of retention by the stomach in the large doses necessary to efficiency. 3 i j to^j 
of the flowers infused in % iv of boiling water is the usual dose, and should be taken on 
an empty stomach and followed by a castor-oil or saline purge after 3 or 4 hours. An 
emulsion of a 6 per cent, infusion with castor-oil, yolk of egg, a few drops of ether and 
oil of anise with 10 to 20 drops of Oleoresin of Male-fern, is more agreeable and efficient 
than the infusion alone. 



CYDONIUM, Quince Seed (Unofficial), — is the seed of Cydonia vulgaris, a tree 
of the nat. ord. Rosacea;, native in Crete and Austria, and cultivated elsewhere. The 
seeds placed in water swell up, forming a mucilaginous mass. The mucilage is the only 
constituent of importance and is contained in the epithelial cells. It has been named 
Cydonin, and considered to be a compound of gum and cellulose. 

Mucilago Cydonii, Mucilage of Cydonium (Unofficial), — is prepared by macerating 
2 parts of Cydonium in 100 of Distilled Water. Dose, indefinite. 

Cvdonium is of value for its mucilage, which is used as a bland, demulcent application 
in conjunctivitis, abrasions of the skin, and fissures of the mucous membranes, and as a 
vehicle for injections in gonorrhoea. Internally it may be used as a soothing remedy for 
the throat, stomach, or intestines. The preparation known as Bandoline, used as a hair- 
dressing, is identical with mucilage of Cydonium. 



CYPRIPEDIUM DIGITALIS. 265 

CYPRIPEDIUM, Ladies' Slipper, — is the rhizome and roots of Cypripedium 

pubescens, and of C. parviflorum, the Moccasin-plant, or American Valerian (nat. ord. 
Orchideje). It contains a volatile oil, a volatile acid, resins, and tannin. 

Extractum Cypripedii Fluidum, Fluid Extract of Cypripedium. — Dose, TTLx-xxx. 

Cypripedin (Unofficial), — is an impure alcoholic extract. Dose, gr.ss-iij. 

Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, possessing the same 
general properties as Valerian, whence one of its common names, American Valerian. 
It is a popular remedy in some parts of the U. S. for nervous hyperesthesia unaccompa- 
nied by organic lesion, especially morbid sensibility of the eye. It is reported to have 
even cured epilepsy, and to be highly useful in neuralgia, hysteria, nervous headache and 
insomnia. 



DAMIANA (Unofficial), — the leaves of Turnera aphrodisiaca, a plant of the nat. 
ord. Turneraceee, growing in Mexico and Lower California. Several varieties of so-called 
Damiana are in the market, but the true leaf is of a light-green color, small, lanceolate, 
and dentate along the margin. It contains a volatile oil and a resin. Dose, ^j daily. 

Extractum Damianse, Extract of Da?niana (Unofficial). — Dose, gr.ij-x. 

Extractum Damianae Fluidum, Fluid Extract of Damiana (Unofficial). — Dose, 
"l*- X J- 

Damiana is said to be a powerful aphrodisiac in cases of sexual atony, but the pub- 
lished reports of its use since its introduction vary greatly as to its efficacy. It is probably 
a stimulant diuretic, a bitter tonic, and a purgative in sufficient doses. 

Besides its use as an aphrodisiac Damiana has been administered with benefit in some 
forms of cerebral exhaustion and general atony of the nervous system, also in sick head- 
aches and in some few cases of paralysis. It forms the chief stock in trade of the 
numerous charlatans who fill the daily papers with advertisements of "manhood- 
restorers." 



DATURA TATULA (Unofficial), — is an indigenous plant of the nat. ord. Solana- 
cex, resembling Stramonium very closely, with which it generally agrees in its physio- 
logical action and therapeutics. It is distinguished by its purple stem, purple flowers and 
anthers, and the darker green of its leaves. It probably contains the alkaloid Daturine 
(see Stramonium), — and has been smoked in asthma, in a few cases giving continued 
relief when Stramonium had failed to render any service. 



DIGITALIS, Foxglove, — Digitalis consists of the leaves, col- 
lected from plants of the second year's growth, of Digitalis purpurea, 
the Purple Foxglove, a plant of the nat. ord. Scrophularinese, which 
grows wild in Europe, and is cultivated in this country, often in private 
gardens for its beautiful spike of purple flowers, and largely by the Shakers 
for the drug market. 

The British Phar. directs that the official drug shall consist of " the dried leaf, collected 
from the wild, indigenous plant, when about two-thirds of the flowers are expanded." 
Much of the leaf found in our shops is of very poor quality, a large proportion being 
inert ; but whether this is due to our Phar. not restricting the official drug to the wild 
plant, or to careless treatment in gathering and drying, is not definitely known. When, 
however, the leaves are imperfectly dried, a process of decomposition sets in, which 
destroys the active principles, and may produce new and poisonous ones. A similar 
decomposition is said to occur whenever the tincture of Digitalis is mixed with watery 
or syrupy solutions. Certain it is, at any rate, that Digitalis is one of the most unreliable 
drugs, in respect to the physiological activity of any particular sample or preparation. 
The seeds are known to contain the active principles in much greater proportion than the 
leaves, but they are never used. 



266 DIGITALIS. 

Constituents. 
The active principle of Digitalis was first designated by the term Digi- 
talinum (Digitalin), under which name a substance was official in the 
U. S. Phar. and a process was given therein for its extraction, until the 
revision of 1880, when it was omitted. It was an amorphous product, of 
complex composition, and did not represent Digitalis. 

In 1 87 1 Nativelle received the Orfila prize from the French Academy for the discovery 
of a crystalline principle in Digitalis, which he named Digitaline. This was supposed 
to be the active principle of the plant, until Roucher, (1872) and Schmiedeberg, (1875) 
found it to be a complex body, consisting of a mixture of Digitoxin and Digitalin. 
Schmiedeberg's latest analysis is now accepted as the most accurate determination yet 
obtained of this vexed question. He enumerates five principles at least as contained in 
Digitalis, viz. : — (i) Digitalin, amorphous, insoluble in water, but readily soluble in 
alcohol; the active ingredient of Homolle's French Digitaline and the Digitalin of the 
U. S. and Br. Pharmacopoeias; — (2) Digitoxin, insoluble in water and sparingly soluble 
in alcohol; the most active of all, and the principal constituent of Nativelle's prize Digi- 
taline ; — (3) Digitaleln, soluble in both water and alcohol ; — (4) Digitonin, readily soluble 
in water, sparingly so in alcohol ; active, but acts like Saponin, forming a solution which 
froths easily and antagonizes the other three ; — (5) Digitin, which seems to be entirely 
inert. The first three are active cardiac stimulants and highly poisonous. The fourth is 
a direct depressant of the heart, antagonizing the stimulant action of the others. All five 
are non-nitrogenous, and, except Digitin, are glucosides. Digitalis contains no alkaloid. 

Preparations. 

Digitalis, Digitalis, — the powdered leaves. Dose, gr.ss-iij. 

Extractum Digitalis, Extract of Digitalis, — By maceration and percolation in Alco- 
hol 2, Water I, distilling off the alcohol, and evaporating the residue. Dose, gr. }{.-}. 

Extractum Digitalis Fluidum, Fluid Extract of Digitalis, — By maceration and 
percolation in Alcohol 2, Water I, and evaporation. Dose, rtyss-iij. 

Tinctura Digitalis, Tincture of Digitalis, — Digitalis 15, Diluted Alcohol to 100. 
By maceration and percolation. Dose, ni v-xxx. 

Infusum Digitalis, Infusion of Digitalis, — Digitalis I l / z , Alcohol 10, Cinnamon 
Water 15, Boiling Water 50, Water to 100. By maceration in boiling water. Dose, 
3 j-iv. Notice that the dose is in drachms, not in ounces. 

Digitalinum, Digitalin, — is the complex product of the process formerly official in 
the U. S. and Br. Phar. Dose, gr. -fa-fa. 

Homolle's (or Quevenne's) Digitalin (Unofficial), — is much used in France in 
form of granules. Consists chiefly of Digitalin with a little Digitoxin, and possesses the 
action of the leaves. An amorphous, yellowish- white powder or small scales, intensely 
bitter, inodorous, but irritant to the nostrils. Dose, gr. -^, equal to about gr. jss of the 
powdered leaves. 

Nativelle's Digitalin, — consists largely of Digitoxin, and is cumulative in action. 
Light, white, crystalline tufts of needles, of very bitter taste ; soluble in alcohol, insoluble 
in water. Dose, gr. fa-fa in pill. 

The Tincture and Fluid Extract, being alcoholic preparations, contain -a large pro- 
portion of Digitalin and Digitale'in, with a small proportion of Digitoxin and Digitonin. 
On the addition of water thereto, the Digitoxin is precipitated to the bottom. The 
Infusion contains a large proportion of Digitonin, some Digitalei'n, and little or no 
Digitalin or Digitoxin. The Infusion is the best preparation for diuretic purposes, the 
Tincture for cardiac action ; but to obtain the action of the plant itself the powdered 
leaves must be used in pill or capsule. To obtain the best action of the Tincture on the 
heart, it should be administered without admixture, or at least, with water alone, the 
latter being added immediately before ingestion and any precipitate being also swal- 
lowed. 



DIGITALIS. 267 

Physiological Action. 

Digitalis is a cardiac tonic, a vascular stimulant, and an excito-motor, 
also emetic, diuretic, hemostatic, anaphrodisiac, and paralyzant. In 
over-doses it irritates the mucous membranes, causing sneezing, severe 
gastric disturbance, nausea, vomiting, colic and purging, the discharges 
being of a grass-green color. It lowers temperature, probably by lessen- 
ing the blood-supply to the tissues, produces headache, irregularity of the 
heart's action, vertigo and an appearance of vibratory fringes of color 
around objects. , 

The Heart is slowed by Digitalis, but its force is at the same time 
increased. The drug stimulates the cardiac muscle and its inhibitory 
apparatus; also the vaso-motor centres, contracting the arterioles, and 
thereby greatly raising the arterial tension. Full doses continued exhaust 
the irritability of the motor ganglia and paralyze the cardiac muscle itself. 
The recumbent posture must be maintained when Digitalis is given for its 
full cardiac effects. Its final effect on striped muscular tissue is to lessen 
the contractile power, causing great weakness and languor. Under it, 
the excretion of urea is at first increased, but soon decidedly diminished. 
It lessens the sexual appetite and impairs the venereal function. 

It has been conclusively shown that in many cases of pneumonia 
Digitalis failed to influence the pulse, the result probably of the partial 
paralyzant influence of high body temperature upon the vagus centre and 
endings in the heart, thus weakening the inhibitory apparatus to such a 
degree that the drug awakens no responsive increase of inhibition. In 
cases with but moderately high pyrexia the characteristic action of the 
drug is not interfered with. 

The Diuretic Action of Digitalis is due to its peculiar influence upon 
the general and renal circulation, it increasing the force of the ventricular 
contractions, while at the same time one of its constituents, Digitalin, 
contracts the blood-vessels of the body, and two others, Digitoxin and 
Digitale'in, dilate the renal arteries. The effect of this combined action is 
to greatly raise the arterial tension and the blood-pressure in the glomeruli, 
their afferent vessels being contracted ; — while the rapidity of the renal 
circulation is increased and its volume augmented by the greater force of 
the heart-beat and the dilatation of the afferent vessels. No other drug 
known has this double power, and therefore, so far as vascular action is 
concerned, Digitalis is the ideal diuretic. Still, while its power to pro- 
duce diuresis in cardiac disease is unquestioned, most observers deny that 
it has any such power in health. 

Lethal doses lessen the reflexes by stimulation of Setschenow's centre, 
and paralyze the muscles and the peripheral nerves, motor and sensory. 
Respiration, at first slowed, becomes rapid and feeble; cyanosis, coma 



268 DIGITALIS. 

and convulsions follow, also death by sudden paralysis of the heart, 
which is arrested in systole. 

Compared with Aconite, both it and Digitalis slow the heart, but 
otherwise their actions are antagonistic. Aconite at first stimulates and 
soon relaxes inhibition and depresses the cardiac motor ganglia, — Digi- 
talis increases inhibition and stimulates the cardiac muscle. Both drugs 
finally paralyze the heart, Aconite by direct depression of its motor 
ganglia, Digitalis by over-stimulation of the cardiac muscle. Under 
Aconite the heart is arrested in diastole, under Digitalis in systole. The 
arterial tension is lowered by Aconite, raised by Digitalis. Aconite acts 
quickly, Digitalis very slowly, — a fact which makes the latter drug of 
little value in poisoning by the former. 

During the use of this drug for any length of time the muscle of the 
heart is so nearly paralyzed by over-stimulation that on suddenly assum- 
ing the erect position the cardiac energy may fail, more especially if the 
doses are administered too closely together to admit of the elimination 
of one before the ingestion of the next. This is the explanation of the 
so-called cumulative action of Digitalis, which is not now generally 
recognized in the sense in which the term was formerly applied. Another 
explanation is that it may stop its own excretion, by arresting the renal 
circulation and the secretion of urine through extreme contraction of the 
renal vessels, and thus may really accumulate in the blood. 

Antidotes, Antagonists and Inco?npatibles. 

Tannic Acid is the chemical antidote, but as the tannate is not inert the stomach 
should be evacuated. Aconite is the best antagonist to the effects of large doses, Opium 
to those of its long-continued use. Saponin and Senegin are considered to be its most 
complete physiological antagonists. Incompatibles are Cinchona, Iron Sulphate, Tinc- 
ture of Ferric Chloride, and Lead Acetate, also syrupy and watery solutions, which may 
decompose the active principles of the plant. 

Therapeutics. 
The employment of Digitalis in disease is chiefly based on its action as 
a cardiac tonic and a diuretic. The forms of heart disease in which it is 
indicated are the affections of the auriculo-ventricular orifices, namely, 
mitral and tricuspid disease, whether regurgitant or obstructive in char- 
acter. It is contra-indicated in aortic disease, except for special symp- 
toms, and in fatty degeneration of the cardiac muscle. Its sphere of 
usefulness is Mitral Regurgitation, especially when accompanied by venous 
engorgement and oedema of the lungs, the right heart, the liver, kidneys 
and subcutaneous tissues. In "such cases its action is shown to striking 
advantage, ameliorating all the symptoms by assisting the flow of blood 
in the veins. By prolonging the diastole, it gives time for the dilated 
auricle to empty itself through the incompetent orifice ; and by strength- 



DIGITALIS. 269 

ening the contraction of the left ventricle, it causes the better approxi- 
mation of the mitral flaps, consequently less regurgitation, less venous 
engorgement, and the propulsion of more blood into the arterial system. 
If it also acts as a diuretic, as it usually does in these cases, the diuresis 
will tend to remove the oedema; and the general improvement in the 
circulation produced by it will relieve the cardiac pain and distress, the 
dyspnoea and cyanosis. The less a case of mitral regurgitation approaches 
the oedematous type, the less good will Digitalis do, as a rule. 

In Mitral Constriction, Digitalis is usually of great assistance, the 
lengthened diastole giving more time for the blood to pass through the 
narrowed orifice, and the increased force of the auricular contraction 
helping in the same direction. 

In Tricuspid Regurgitation or Constriction, Digitalis is beneficial in the 
same manner as in disease of the mitral valve. It is particularly useful in 
dilatation of the right side of the heart with incompetence of the tricuspid. 
The rational symptoms which indicate its use are — rapid and feeble 
cardiac action, low arterial tension, cough, dyspnoea, pulsating jugulars, 
a dusky face, scanty and high-colored urine and general dropsy. 

In Aortic Regurgitation, Digitalis is generally injurious ; the prolonged 
diastole caused by it giving more time for the blood to regurgitate 
through the imperfectly closed orifice, and thus increasing the danger of 
fatal syncope. It may do good if compensatory hypertrophy has not set 
in, if the heart is feeble and its action rapid, or when there is but little 
blood regurgitating, or when there are reasons, such as the coincident 
presence of aortic obstruction, for wishing to strengthen and regulate 
the contraction. In any case, the dose administered should be a small 
one, and its effects should be carefully watched. 

In Aortic Constriction, Digitalis is generally contra-indicated, especially 
when, as is usually the case, this lesion is accompanied by aortic regurgi- 
tation. It may be of service, however, when the force of the heart-beat 
requires strengthening; or when, as a result of the obstruction, mitral 
dilatation has set in, with much regurgitation, and the consequent venous 
and pulmonary engorgement. It should not be used in aortic stenosis 
with compensatory hypertrophy, in simple hypertrophy when compen- 
sated, in pericarditis or in fatty degeneration of the heart, except tem- 
porarily for some special indication. 

In the irritable heart of soldiers Digitalis is often curative, and palpita- 
tion, cardiac failure and venous engorgement are well treated by it. In 
exophthalmic goitre it has apparently benefited some cases, when used 
over a long course of treatment ; but, as a rule, this affection is not 
amenable to its influence. 

When the cardiac action of Digitalis is desired, the tincture should be 
employed, given on sugar or bread, prohibiting the ingestion of any 



27O DIGITALIS. 

aqueous fluid within 20 minutes either before or after swallowing it. If 
the diuretic action is required, the proper preparation is the infusion, 
which contains a much larger proportion of Digitonin than of the other 
principles. This agent, acting upon the renal apparatus and antagoniz- 
ing the action of the other three, is freely soluble in water, but sparingly 
so in alcohol. On the other hand, Digitalin, to which the cardiac action 
of the drug is chiefly due, is almost insoluble in water, but readily soluble 
in alcohol; and Digitoxin, the most active constituent, is insoluble in 
water, though somewhat soluble in alcohol. 

In Bright's disease Digitalis is not a suitable diuretic. It has been 
used in the early stage of the acute form, but it is very questionable prac- 
tice to dilate the vessels of any acutely inflamed organ. Moreover, in such 
cases the arterial tension is always somewhat raised, and this drug only 
aggravates that condition. In chronic Bright's disease it is still more 
injurious, for the same reason, the arterial tension being very high therein. 
It may be of service, however, in cases of renal cirrhosis, when the car- 
diac hypertrophy has failed to overcome the peripheral resistance, and 
consequently there is dilatation of the left ventricle and the left auriculo- 
ventricular orifice, with the resulting mitral regurgitation. In such cases, 
a diuretic pill is frequently of service, consisting of Digitalis leaves in 
powder, Calomel and Squill, a grain of each, made into pill with extract 
of Hyoscyamus. 

Digitalis is always an uncertain diuretic unless the heart is diseased ; 
yet it has rendered good service in renal dropsy as well as in the cardiac 
form. Its contractile power over the arteries may so predominate as to 
arrest the renal circulation completely, and stop the secretion of urine 
(Brunton). On this account it is well to administer at the same time an 
agent which causes dilatation of the renal vessels, as Sodium Nitrite. It has 
been employed with benefit in the early stage of scarlet fever, and when 
the kidneys strike work in that disease. As a hemostatic it may be used 
in hemorrhage from a large surface, in the hemorrhagic diathesis, hemop- 
tysis, and menorrhagia. As an antipyretic it has been much used in 
fevers, in the first stage of pneumonia, and in other inflammations, but a 
reaction is setting in against this employment of so powerful a heart- 
depressant. In rheumatic fever it lowers the temperature, shortens the 
duration of the disease, and is particularly indicated for any cardiac 
complications. It was formerly much used in delirium tremens, in con- 
gestive headaches, acute mania and other congestive conditions of the 
brain, but generally without much benefit. In spermatorrhoea of the 
plethoric it may be well combined with Potassium Bromide, and when 
this affection is complicated with an atonic condition, shown by feeble 
erections, frequent emissions and cold feet and hands, it is a serviceable 
anaphrodisiac. Finally, Digitalis is said by high authority to be particu- 



DIOSCOREA DITA BARK DROSERA DUBOISIA. 27 I 

larly adapted to blondes and persons of sanguine and indolent tempera- 
ment. Sometimes the vomiting caused by it is so severe as to prevent 
its use. 



DIOSCOREA, Wild Yam, Colic-root (Unofficial), — is the rhizome of Dioscorea 

villosa, a creeping plant of the nat. ord. Dioscoracese, indigenous to the eastern U. S. 
It contains an acrid resin, and is reported to be expectorant and diaphoretic in action, as 
well as stimulating to the intestinal canal, and in large doses to cause general neuralgic 
pains with erotic excitement. It is used with great success in bilious colic ; and in the 
cramps of cholera morbus, spasmodic hiccough, dysmenorrhcea and nocturnal emissions 
of sthenic type it is said to be very efficient. A powdered extract named Dioscorein is on 
the market, of which the dose is gr. j-iv. A fluid extract made according to the pharma- 
copceial rule may be administered in doses of n\xv-xxx. 



DITA BARK (Unofficial), — is the bark of Alstonia scholaris ', a tree of the nat. ord. 
Apocynaceae, growing in the Philippine Islands. It contains two active alkaloids, 
Ditaine and Ditamine, the former of which has an action identical with that of Curare. 
The bark is considered tonic and antiperiodic, and is used in the East as a remedy for 
intermittents. It may be given in doses of 3 j-iv, in powder or as fluid extract. 



DROSERA, Sundew (Unofficial), — A fluid extract of Drosera rotundifolia, the 
round-leaved Sundew r , is said to have been successfully used in phthisis pulmonalis. It 
, is certainly a most useful agent in whooping-cough and other spasmodic coughs ; especially 
when marked by violent paroxysms, the cough being loud and harsh, and followed by 
bleeding from the nose or mouth, and perhaps by vomiting of the contents of the 
stomach. The expressed juice has been applied to warts and corns, for the purpose of 
curing them. Dose of the fluid extract, TTLv-xx. 



DUBOISIA (Unofficial), — is the leaf of Duboisia ?nyofio7'oides, an 
Australian tree of the order Solanaceae. It contains a poisonous alkaloid, 
Duboisine, which is believed to be identical with Hyoscyamine, and 
strongly resembles Atropine. 

Unofficial Preparations. 
Extractum Duboisiae, Extract of Duboisia,— -Dose, gr.y&-%. 
Tinctura Duboisiae, Tincture of Duboisia, — Dose, rt\v-xx. 
Duboisinas Sulphas, Duboisine Sulphate (Langenberg's), — Dose, Z x -\\~^~^- 

Physiological Action and Therapeutics. 

The actions of Duboisia are in all respects similar to those of its con- 
gener, Belladonna, except that Duboisine is more soluble in water than 
Atropine, is less irritating to mucous membranes, and more prompt in 
mydriatic action, but its effects are of shorter duration. It is also less of 
a cerebral excitant and more of a calmative and hypnotic. On man its 
action is said by some authorities to be more powerful than that of Atro- 
pine, but less powerful on frogs. If administered in the intervals between 
meals it disorders the ensuing digestion, but does not so act if given 
while digestion is in progress. 

Duboisine is highly praised for its sedative action in the mental exci- 



272 DULCAMARA. 

tability of the insane, in the treatment of the morphine habit and in 
paralysis agitans. In doses of gr. yi-g- to y 1 - of the sulphate, admin- 
istered hypodermically twice daily, it induces quiet and refreshing sleep 
and is not dangerous. When given in larger doses it may produce 
vertigo, nausea or even syncope, but no fatal cases from its moderate use 
have been reported (Massant). Its sedative effect is at the same time the 
most persistent and also that of which the patient first acquires a toler- 
ance. Of 22 cases in which the calmative effect was at first decided, a 
tolerance was acquired in eight. In such cases the sedative action of the 
drug may be restored by ceasing its continuous administration and length- 
ening the interval between the doses (De Montyel). It has been well 
employed in puerperal mania, and may be used instead of Atropine in 
many conditions, especially in the night-sweats of phthisis, respiratory 
neuroses and cardiac failure. It is employed as a mild mydriatic by eye 
surgeons, its advantages for them over Atropine being its more rapid 
action in paralyzing accommodation and effecting mydriasis, the shorter 
duration of its effects and the slight degree of conjunctival irritation 
produced by it. Duboisine is an efficient antagonist to Morphine. Its 
own antagonists and incompatibles are the same as for Atropine, and are 
stated under Belladonna, ante, page 181. 



DULCAMARA, Bittersweet, — the young branches of Solatium 
Dulcamara, or Woody Night-shade, a shrub of the nat. ord. Solanacese, 
growing in Europe and N. America. It contains the glucoside Dul- 
camarin, a peculiar principle named Picroglycion, and the alkaloid 
Solanine, which exists in the stems of other species of Solanum, namely, 
S. tuberosum (potato), S. Lycopersicwn (tomato), and S. nigrum (black 
nightshade). Solanine is of bitter taste, alkaline reaction, crystalline 
in minute prisms soluble in 125 of boiling alcohol but very insoluble in 
water. It is a narcotic poison, but exists in very small quantity in the 
plant. 

Preparations. 
Extractum Dulcamarse Fluidum, Fluid Extract of Dulcamara, — Dose, ^j. 
Decoctum Dulcamarae, Decoction of Dulcamara (Unofficial), — may be made of 
10 per cent, strength and given in doses of 3j j-ij. 

Physiological Action and Therapeutics. 
Dulcamara is but imperfectly understood. In overdoses it has pro- 
duced nausea and vomiting, vertigo, convulsive muscular movements, 
pruritus, erythematous eruptions on the skin, and languid circulation with 
a dusky color of the face and hands. In children who have eaten the 
berries there have been observed signs of severe enteralgia, abdominal 
tenderness, nausea, thirst, heat in the throat and chest, great prostration, 



ELASTICA. 273 

rapid pulse, quick and painful respiration. In very large doses it is a 
narcotic poison, causing paralysis by depression of the central nervous 
system, with lowered activity of the heart and respiration. It is believed 
by some authorities to be anaphrodisiac, diaphoretic and diuretic. 

Dulcamara was formerly used in a variety of affections, as herpetic 
diseases, chronic rheumatism, gout, jaundice, etc. It is now chiefly 
employed in obstinate scaly skin diseases, as psoriasis and pityriasis, in 
which it is unquestionably serviceable. It is also serviceable in the diar- 
rhoea of children when produced by exposure to cold and damp, in mania 
with strong venereal propensities, in chronic bronchitis and in whoop- 
ing-cough. As a diaphoretic it has been used with benefit in rheumatic 
and venereal disorders, and is often beneficial in nasal, pulmonary and 
vesical catarrhs. It is said to be particularly useful in affections of a 
rheumatic or catarrhal nature when caused by exposure to damp weather. 



ELASTICA, India-rubber {Caoutchouc), — is the prepared milk- 
juice of various species of Hevea (nat. ord. Euphorbiaceae), growing in 
S. America, and being known in commerce as Para Rubber. It is very 
elastic, insoluble in water, diluted acids, or diluted solutions of alkalies, 
soluble in chloroform, carbon disulphide, oil of turpentine, benzin and 
benzol. When pure, or nearly pure, it floats on water. 

India-rubber is a hydrocarbon, and may be combined with sulphur 
by the aid of heat (vulcanized), which process, long continued, converts 
it into hard rubber. It is used in the fabrication of catheters, bougies, 
pessaries, court plaster, bandages, elastic stockings, tubing, etc. An 
analogous substance is Gutta-percha, which was official in the U. S. 
Phar., 1880. 

Gutta-percha (Unofficial), — is the concrete exudation of honandra gutta, a large 
tree of the nat. ord. Sapotacese, growing in the Malay peninsula and adjoining islands. 
Occurs in tough but somewhat flexible pieces, of grayish or yellowish color, plastic 
above 140 F., soft at 212 F., insoluble in water or alcohol, soluble in chloroform, 
oil of turpentine, carbon disulphide, benzin and benzol. It contains a hydrocarbon, 
Gutta, C 10 H 16 (80 per cent.), two Resins named FUiavil and Albau, also a volatile oil, 
salts, fat and coloring matter. 

Preparations of Gutta-percha. 

Liquor Gutta-perchae, Solution of Gutta-percha (Unofficial), — Gutta-percha 9, Car- 
bonate of Lead 10, in Chloroform 91. Used as a protective application to eruptions and 
slight wounds, the evaporation of the menstruum leaving behind a thin adhesive and non- 
irritating pellicle. 

Traumaticin (Unofficial), — is the name given to a 10 per cent, solution of Gutta- 
percha in Chloroform, which forms on drying a permanent, unirritating, adhesive, flexible 
and non-contractile skin for the treatment of skin affections and slight wounds. It forms 
an excellent basis for the application of Chrysarobin to psoriasis. 

Gutta-percha has neither physiological action nor therapeutics, being used for its 

physical qualities alone. In surgical practice it has several applications, making a good 

material for splints, as it can be softened in hot water and adapted to any surface while 

pliable. From it are manufactured pessaries, specula, stethoscopes and other instruments. 

18 



2 74 ELATERINUM ERGOTA. 

The solution may be used as a protective covering for excoriations and slight wounds, to 
prevent pitting in small-pox, and to paint over the line of suture after post-mortem 
examinations. 



ELATERINUM, Elaterin, C 20 H 28 O 5 , — is a neutral principle ex- 
tracted from Elateriwn, a substance deposited by the juice of the fruit of 
Ecballium Etaterium, or Squirting Cucumber, a cultivated European 
plant of the nat. ord. Cucurbitacese. Elaterium is no longer official by 
reason of its variable quality. Elaterin occurs in small, colorless scales 
or prisms, of bitter taste and neutral reaction, insoluble in water, soluble 
in 337 of alcohol and in solutions of the alkalies. Dose, gr. ^- * 2 . 

Preparation. 

Trituratio Elaterini, Trituration of Elaterin, — Elaterin io, Sugar of Milk 90, 
thoroughly mixed by trituration. Dose, gr. ss-j. 

Elaterin is the most powerful of the hydragogue cathartics, causing 
profuse, watery stools, and when given in large doses great prostration 
and gastro-intestinal irritation, nausea and vomiting. On the lower ani- 
mals it does not produce purgation, but profoundly impresses the nervous 
system, causing irregular breathing, convulsions and death. 

Its chief use is to produce free watery discharges in ascites, anasarca, 
uraemia and cerebral disorders, but while the most efficient agent we 
possess for this purpose it must be used with great caution in the aged 
and feeble, as it is very depressant. 

ERGOTA, Ergot {Ergot of Rye), — is the sclerotium (compact 
mycelium or spawn, intermediate fibrous stage) of Claviceps purpurea 
(class Fungi), growing within the flower and replacing the grain of Rye, 
Secale cereale, (nat. ord. Graminese). It occurs in fusiform, curved, 
grain-like bodies, of purplish-black color, peculiar and heavy odor, and 
oily, disagreeable taste. It should be only moderately dried, and should 
be preserved in a close vessel, and have a few drops of chloroform dropped 
upon it from time to time, to prevent the development of insects. When 
more than one year old it is unfit for use. Dose, gr. x-3j. 

Composition of Ergot. 
The composition of Ergot and the nomenclature of its supposed con- 
stituents is a subject upon which there exists a great diversity of opinion, 
and about which there is nothing settled. The following synopsis gives 
the views of the different persons who have examined into the matter. 

Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he claimed to 
be the active principles, and to be combined with Ergotic Acid, a volatile body yielding 
crystallizable salts. He also claimed the presence of Trimethylamine as a Phosphate. 

Tanret (1877) isolated a crystallized alkaloid, which he named Ergotmine, C 35 H 40 - 
N 4 6 (dose, gr. ^"iV)' a * so a volatile camphoraceous substance. 



ERGOTA. 275 

Dragendorf and his pupils (1S75-1879) stated the active principles to be two in 
number, Sclerotic or Sclerotinic Acid, a very powerful body, yellow-brown, amorphous, 
tasteless and well adapted for hypodermic use in doses of gr. ^q-to' anc ^ Scleromucin, a 
colloid substance, also quite active. Besides these they held that Ergot contained various 
coloring matters (Sclererythrin, Scleroxanthin, etc.), also a non-drying Oil, a peculiar 
sugar (Mykose), a number of alkaloids (Trimethylamine, etc.), and other principles which 
are inert. 

Kobert (1885) announces that Ergot contains three active principles, viz., (1) Ergo- 
tinic Acid, a glucoside, and the chief constituent of Sclerotinic Acid ; having no ecbolic 
action, but affecting the nervous system, the heart and the respiration ; — (2) Sphacelinic 
Acid, non-nitrogenous, unstable, soluble in alcohol, insoluble in water, stimulates the 
vaso-motor centre, and is believed to be the active agent in contracting the blood-vessels, 
and producing gangrenous ergotism ; — (3) Cornutine, an alkaloid, believed to be the 
agent which contracts the uterus. It produces convulsions and peristaltic contractions of 
the uterus, and is the active agent in convulsive ergotism. 

Tanret's Ergotinine has been proved to have no action on the uterus. 
The Ergotin of Bonjean, Wiggers and Tanret is not a fixed compound, 
but a mixture. The Ecboline of Wiggers is also a mixture. Sclerotinic 
Acid is said by many authorities to act on the uterus, but this is positively 
denied by many others. It is probably a very uncertain preparation, and 
is said to be really a mixture of Sphacelinic acid and Cornutine. For the 
Ergotin of commerce see below. Ergot also contains Trimethylamine, to 
which its odor is due, a fixed oil, (30 per cent.) and tannin. 

Preparations. 

Extractum Ergotse Fluidum, Fluid Extract of Ergot, — prepared with Acetic Acid 
and Diluted Alcohol. Dose, 3 ss— ij . 

Extractum Ergotae, Extract of Ergot, commonly called Ergotin, — is prepared by 
evaporating the fluid extract at a temperature not above 122° F., until reduced to a pilu- 
lar consistence. Dose, gr. ij-xx. 

Vinum Ergotae, Wine of Ergot, — strength 15 per cent. Dose, 5J-5J. Is made by 
an improved method and is more reliable than that formerly official. 

Ergotin (Unofficial), is the name of several watery extracts found on the market, and 
varying much in action both from each other and from the parent drug. That made by 
Squibb has about the same strength as the official extract, and represents the general 
powers of Ergot. It may be used hypodermically in doses of gr. ^-gr.v. The Ergotin 
of Bonjean is also an aqueous extract, but is very variable in quality and frequently inert. 
Wiggers' Ergotin is insoluble in the ordinary menstrua, and inert on the vascular appa- 
ratus, but causes colic and gastro-enteritis. 

Physiological Action. 

Ergot is an excito-motor and a hemostatic, chiefly affecting the spinal 
cord, circulation, respiration, intestinal and uterine muscular fibres. Its 
principal action is the production of an artificial anaemia, and tetanic 
contraction of unstriped muscular fibre. Its phenomena are divided into 
two sets, named respectively Acute and Chronic Ergotism, according as 
the drug is administered in large doses, or in small quantity for a consid- 
erable length of time. 

Acute Ergotism. In large doses Ergot acts as a gastro-intestinal irri- 
tant, causing nausea and vomiting, gastralgia, colic, thirst, difficult mic- 
turition and purging. It slows the heart, raises the arterial tension greatly, 



2/6 ERGOTA. 

dilates the pupils and produces pallor, vertigo and frontal headache. Its 
action on the circulation is due to its inducing arterial anaemia, but 
whether this is done by contraction of the arterioles through direct action 
on their muscular fibres or by central stimulation of the vaso-motor system, 
or by producing active venous dilatation, thus draining the arterial sys- 
tem, is a much disputed question. It certainly stimulates the contraction 
of unstriped muscular fibre, especially affecting the sphincters and the 
uterus, causing continuous labor pains and tonic contraction of the sphinc- 
ter vesicae, making micturition difficult if not impossible. It also pro- 
duces cerebral and spinal anaemia, coldness of the surface, tetanic spasms 
and violent convulsions, but very large doses (several ounces) are neces- 
sary to such results. As much as §iij of the fluid extract has been given 
daily for a week or more, without producing any marked effect. 

Chronic Ergotism occurs in two forms, the Convulsive, and the Gan- 
grenous, — either usually excluding the other. The convulsions are 
tetanoid spasms of the flexor muscles, the uterus, the intestinal fibres, 
and the muscles of respiration, ending in coma and death by asphyxia. 
The gangrenous form begins with coldness and numbness of the limbs, 
formication of the skin all over the body, loss of sensibility and abolish- 
ment of the special senses, bullae of blood and ichor, followed by dry or 
moist gangrene of the lower extremities, buttocks and other parts, epi- 
leptiform convulsions, coma and death. Autopsies show changes in the 
posterior columns of the cord, resulting probably from the spinal anaemia. 

Experiments with the various derivatives of Ergot show that no one 
of its constituents represents the power of the drug itself. Those which 
probably come nearest to it in action are the Ergotinine of Tanret and 
Sclerotinic Acid. 

Analogues of Ergot are Ustilago (see under Zea), Gossypii Radicis 
Cortex (Cotton-root Bark), and Caulophyllum (Blue Cohosh). They are 
each described under their respective titles. 

Antagonists and Incompatibles. 
Amyl Nitrite, i^conite, Veratrum Viride, Tobacco and Lobelia antagonize its action 
on the circulation. Caustic alkalies and metallic salts are chemically incompatible. 

Therapeutics. 
Ergot has a wide field of application. Its most familiar use is to pro- 
mote uterine contraction in labor, but as the contractions produced by 
it are continuous instead of the natural intermittent ones, it is highly 
dangerous when there is any obstacle in front of the child, the probable 
results being rupture of the uterus, paralysis of the foetal heart, and severe 
laceration of the perineum. At the end of the second stage, when the 
head is born, is the best time for its use (if employed in labor at all), in 
order to promote firm uterine contraction, thereby guarding against 
post-partum hemorrhage, and promoting the expulsion of the placenta. 



ERIGERON ERIODICTYON. 277 

The tendency, however, of obstetrical teaching, is against its employ- 
ment at all in labor; while, in practice, the teaspoonful of Ergot is 
almost invariably administered as soon as possible after the child is born. 
In many uterine affections, as chronic metritis, subinvolution, congestive 
dysmenorrhea, menorrhagia, fibroids and polypi, Ergot is well employed, 
producing firm contraction of the womb and promoting absorption of 
inflammatory products. It is extremely useful in amenorrhcea due to 
plethora, and in the atonic form of spermatorrhoea. In conjunctivitis, 
gonorrhoea, and inflammations of mucous membranes generally, it is of 
striking benefit, if used both locally and internally. It is also an excel- 
lent remedy in acute and chronic dysentery, chronic diarrhoea, atonic 
hemorrhages of arterial type, mania due to cerebral hyperaemia, head- 
ache and migraine of congestive form, myelitis, spinal congestion, 
cerebro-spinal meningitis, splenic enlargement, lax sphincters of the 
rectum and bladder, and in incontinence of urine from paralysis of the 
sphincter vesicae. Hemorrhoids are well treated by its local application, 
but here it should not be used internally as it promotes venous conges- 
tion. In aneurism it aids coagulation by slowing the blood current, and 
in cardiac hypertrophy without valvular lesion it acts well by slowing the 
heart. In diabetes insipidus full doses of Ergot are often curative, and 
it has been used with benefit in diabetes mellitus. 

Hypodermically, the aqueous extract dissolved in water and free from 
alcohol or any other irritating substance, is in many cases much more 
prompt in action than when given per orem, especially if injected near 
to the seat of the affection. This is particularly true in post-partum and 
other hemorrhages, prolapse of the rectum, chronic metritis and subin- 
volution of the womb, uterine fibroids, varicocele and varicose veins. 
When so administered it will frequently so contract the sphincter of the 
bladder as to produce retention of urine, and require the use of the 
catheter. 



ERIGERON, Fleabane (Unofficial), — is the flowering plant Erigeron canadense, a 
weed of the nat. ord. Composite, growing in N. America. It contains a Volatile Oil, 
which is official, also tannic acid and a bitter extractive. 

Oleum Erigerontis, Oil of Fleabane, — a pale yellow liquid, of sp.gr. about 0.850, 
becoming darker by age and exposure to air, of peculiar and persistent odor, pungent 
taste and neutral reaction, readily soluble in alcohol. Dose, TT^x-^ss. 

Oil of Erigeron has the same action as Oil of Turpentine but is less irritant and less 
efficient. It has considerable reputation as a hemostatic, especially in menorrhagia and 
intestinal hemorrhage of passive form, as in typhoid fever. It is also used with benefit 
in diarrhoea and dysentery, and in hemoptysis without fever or other evidence of irritation 
it is a very valuable remedy. 



ERIODICTYON, — the leaves of Eriodictyon ghitinosum, or Yerba Santa, a Cali- 
fornian shrub of the nat. ord. Hydrophyllacece. They contain an acrid Resin and an 
aromatic Volatile Oil. 



278 EUCALYPTUS. 

Extractum Eriodictyi Fluidum, Fluid Extract of Eriodictyon, — Dose, TT^xv-gj. 

Extractum Eriodictyi, Extract of Eriodictyon (Unofficial), — Dose, gr.ij-x. 

Eriodictyon is expectorant, and covers the taste of Quinine in a remarkable manner, 
for which purpose it is combined in mixture with Glycyrrhizin, under the title " Vela- 
tine" as a proprietary preparation (see ante, page 242). It is used with fair success in 
bronchial and laryngeal affections, also in asthma. Combined in syrup with Grindelia it 
is very efficient for coughs. 



EUCALYPTUS,— the leaves collected from the older parts of the 
tree, of Eucalyptus globulus, or Blue Gum-tree (nat. ord. Myrtaceae), a 
native of Australia, now grown in California, Italy, etc. They contain 
tannic acid, a resin, a fatty acid and a Volatile Oil. The latter consists 
of three different oils which distil over at different temperatures, the first 
product being the official substance named Eucalyptol, C 10 H 18 O, which 
by the action* of Phosphoric Acid is converted into Eucalyptene, 3. sub- 
stance allied to Cymene, and Eucalyptolen. 

Preparations. 

Extractum Eucalypti Fluidum, Fluid Extract of Eucalyptus, — is three-fourths 
alcohol. Dose, TT\,x-3J. 

Oleum Eucalypti, Oil of Eucalyptus, — the volatile oil, is distilled from the fresh 
leaves of various species of Eucalyptus, that from E. amygdalina being considered 
wanting in Eucalyptol. Is soluble, in all proportions, in alcohol, carbon disulphide, or 
glacial acetic acid. Dose, ir\v-xxx, in emulsion or capsules. 

Eucalyptol, C 10 H 18 O, — is a neutral body obtained from the volatile oil; a colorless 
liquid, of aromatic, camphoraceous odor, and pungent, cooling taste; soluble in all pro- 
portions in alcohol, carbon disulphide and glacial acetic acid. Dose, n\iij-x. 

Physiological Action. 

The taste of Eucalyptus is warm, aromatic, bitter and camphoraceous. 
It increases the flow of saliva, the gastric juice and the intestinal secre- 
tions, and in small doses promotes appetite and digestion, increases the 
heart's action and lowers arterial tension. In large doses it produces 
eructations, indigestion, diarrhoea, nausea and vomiting, lowered temper- 
ature, great muscular weakness, and if continued will irritate and congest 
the kidneys, and induce a feverish state with symptoms of cerebral con- 
gestion, and great constitutional disturbance. In toxic dose it is a nar- 
cotic poison, and a fatal dose causes paralysis of respiration by direct 
action on the respiratory centre in the medulla. 

Eucalyptus is powerfully antiseptic, and destructive to low forms of 
life, a stimulating expectorant and an efficient diaphoretic. By some 
authorities it is believed to reduce the size of an enlarged spleen, and to 
possess anti-malarial properties by absorbing noxious germs as well as by- 
draining the soil of its water, and by its aseptic emanations purifying the 
atmosphere in its vicinity. It is largely cultivated in malarial districts 
for these properties, and is reported to have rendered habitable a portion 
of the deadly Roman Campagna. 



EUONYMUS EUPATORIUM. 279 

Eucalyptus is eliminated by the skin, bronchial mucous membrane 
and the kidneys, imparts its odor to the breath and the urine, and is more 
or less irritant at the points of its elimination. 

Therapeutics. 
Eucalyptus is an efficient stomachic in atonic dyspepsia, chronic gastric 
and intestinal catarrh, and in conditions of the intestinal canal which 
favor the development of worms. In chronic catarrhal conditions of the 
genito-urinary organs, the broncho-pulmonary mucous membrane, and 
especially the bladder, it is very useful, acting as a stimulant and disinfec- 
tant to the mucous membranes. It is equally beneficial in chronic bron- 
chitis and bronchorrhcea, in cachectic states generally, and in convales- 
cence from acute diseases. In epidemic influenza (grippe) the oil has 
been used internally with good results, and sprinkled on blotting-paper 
placed in offices and stores has seemed to act as a prophylactic on persons 
employed therein. In hysteria, chorea and asthma it is beneficial, in the 
latter affection being advantageously smoked in cigarettes with Stramo- 
nium or Belladonna leaves. In malaria as a reconstructant it is better 
than Quinine, and it has considerable utility in obstinate intermittents 
where it is desirable to stop the use of Cinchona preparations. As an 
antiseptic it is highly valuable in dilute solution for application to ulcers, 
and as a substitute for Carbolic Acid on gauze in the antiseptic treatment 
of wounds. It is also used in dilute solution locally, as a stimulating dis- 
infectant in stomatitis, and in the subacute stages of pharyngitis and ton- 
sillitis. An aqueous preparation is highly recommended as a vehicle for 
alkaloids in solution for hypodermic use, to prevent the development of 
the penicillium, which rapidly destroys the alkaloid present. 



EUONYMUS, Wahoo, — is the bark of Euonymus atropurpureus , a shrub of the 
nat. ord. Celastrineae, growing in the U. S. It contains an amorphous, bitter principle 
named Euonymin, also Resins, Euonic Acid, and Asparagin, fixed oil, etc. 

Extractum Euonymi, Extract of Euonymus, — Dose, gr.j-v. 

Euonymin (Unofficial), — the eclectic preparation, consists of the fixed oil and resin, 
and is given in doses of gr. ss-v. 

Euonymus is classed with Rhubarb, Jalap, Aloes, etc., as a tonic-astringent and resin- 
bearing purgative. It is said to be also diuretic and expectorant, and a very efficient 
cholagogue. Its cathartic action is similar to that of Rhubarb, but milder. It has been 
employed with benefit in some cases of dropsy, also in habitual constipation, torpid liver, 
and pulmonary affections. In overdoses it will set up considerable gastro-intestinal 
irritation. 



EUPATORIUM, Thorough-wort (Boneset), — the leaves and flowering tops of 
Eupatorium perfoliatum, an American plant of the nat. ord. Composite. It contains a 
neutral, bitter principle, named Eupatorin, tannic acid, a volatile oil, etc. 

Extractum Eupatorii Fluidum, Fluid Extract of Eupatorium, — Dose, IT^x-gj. 

Eupatorium is a bitter tonic and efficient diaphoretic, also in full doses emetic and 
aperient. It has been supposed to have antiperiodic and taeniafuge powers. A warm 



280 EUPHRASIA FEL BOVIS FERRUM. 

infusion (Boneset tea) is a popular diaphoretic in remittent and typhoid fevers, and at the 
onset of an attack of acute catarrh or general cold. As a bitter tonic it may be used with 
advantage in dyspepsia and general debility. Its common name is derived from its sup- 
posed power to relieve the bone pains of dengue or the " break-bone fever." 

Another variety of Eupatorium, E. purpureum, or Gravel-root, is reputed to have de- 
cided power over the uric acid diathesis. 



EUPHRASIA, Eye-bright (Unofficial), — is a small annual plant of the nat. ord. 
Strophulariaceae, growing in Europe and the U. S., containing Euphrastic Acid, tannin, 
etc. It was formerly of great repute in various eye-affections, and may be of utility as a 
mild astringent in catarrhal conjunctivitis. Its chief value, however, is to abort an attack 
of acute nasal catarrh with lachrymation, for which purpose a few drops of the tincture 
every two hours is remarkably efficient. In hay-fever also it is of decided utility in miti- 
gating the catarrhal symptoms, and in the acute coryza of measles it will be found an ex- 
cellent remedy. A tincture (I to 9) of the fresh plant should be used, and given in doses 
of mj-v. 



FEL BOVIS, Ox-gall {Fel Tauri),— the fresh gall or bile of Bos Taurus, is a 
dark-green, viscid liquid, of peculiar odor, bitter taste, and neutral or faintly alkaline re- 
action. It contains Sodium Glycocholate, Sodium Taurocholate, Cholesterin and color- 
ing matter. 

Fel Bovis Purincatum, Purified Ox-gall, — 3 of Ox-gall and I of Alcohol evaporated 
to pilular consistence after standing 24 hours. Dose, gr.v-xv. 

Bile is tonic, antiseptic and purgative. It assists in the emulsification of fats, and 
stimulates the absorbent powers of the mucous membrane. In the stomach it neutralizes 
the gastric juice, precipitating the pepsin, and is apt to cause nausea and vomiting. Re- 
cently it is found to act well in stimulating the resolution of hypertrophies when locally 
applied to the part, as the mammae, tonsils, pannus, etc. It is used as a laxative in con- 
stipation when the natural secretion of bile is deficient, but has no advantage over other 
purgatives. 



FERRUM, Iron, Fe, — is metallic Iron in the form of fine, bright, 
and non-elastic wire. 

Ferrum Reductum, Reduced Iron, — consists of metallic Iron in fine 
powder, obtained by reducing the Sesquioxide by hydrogen at a dull red 
heat. It is a very fine, gray-black, lustreless powder, odorless, tasteless, 
and insoluble in water and alcohol, but soluble in dilute sulphuric acid 
with the evolution of nearly odorless hydrogen gas. Dose, gr. j-v, after 
meals. 

Salts of Iron and their Preparations. 

Liquor Ferri Acetatis, Solution of Ferric Acetate, — is an aqueous solution, contain- 
ing about 31 per cent, of the anhydrous salt, and corresponding to about 7^ per cent, of 
metallic iron. A dark, red-brown, transparent liquid of acetous odor, sweetish and faintly 
styptic taste, reaction slightly acid. Dose, TT\;ij— x. Used chiefly in pharmacy. 

Ferri Carbonas Saccharatus, Saccharated Ferrous Carbonate, — has at least 15 per 
cent, of ferrous carbonate. A greenish-gray powder, of sweetish taste at first, changing 
to ferruginous. Partially soluble in water, but soluble in dilute hydrochloric acid with 
evolution of C0 2 . Action, — slightly stimulant to digestive tract. Dose, gr.ij-x. 

Massa Ferri Carbonatis, Mass of Ferrous Carbonate ( Vallef s Mass), — Ferrous Sul- 
phate loo, Sodium Carbonate 100, Honey 38, Sugar 25, Syrup and Distilled Water each, 
to make 100. Has 42 per cent, of Ferrous Carbonate. An astringent, non-irritant, fer- 
ruginous tonic. Dose, gr. j-v, after food. 



FERRUM. 28l 

Pilulae Ferri Carbonatis, Pills ; of Carbonate of Iron {Ferruginous Pills, Chalybeate 
Pills, Bland's Pills), — made by mixing Ferrous Sulphate, about 2^ grains for each pill, 
with Potassium Carbonate, Sugar, Tragacanth, Althaea, Glycerin and Water. Dose, j-ij 
pills, after food. 

Mistura Ferri Composita, Compound Iron Mixture (Griffith's Mixture), — has of 
Ferrous Sulphate 6, Myrrh 18, Sugar 18, Potassium Carbonate 8, Spirit of Lavender 60, 
Rose water to 1000. Is really a solution of the Carbonate formed by reaction between 
the two principal constituents. Is an excellent chalybeate. Dose, 3 ij-iv. 

Ferri Chloridum, Ferric Chloride {Perchloride of Iron), Fe 9 Cl 6 -f- I2H. 2 0, — orange- 
yellow, deliquescent, pieces, of styptic taste and acid reaction, freely soluble in water, 
alcohol or ether. Action, — strongly astringent, hemostatic. Never used internally. 

Liquor Ferri Chloridi, Solution of Ferric Chloride, — an aqueous solution of the pre- 
ceding, containing 37.8 per cent, of the anhydrous salt, with some free HC1 acid. 
Action, — strongly astringent and styptic. Dose, n^ij-x, well diluted. 

Tinctura Ferri Chloridi, Tincture of Ferric Chloride, — a hydro -alcoholic solution 
of Ferric Chloride, containing about 13. 6 per cent, of the anhydrous salt, corresponding 
to about 4.7 per cent, of metallic iron. Has of the preceding solution 25 in Alcohol to 
make 100. A bright, brownish liquid, of ethereal odor, styptic taste and acid reaction. 
Is used in Mistura Ferri et Ammonii Acetatis. One of the best preparations of Iron. 
Action, — ferruginous tonic. Dose, n\v— xx, in water, syrup or glycerin. 

Ferri Citras, Ferric Citrate, Fe 2 (C 6 H 5 7 ) 2 + 6H 2 0, — garnet-red, transparent scales, 
slowly soluble in water, not in alcohol. Action, — mildly stimulant. Dose, gr. ij-v. 
Formed by evaporating the following : — 

Liquor Ferri Citratis, Solution of Ferric Citrate, — an aqueous solution, containing 
about 35^ per cent, of the anhydrous salt, corresponding to about ^]/ z per cent, of 
metallic iron. Solution of Ferric Sulphate 105, Citric Acid 30, Ammonia Water 88, 
Water to 100. A dark-brown liquid, of slightly ferruginous taste and acid reaction. 
Dose, rr\v-xv. 

Vinum Ferri Citratis, Wine of Ferric Citrate, — made from Iron and Ammonium 
Citrate 4, Tincture of Sweet Orange Peel 15, Syrup 10, White Wine to 100. An Elixir 
of Iron. Dose, gj-ij. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ) 6 , — a white or grayish-white 
powder, odorless, tasteless, slightly soluble in water, freely so in HC1 acid or in a solu- 
tion of sodium citrate. Action, ferruginous tonic. Dose, gr.v-x. 

Ferri Iodidum Saccharatum, Saccharated Ferrous Iodide, — a yellowish-white 
powder, very hygroscopic, odorless, of sweetish, ferruginous taste, and slightly acid reac- 
tion, soluble in 7 of water, insoluble in alcohol. Action, — ferruginous tonic. Dose, gr. 
v— xxv in pill or elixir. 

Pilulae Ferri Iodidi, Pills of Ferrous Iodide, — made with Reduced Iron, Iodine, 
Licorice, Sugar, Acacia and Water, covered with a coating of Balsam of Tolu in Ether. 
" Blancard*s Pills" only differ from these by being covered with a coating of reduced 
iron to protect the interior from oxidation, but it also protects them from the solvent 
action of the gastric juice. Dose, I or 2 pills ter in die. 

Syrupus Ferri Iodidi, Syrup of Ferrotts Iodide, — is a syrupy liquid containing 10 
per cent, of ferrous iodide. A transparent, pale green liquid, of sweet, ferruginous taste 
and neutral reaction. Action, — ferruginous tonic. Dose, TTLv-xxx. 

Ferri Lactas, Ferrous lactate, Fe(C 3 H 5 3 ) 2 -+- 3ILO, — pale, greenish-white, crystal- 
line grains, soluble in 40 of water, freely in solution of an alkali citrate, yielding a green 
solution, almost insoluble in alcohol. Action that of a feeble ferruginous tonic. Is a 
constituent of Syrupus Hypophosphitum cum Ferro. Dose, gr. j-iij, in pill or syrup. 

Liquor Ferri Nitratis, Solution of Ferric Nitrate, — an aqueous solution of Fe 2 - 
(N0 3 ) 6 , containing about 6.2 per cent, of the anhydrous salt, corresponding to about 1.4 
per cent, of metallic iron. A transparent, amber-colored liquid, of acid, styptic taste and 
acid reaction. Action, — medium as to irritation, astringent and hemostatic. Dose, 
Tt\v-xv, well diluted. 

Ferri Oxidum Hydratum, Ferric Hydrate {Ferric Hydroxide, Hydrated Oxide of 
Iron), Fe.,(OH) 6 , — a brown-red magma, wholly soluble in HC1 without effervescence. 
Should be freshly prepared by mixing together Solution of Ferric Sulphate 100, Ammonia 
Water no, and Water to 250. The two solutions aforesaid should be kept in separate 



282 FERRUM. 

bottles, on hand, ready for mixing, in quantity of 200 cubic centimeters of the first and 
220 of the latter, and when required the precipitate may be washed by pressing in a 
wet muslin strainer, until no more liquid passes, then diluting as directed. It is the 
chemical antidote for Arsenic. Dose, gj in water, frequently repeated. 

Ferri Oxidum Hydratum cum Magnesia, Ferric Hydrate with Magnesia {Arsenic 
Antidote), — is a more convenient and more efficient antidote for Arsenic than the preced- 
ing, as the excess of the alkaline precipitant is non-irritant, and is itself an Arsenic anti- 
dote. The two following solutions should be kept ready : ( 1) Solution of Ferric Sulphate 
50 Cc. in Water 100 Cc. (2) Magnesia, 10 grammes rubbed up with Water 750 Cc. in 
a bottle of 1000 Cc. capacity. When wanted, shake the latter to a homogeneous magma, 
add it gradually to the former, and shake them together to a uniform, smooth mixture. 
Should be given in large doses ( 3 j) and frequently repeated. 

Emplastrum Ferri, Iron Plaster (Strength ening Plaster), — has of Ferric Hydrate, 
dried, 9, Olive Oil 5, Burgundy Pitch 14, Lead Plaster 72. 

Trochisci Ferri, Troches of Iron, — each troche has of Ferric Hydrate gr.v, with 
Vanilla, Sugar and Tragacanth. Dose, j-iij troches, thrice daily. 

Ferri Phosphas Solubilis, Soluble Ferric Phosphate, — bright-green, transparent 
scales, of acidulous, saline taste, soluble in water, not in alcohol. Used as an adjuvant 
to laxative pills to prevent the after reactionary constipation. Dose, gr.v-x. Made by 
reaction between Ferric Citrate and Sodium Phosphate. 

Ferri Pyrophosphas Solubilis, Soluble Ferric Pyrophosphate , — green, transparent 
scales, of acidulous taste, soluble in water but not in alcohol. Is almost tasteless and 
unirritating, and non-constipative. Dose, gr. ij-v. Made by reaction between Ferric 
Citrate and Sodium Pyrophosphate. 

Ferri Sulphas, Ferrous Sulphate, FeS0 4 + 7H 2 0, — large, pale, bluish-green prisms, 
efflorescent, of saline, styptic taste, and acid reaction, soluble in 1.8 of water at 59 F., 
insoluble in alcohol. Is chiefly used to make the Dried Sulphate and other preparations. 

Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, 2FeS0 4 + 3H 2 0,— a grayish- 
white powder, nearly soluble in water, consisting of the preceding salt, heated gradually 
until it ceases to lose weight. The most astringent and irritating ferrous salt, but an 
excellent one in small doses. Is a constituent of Pil. Aloes et Ferri. Dose, gr. ss-ij, 
in pill. 

Ferri Sulphas Granulatus, Granulated Ferrous Sulphate, FeS0 4 -f 7H 2 0, — is the 
same salt as above described, precipitated by Alcohol from solution in dilute sulphuric 
acid. Dose, gr. ss-ij. 

Liquor Ferri Subsulphatis, Solution of Ferric Subsulphate (MonsePs Solution), — 
is an aqueous solution of Basic Ferric Sulphate, containing 43.7 per cent, of the salt. A 
dark, reddish-brown, almost syrupy liquid, of very astringent but not caustic taste, and 
acid reaction, mixing with water or alcohol in all proportions without decomposition. Is 
but slightly irritating and powerfully astringent, chiefly used locally as an astringent and 
hemostatic, but may be given internally in doses of tf\,iij-x, well diluted. 

Liquor Ferri Tersulphatis, Solution of Ferric Sulphate, — is an aqueous solution of 
Normal Ferric Sulphate, Fe 2 (S0 4 ) 3 , containing 28.7 per cent, of the salt. Has the same 
properties as described for the preceding, but a less sp. gr. Is used to make other prepara- 
tions of Iron. 

Ferri Valerianas, Ferric Valerianate, Fe 2 (C 5 H 9 2 ) 6 , — a dark, tile-red, amorphous 
powder, of faint, valerianic odor, and mildly styptic taste, insoluble in cold water, decom- 
posed by hot water, readily soluble in alcohol. Of doubtful value as a valerianate. 
Varies somewhat in chemical composition. Dose, gr. j-iij, in pill. 

Compound Iron Salts and their Preparations. 

Liquor Ferri et Ammonii Acetatis, Solution of Iron and Ammonium Acetate 
(Bashani's Mixture), — prepared from Tincture of Ferric Chloride 2, Diluted Acetic 
Acid 3, Solution of Ammonium Acetate 20, Aromatic Elixir 10, Glycerin 12, Water to 
100. An excellent and very pleasant preparation, having some diuretic and diaphoretic 
powers. Dose, 3 ij-v, well diluted. 

Ferri et Ammonii Citras, Iron and Ammonium Citrate, — prepared from Solution of 
Ferric Citrate 10, Ammonia Water 4, mixed and evaporated. Transparent, garnet-red 
scales, deliquescent, readily soluble in water, insoluble in alcohol. Dose, gr.ij-v. 



FERRUM. 283 

Ferri et Ammonii Sulphas, Ferric Ammonium Sulphate {Ammonio -ferric Alum) — 
pale, violet crystals, efflorescent, of styptic taste and slightly acid reaction, soluble in 3 of 
water, insoluble in alcohol. Is the least astringent of the sulphates of iron, but more so 
than any of the salts formed by vegetable acids. Dose, gr. iij-xv. 

Ferri et Ammonii Tartras, Iron and Ammonium Tartrate {Ammonio-ferric Tar- 
trate'), — transparent, reddish-brown scales, slightly deliquescent, of sweetish and slightly 
ferruginous taste, very soluble in water, insoluble in alcohol. Contains an equivalent of 
about 25 per cent, of Ferric Oxide, and has but slight irritant qualities. Dose, gr.v-xx. 

Ferri et Potassii Tartras, Pota s si -ferric Tartrate, — transparent, garnet-red scales, 
slightly deliquescent, of sweetish and slightly ferruginous taste, very soluble in water, 
insoluble in alcohol. Is the least disagreeable in taste of all the iron preparations, and 
contains a little more ferric oxide than the preceding salt. Is but slightly astringent and 
is not constipating. Dose, gr.v-x. 

Ferri et Quininae Citras, Iron and Quinine Citrate, — prepared from Ferric Citrate 
85, Quinine, dried, 12, Citric Acid 3, Aq. Destil. q. s. ad 100, mixed and evaporated. 
Thin, transparent, yellowish-brown scales, slowly deliquescent, of bitter taste, slowly sol- 
uble in water, slightly soluble in alcohol. Contains II % per cent, of dry quinine. Action, 
astringent and stimulant to the digestive tract. Dose, gr. iij-v. 

Ferri et Quininae Citras Solubilis, Soluble Iron and Quinine Citrate, — Ferric 
Citrate 85, Quinine, dried, 12, Citric Acid 3, Ammonia Water, Distilled Water, to 100. 
Thin, transparent scales, of greenish, golden-yellow color, rapidly soluble in cold water, 
partially soluble in alcohol. Dose, gr. iij-v. 

Vinum Ferri Amarum, Bitter Wine of Iron, — has of the preceding 5 parts, Tinct. 
Aurantii Dulcis, 15, Syrup 30, White Wine to 100. May replace the various " elixirs 
of iron and calisaya. " Dose gj-iv. 

Ferri et Strychninae Citras, Iron and Strychnine Citrate, — Ferri et Ammonii Citras 
98, Strychninae I, Ac. Citric I, Aq. Destil. 120, mixed and evaporated. Transparent, 
garnet-red scales, deliquescent, readily soluble in water, slightly so in alcohol. Contains 
I per cent, of Strychnine. Action, — astringent and stimulating. Dose, gr. j-iij. 

Syrupus Ferri, Quininae et Strychninae Phosphatum, Syrup of the Phosphates of 
Iron, Quinine and Strychnine. [Described under Phosphorus.] 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron. [De- 
scribed under Phosphorus.] 



Unofficial Preparations of Iron. 

Ferratin, Acid Albuminate of Iron, — is a patented preparation, which is claimed to 
be the characteristic iron compound of the liver, but this is denied by competent authority. 
It is artificially prepared from albumen, is insoluble in water and dilute acids, but is sol- 
uble in water having a slight alkaline reaction. It causes no digestive disturbance, and 
has given good results in anaemia, chlorosis, and allied affections. Dose, gr. jss-viij, in 
powder or in milk. 

Ferri Albuminas, Iron Albuminate , — a cinnamon-brown powder, soluble in water 
acidulated slightly with HO. Dose, gr. x-xxx, in simple aqueous solution, or in pill. 

Ferri Arsenas, Ferrous Arsenate, Fe 3 As 2 8 , — a green, tasteless powder, insoluble in 
water, soluble in HC1 acid. Its activity is due to the arsenic alone. Dose, gr.y — \. 

Ferrum Dialysatum, Dialysed Iron, — composition varies from Fe 2 Cl 6 + i2Fe 2 3 to 
Fe 2 Cl 6 + 95Fe 2 3 , and is a 10 per cent, solution of Ferric Oxychloride in water. Pre- 
pared by treating a solution of Chloride of Iron with Ammonia, ferric hydrate being 
precipitated, this being dissolved by agitation is placed in a dialyzer and suspended in 
water, which is renewed as long as it shows a trace of HC1 acid. It is a reddish-brown 
liquid, free from astringent, styptic taste, but is a very feeble chalybeate, incapable of 
absorption except by change into a hydrated sesquioxide in the alimentary canal. Is used 
as a chalybeate, and as an antidote to Arsenic, but is not considered an eligible prepara- 
tion. Dose, rr\x-xxx. 

Syrupus Ferri et Manganesii Iodidi, Syrup of Iron and Manganese Iodide, — is a 
pale, straw-colored liquid, containing a little sulphate of potassium, and in each fluid 5 
has 50 grains of the mixed iodides in the proportion of Iron Iodide 3 parts to I of Man- 
ganese Iodide. Dose, rr^ x-xxx- gj. 



284 FERRUM. 

Syrupus Ferri et Manganesii Phosphatis, Syrup of Iron and Manganese Phos- 
phate, — as used by Dr. Simpson, of Edinburgh, contains in each 3 of syrup 2 grains of 
Iron Phosphate and I grain of Manganese Phosphate. Dose, ^j. 

Mistura Ferri Aromatica, Aromatic Iron Mixture, — Pale Bark 4, Calumba 2, 
Cloves I, Iron Wire 2, Tr. Cardamomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50. 
Macerate the first 4 in the last one for 3 days, filter, add the tinctures and make up to 
50 parts. Dose, ^j-ij. 

Mistura Ferri Laxans, laxative Iron Mixture, — Ferri Sulph. gr. ij, Magnesii Sulph. 
gj, Ac. Sulphurici Dil. TT^iij, Spt. Chloroformi rr^xx, Aq. Menth. Pip. ad 3 j. Dose, ^j. 

Mistura Ferro-salina, Ferro-saline Mixture, — Magnesii Sulph. ^j, Potassii Bitart. 
3 j, Ferri Sulph. Exsic. gr. x, Aquoe quart j. Dose, a wineglassful. 

Notes on the Preparations of Iron. 

Oxides and Carbonates, including Ferrum Reductum, Ferri Car- 
bonas Saccharatus, Mistura Ferri Composita, Pil. Ferri Comp., Massa 
Ferri Carb., Ferri Oxidura Hydratum, Ferri Oxidum Hyd. cum Mag- 
nesia, and Mist. Ferri Aromatica, — possess the hematinic action of iron 
with but little astringency, and are therefore selected to restore the blood 
in anaemia, chlorosis and amenorrhcea, with tendency to dyspepsia and 
constipation. The Hydrated Oxides are only used as antidotes in arseni- 
cal poisoning. Ferrum Reductuni is one of the best forms for internal 
use, but gives rise to sulphuretted or phosphoretted eructations which are 
very disagreeable. The Subcarbonate is little more than the Red Oxide, 
but in the Massa Ferri Carb. the oxidation is prevented by the sugar. 

Mineral Acid Salts and their preparations comprise the Sulphate in 
its 3 forms, the solutions of the Subsulphate and Tersulphate, the Phos- 
phate, Pyrophosphate and Hypophosphite, the Chloride and its prepara- 
tions and the Liquor Ferri Nitratis. They are characterized by their 
astringent and corrugating action, and are used locally especially as 
hemostatics, the Solution of the Subsulphate being preferred for topical 
use, as it is powerfully styptic but not corrosive. The Tincture of the 
Chloride is one of the best preparations for internal use, and is most 
agreeable in the form of Creuse's tasteless preparation, which is made as 
follows, — Liq. Ferri Chloridi §j, Acidi Citrici 544 grains, Sodii Carb. 
1000 grains or q. s., Aquae Destil. ^j, Alcoholis q. s. Dissolve the citric 
acid in the distilled water and heat to the boiling point, gradually adding 
sodium carbonate until the acid is saturated ; mix this with the iron solu- 
tion and make up to giv with alcohol. Of the Phosphates the best is the 
Pyrophosphate, which is easily assimilated, readily soluble and entirely 
unirritating. 

Vegetable Acid Salts and their preparations comprise the Lactate, 
the Citrate and its preparations, also the preparations of the Acetate and 
the Tartrate. They are the least irritating to the stomach but are also 
the least efficient as chalybeates. They may be administered in white 
wines, or with alkalies and vegetable acids in effervescing mixtures. 

Other Compounds are those in which Iron is combined with substances 



FERRUM. 285 

equally active, as the preparations of the Iodide, those with Quinine, 
Strychnine, etc. Generally these preparations are used for a twofold 
purpose, namely, to relieve anaemia and at the same time act upon the 
specific ailment on which the anaemia depends. 

The Albuminate is considered by several authorities to be the most 
readily assimilated of all the iron preparations. 

Physiological Action. 

Metallic iron is not inert, for in the stomach it acquires molecular 
activity through its oxidation, setting hydrogen free. It is a normal con- 
stituent of the blood (1 part to 230 of red corpuscles), existing probably 
as an oxide in combination with hematin, which is not formed without 
it. It is also found in the bile, lymph, chyle, gastric juice, in the pig- 
ment of the eye, in the milk and the urine. Given medicinally in small 
doses it promotes appetite and digestion, and improves the quality of the 
blood, increasing the number of the red corpuscles. In the stomach all 
the salts of iron are converted into the Chloride and in the duodenum 
into an alkaline Albuminate, entering the blood along the whole length 
of the alimentary canal. Only a small portion of iron is absorbed, the 
rest being eliminated by the intestinal canal, blackening the feces by 
conversion into a sulphide. Of the portion absorbed from the alimentary 
canal, only a small part reaches the systemic circulation and is eliminated 
by the kidneys, the greater part being excreted by the liver with the 
bile. 

Iron in large doses, or small ones long-continued is directly unfavor- 
able to digestion, nausea and vomiting being produced by the soluble 
preparations ; the per-salts are actively irritant ; the Iodide, Chloride, 
Nitrate and Sulphate being active poisons, are highly astringent, and act 
injuriously on the teeth. 

Locally most of the iron salts are more or less constringing to the tis- 
sues and the mucous membranes, acting as hemostatics and astringents 
by virtue of their power to coagulate albumen, and acting injuriously on 
the teeth. The Tincture of the Chloride is considered diuretic. 

Incompatibles. 

Alkalies and their carbonates, Acids, acidulous salts, and vegetable Astringents are 
incompatible with most preparations of Iron, the latter group being so by virtue of their 
Tannic and Gallic Acids which form a deep blue-black precipitate (Tannate of Iron) 
with the per-salts. The Tincture of the Chloride is decomposed by alkalies, alkaline 
earths and their carbonates, astringent vegetable infusions, and by mucilage of acacia, 
which latter produces therewith a brown, semi-transparent jelly. 

Therapeutics. 
The chief indication for the internal administration of Iron is anaemia, 
when plethora exists it is contraindicated. It should always be given 



286 FICUS. 

after meals, and occasionally suspended for a time, to avoid deranging 
the stomach. When appetite and digestion are promoted by Iron it will 
do the greatest amount of good, many authorities holding that the prin- 
cipal benefit derived from its use, even in anaemia, is due to its stimulat- 
ing action upon digestion and the primary assimilation. The Sulphate is 
here probably the most efficient salt and is well used in combination with 
aloes when there exists any intestinal torpor, especially as it increases 
the cathartic power of the latter drug, economizing it, and conferring 
upon it a permanence of action, which alone it does not possess. In 
pseudo-leucocythsemia, chorea of anaemic girls at the age of puberty, epi- 
lepsy and neuralgia of the anaemic, amenorrhcea and other menstrual dis- 
orders of the same class of subjects, and in acute rheumatism of pale, 
cachectic persons, the chalybeates are generally very efficient remedies, 
especially the Tincture of the Chloride. The same preparation is exten- 
sively employed in erysipelas and diphtheria with good results. In albu- 
minuria with chronic disease of the kidneys the Tincture of the Chloride 
is a useful chalybeate diuretic. In many cardiac diseases of the anaemic, 
fatty heart, weak heart, dilatation, mitral disease, etc., ferruginous prepa- 
rations are often of signal advantage. In the syphilitic cachexia, chancroid, 
and sloughing phagedena, the Iodide gives good results, particularly when 
the subject is one of debilitated constitution. In the nocturnal incon- 
tinence of children the Syrup of the Iodide is one of the most efficient 
remedies. In all chronic affections of the respiratory organs, when hem- 
orrhage is not existing or threatened, the Iron, Quinine and Strychnine 
Phosphate is used with much benefit. In passive hemorrhages, especially 
when due to anaemia, the Tincture of the Chloride is very effective, and 
in all active bleeding the Solution of the Subsulphate locally used is a 
prompt and efficient hemostatic. A weak solution of this preparation (jj 
ad j§viij), used in the form of spray, is the most serviceable astringent in 
obstinate epistaxis, and in hematemesis the same solution may be swal- 
lowed in small quantities at short intervals. In chronic diarrhoea and 
dysentery the Solution of the Nitrate is an efficient astringent, and a weak 
solution of the Chloride is used as a rectal injection against thread- 
worms. 

In arsenical poisoning the most effective antidote is the Hydrated 
Oxide, which forms with Arsenous Acid an almost insoluble compound. 
The solutions used in its preparation should be kept on hand and only 
mixed when wanted for use. 



FICUS, Fig, — is the fleshy receptacle of Ficas Carica, bearing fruit upon its inner 
surface. The fig-tree is a member of the nat. ord. Urticacese and a native of the shores 
of the Levant, but is cultivated in Southern Europe and in other warm countries. Figs 
contain about 62 per cent, of grape sugar, also gum, fat, etc., and are a constituent of the 
official Confectio Sennas. 



FCENICULUM FORMALIN. 287 

Figs are demulcent, laxative and nutritious. They are used in their fresh state as an 
aliment, but if eaten in quantity may produce flatulence, enteralgia and diarrhoea. They 
are chiefly used as an article of diet in habitual constipation, but may be employed as an 
ingredient of demulcent decoctions, and locally as a poultice to gum-boils. 



FCENICULUM, Fennel, — is the fruit of Foeniculum capillace2im, a European 
cultivated plant of the nat. ord. Umbellifene. It contains a volatile oil, united with a 
terpene, and is a constituent of Pulvis Glycyrrhizie Compositus. 

Oleum Foeniculi, Oil of Fennel, — the volatile oil r a light-yellow colored liquid, 
having the odor of fennel, a warm taste and neutral reaction, soluble in alcohol. It is an 
ingredient of Spiritus Juniperi Compositus. Dose, TT^ij— v. 

Aqua Fceniculi, Fennel Water, — contains 2 parts of the oil in 1000 of distilled 
water. Dose, 3SS-5J. 

Fennel is an aromatic stomachic and a mild stimulant. It is chiefly used as an agree- 
able carminative in flatulence and colic, and as a corrigent to Senna, Rhubarb, and other 
disagreeable medicines. An infusion is often used as an enema to expel flatus in infants. 



FORMALIN (Unofficial), — is the proprietary name given by its 
patentees to a 40 per cent, aqueous solution of Formic Aldehyde (see ante, 
page 107), which solution has heretofore been used mainly as a pre- 
servative of meat and in histological work as a fixing agent. It is one of 
the most powerful germicides, equal if not superior to corrosive subli- 
mate and practically non-toxic in the strength employed. It is also a 
most energetic disinfectant, and sprayed over floors and walls or dropped 
on hot plates or sheets of metal, will disinfect a room more effectually 
than any other agent. As a deodorant it is equally efficient, completely 
destroying the peculiar methyl-mercaptan odor of the feces, and entirely 
deodorizing sulphuretted hydrogen. It is rapidly becoming the favorite 
surgical antiseptic. It mixes with water in all proportions, so that any 
dilution required can be easily prepared. To make a 1 per cent, solution 
one part of Formalin is added to forty parts of water (1 oz. to 2 x / 2 
pints), it being itself a 40 per cent, solution. Solutions of 1 per cent, 
strength are sufficiently strong for most purposes, and when sprayed above 
the patient's head by a steam-atomizer for 20 minutes thrice daily have 
proved highly efficient in whooping-cough and chronic bronchitis. Weaker 
solutions (^ per cent.) are used as gargles and mouthwashes and for the 
irrigation of cavities, and stronger ones (2^ percent.) for psoriasis, lupus 
and other skin diseases. Solutions of 1 part in 2,000 or 3,000 are highly 
recommended by Dr. Davidson for local application in the septic abrasions 
of the cornea ending in hypopyon ulcers, which form so large a part of 
ophthalmological work in manufacturing communities. Formalin has a 
tannin-like effect upon the skin, producing a leathery condition which 
passes into that of a localized necrosis without suppuration, leaving the 
surface with the appearance of a newly-healed superficial wound. It has 
marked toxic properties when inhaled in quantity. 



288 FRANGULA FUCHSIN GALBANUM GALLA. 

FRANGULA, Buckthorn, — the bark, collected at least one year before being used, 
of Rhamnns Frangula, or Alder Buckthorn, a European shrub of the nat. ord. Rhamnece. 
It contains several principles, of which the only important one is Frangulin, or Rhamno- 
xanthin, a lemon-yellow, odorless and tasteless glucoside, insoluble in water and but 
sparingly so in alcohol or ether, and thought to be identical with Cathartin, the active 
principle of Senna. Another species of the genus Rhamnus is described under the title 
Rhamnus Purshiana. 

Extractum Frangulse Fluidum, Fluid Extract of Frangula. — Dose, gss-ij. 

Frangula-bark when fresh is a violent irritant to the gastro-intestinal tract, producing 
vomiting, purging, and much pain. The old dried bark is a safe purgative without irri- 
tant qualities, and is much used in the constipation of pregnancy, and other conditions 
requiring purgation. The fluid extract is the best form for administration. 



FUCHSIN, Roseine, Magenta, Anilin Red (Unofficial), — is the Hydrochlorate of 
Rosanilin, C 20 H ]0 N 3 -|- HC1, occurring in brilliant, elongated crystals having a green lustre, 
readily soluble in water and therewith making a bright red solution. Given internally it 
has produced salivation, vomiting, and diarrhoea; and when injected intravenously it has 
caused trembling, staggering, albuminuria and fatty degeneration of the kidneys, symptoms 
which are thought to be possibly due to the presence of Arsenic or Anilin as impurities. 
It imparts a magenta color to the urine, and is excreted by the kidneys, liver and salivary 
glands. It has been found to be very efficient in reducing albuminuria, in many instances 
having entirely arrested it. It is best administered in pill with a vegetable extract as 
Liquorice or Gentian, and in doses of gr. )4-iv, according to age. 



FUCUS VESICULOSUS, Bladder-wrack, Sea-wrack (Unofficial),— is a peren- 
nial plant of the nat. ord. Algae, growing on the shores of the Atlantic and Pacific Oceans 
as a sea-weed. It has a flat leaf, with a midrib throughout its length, and small spherical 
vesicles, filled with air, in the leaf. It contains mucilage and much Soda in saline com- 
bination, also Iodine, but less of the latter than other algce growing in deeper water. A 
decoction of the fresh plant is the best form for administration. 

Fucus Vesiculosus is one of a number of marine plants which are used in various parts 
of the world as food for man and cattle and as manure. The species under consideration 
is considered alterative and tonic, and has been employed in goitre, glandular and joint 
enlargements and psoriasis, but especially to produce absorption of adipose tissue in the 
obese. An extract is sold under the title " Anti-fat." 



GALBANUM (Unofficial), — is a gum-resin obtained from Ferula galbatiif.ua, an 
Asiatic plant of the nat. ord. Umbelliferae, and probably from other allied plants. It 
occurs in minute tears, agglutinated into a hard mass, of balsamic odor and acrid, bitter 
taste. It contains a Volatile Oil isomeric with Turpentine, a Gum, and a mixture of 
Resins which yield by dry distillation a blue oil and Umbelliferon, a tasteless substance 
in satiny crystals. Dose, gr. x-xx, in pill or emulsion. 

Galbanum is stimulant, expectorant and antispasmodic, acting much like Ammonia 
and Asafetida, and usually given with either of these substances. It is used in chronic 
bronchitis and catarrh of mucous membranes generally, in amenorrhoea and chronic rheu- 
matism. 



GALLA, Nutgall, — is an excrescence on Quercus lusilanica, the Dyer's Oak, a 
shrub of the nat. ord. Cupuliferae, growing in Western Asia, and is caused by the punc- 
ture and deposited ova of the insect Cynips Gallce tinctoricz. Galls are hard, globular 
bodies, of blackish-gray color, tuberculated on the surface, having a central cavity and 
an intensely astringent taste. They contain from 15 to 75 per cent, of Tannic Acid, 
about 5 per cent, of Gallic Acid, and other unimportant constituents. Dose, gr.v-xv. 

Tinctura Gallae, Tincture of Nutgall, — strength 20 per cent. Dose, ^ss-iij. 

Unguentum Gallae, Nutgall Ohitment, — strength 10 per cent. 

The action of Nutgalls is powerfully astringent, due to the Tannic and Gallic Acids 



GAULTHERIA GELSEMIUM. 289 

contained in them. Having no special action or use of their own, their qualities may be 
learned by consulting the articles Acidum Tannicum and Acidum Gallicum, ante, 
pages 94 and 84. 



GAULTHERIA, Wintergreen (Unofficial), — is the leaf of Gaultheria procumbens, 
an American evergreen plant of the nat. ord. Ericaceae. Its active principle is the Vola- 
tile Oil, which is official. It also contains Tannic Acid, Arbutin, Orson, Ericolin, etc. 

Oleum Gaultheriae, Oil of Wintergreen, — is the volatile oil, a liquid of peculiar and 
aromatic odor, sweetish, warm taste, and a slightly acid reaction. It is readily soluble 
in alcohol, and consists of Methyl Salicylate 90 per cent., and Gaultherilene, a hydrocar- 
bon, 10 per cent. Dose, Tnjij-x. It is nearly identical with the Volatile Oil of Betula. 

Spiritus Gaultheriae, Spirit of Gaultheria, — has of the oil 5 per cent., dissolved in 
95 of alcohol. Used for flavoring. Dose, ^ss-ij. 

Gaultheriae is stimulant and slightly astringent. Its chief value is as one of the sources 
of the oil named after it, which is also found in the sweet birch and many other plants, 
and, containing so large a proportion of Methyl Salicylate or Methylsalicylic Acid, is 
powerfully antiseptic and antipyretic. In large doses it is irritant to the stomach, in one 
case ^j having caused death by violent gastritis. 

Oil of Gaultheria is used successfully as a substitute for Salicylic Acid in many condi- 
tions, especially in rheumatic and gouty disorders. The plant has been used as an 
emmenagogue and a galactagogue, but its principal employment is in the form of the 
spirit as an agreeable flavoring agent. 



GELSEMIUM, Gelsemium {Yellow Jasmine), — is the rhizome 
and roots of Gelsemium sempervirens, a climbing plant of the nat. ord. 
Loganiaceae, with showy yellow flowers, which grows in the forests of the 
southern U. S., forming festoons from one tree to another. It contains 
a volatile oil, a resin and an alkaloid, Gelsemine, in combination with 
Gelsemic Acid. Dose, gr. ij-xx. 

Preparations. 
Extractum Gelsemii Fluidum, Fluid Extract of 'Gelsemium. — Dose, Tnjj-xx. 
Tinctura Gelsemii, Tincture of Gelsemium, — strength 15 per cent. Dose, Tr^x- 5[j. 
Gelsemina, Gelsemine, C n H ]9 N0 2 (Unofficial), — an amorphous, colorless, inodorous, 
nearly insoluble solid, of intensely bitter taste, and strong basic properties, neutralizing 



Physiological Action. 
Gelsemium is a powerful motor-depressant, causing paralysis of motility 
and depression of sensibility by central action on the spinal cord. It is 
also antispasmodic and diaphoretic. In moderate doses it produces 
languor, slowing of the cardiac rate, enfeebled muscular action, impaired 
sensibility, drooped eyelids and dilated pupils, with some diaphoresis. 
In toxic dose, as a teaspoonful of the fluid extract, it produces vertigo, 
diplopia, drooped eyelids and dilated pupils (paralysis of 3d nerve), 
labored respiration, slow and feeble heart, dropped jaw, staggering gait, 
extreme muscular weakness and almost complete anaesthesia, profuse dia- 
phoresis, loss of articulation, and death by asphyxia from paralysis of the 
muscles of respiration, consciousness being preserved until C0 2 narcosis 
19 



29O GENTIANA. 

sets in. Convulsions, with backward movements, occur in animals but 
not in man. Motion is affected before sensibility in warm-blooded ani- 
mals, sensibility before motion in frogs. 

Gelsemium is not an arterial depressant, although it lowers the heart- 
rate, and is not irritant to the gastro-intestinal tract, but it produces a 
decided lowering of the body temperature. The effects of a moderate 
dose pass off in about three hours. 

Antagonists and Inco?npatibles. 

Morphine is the most complete antagonist, so are also Digitalis, Ammonia, Alcohol, 
and to some extent the tincture of Xanthoxylum fraxineum. Emetics, heat, faradization 
of the respiratory muscles and artificial respiration are measures of prime importance. 
The caustic Alkalies and Tannic Acid are chemically incompatible. 

Therapeutics. 

Gelsemium is indicated in all conditions of exalted nerve function, and 
contra-indicated whenever there is a weak heart. It is best used in 
cerebro-spinal meningitis, mania with great motor excitement and persist- 
ent insomnia, delirium tremens, many forms of sleeplessness, pneumonia 
and pleurisy if the heart be strong, coughs of convulsive and spasmodic 
character, neuralgia of the fifth nerve, remittent fever, after-pains, ovarian 
neuralgia, dysmenorrhcea, irritable bladder of women, and incontinence 
of urine from spasm of the vesical muscular fibres. In most of these 
affections the remedy must be pushed to the inducing of some physio- 
logical symptoms, but its action should not be carried beyond the pro- 
duction of drooped eyelids, diplopia and muscular debility. It has also 
been used with varying success in intercostal neuralgia, myalgia, sciatica, 
spasmodic asthma, sick headache, eczema, pruritus and tetanus. Its 
especial field, however, is in remittent and typho-malarial fevers and 
cerebro-spinal meningitis. It is not suitable to low fevers and has not 
sufficient power as a cardiac depressant to be of much use in sthenic forms. 

There is much evidence for the claim, made for the drug Gelsemine, of 
singular efficiency in antagonizing the mental condition occasionally 
manifested by an unusual degree of dread, in regard to some approach- 
ing ordeal, or ordinary trial of life ; as, for example, that of a woman 
concerning her impending confinement, or of a student in reference to 
his examinations. In very many such cases, the use of Gelsemine, in 
small doses frequently repeated (g r . T -J--g- ter die), has seemed to remove 
the state of abnormal fear entirely. 



GENTIANA, Gentian, — is the root of Gentiana lutea, the Yellow 
Gentian, one of a numerous family of plants (nat. ord. Gentianeae), 
inhabiting the mountainous districts of Europe. An American species, 
G. Catesbcei, Blue Gentian, is considered nearly equal in value to the 



GERANIUM GLYCERINUM. 29 1 

official species. It contains an active, bitter glucoside, Gentopic?'in or 
Gentianin, C 20 H3 O 12 , which is crystalline and soluble in water, also an 
inert, amorphous body, Gentianic or Gentesic Acid, gum, considerable 
sugar, and a trace of volatile oil, but no tannin. 

Preparations . 
Extractum Gentianae, Extract of Gentian, — aqueous. Dose, gr. j-v. 
Extractum Gentianae Fluidum, Fluid Extract of Gentian, — Dose, gss-j. 
Tinctura Gentianae Composita, Compound Tincture of Gentiaji, — Gentian 10, 
Bitter Orange Peel 4, Cardamon I, Alcohol and Water to 100. Dose, gss-ij. 

Unofficial Preparations. 

Infusum Gentianae Compositum, Compound Infusion of Gentian, — contains Gen- 
tian 10, Bitter Orange Peel 2^, Coriander 2.y z , Alcohol 40, Water to 320. Dose, 3J-3 j. 

Mistura Gentianae Alkalina, Alkaline Mixture of Gentian, — Ac. Hydrocyan. Dil. 
TTViij, Sodii Bicarb, gr. xv, Infusum Gentianae Co. to ^j. One dose. 

Mistura Gentianae et Sennae, Mixture of Gentian and Senna, — Infusum Senna? 
3 iij , Tr. Cardamomi Co. £j, Infusum Gentianae Co. ^yj. One dose. 

Physiological Action and Therapeutics. 
Gentian is a simple bitter without astringency or aroma, its action cor- 
responding to that of Calumba (see ante, page 203), but it is more apt 
to disagree with the stomach. In addition, like Cornus, a member of 
the same class, it has considerable repute as an antiperiodic and feb- 
rifuge. Gentian has been considered a valuable tonic throughout all 
Europe from the earliest historical times. It is highly esteemed as a 
stomachic tonic in dyspepsia connected with a gouty diathesis, in hysteria, 
jaundice, and convalescence from acute diseases and from malarial fever. 
The compound tincture is an excellent vehicle for cod-liver oil, and the 
now unofficial infusion is a good vehicle for the administration of chaly- 
beates, mineral acids and neutral salts. The discoloration which iron 
salts make with gentian preparations is probably due to Gentesic Acid 
and not to tannin, as it contains none of the latter. 



GERANIUM, Cranesbill, — is the rhizome of the indigenous perennial Geranium 
maculatum (nat. ord. Geraniaceae) . Its active constituents are tannic and gallic acids. 

Extractum Geranii Fluidum, Fluid Extract of Geranium. — Dose, rr^v-^j. 

Geranium is an efficient astringent, and its action corresponds with that of Tannic 
Acid (see ante, page 94). Having no unpleasant taste it is a useful agent for infants and 
others having delicate stomachs, and is a very popular domestic remedy in many parts of 
the country. It is especially used in diarrhoeas, dysentery, cholera infantum, hemor- 
rhages, relaxed conditions of mucous membranes, gleet and leucorrhcea. 



GLYCERINUM, Glycerin, — is a liquid, obtained by the decom- 
position of vegetable or animal fats or fixed oils, containing not less than 
95 per cent, of absolute Glycerin, C 3 H 5 (HO) 3 , which is a sweet principle 
existing in fats and fixed oils in combination with the fatty acids. 



292 GLYCERINUM. 

Glycerin is a clear and colorless liquid, of syrupy consistence, hygroscopic, non-drying, 
odorless, of warm and very sweet taste, neutral reaction, sp. gr. 1. 250, soluble in water 
and alcohol, but insoluble in ether, chloroform and fixed oils. It dissolves Tannin, 
Gallic Acid, Carbolic Acid, Salicylic Acid, Bromine, Iodine, etc., and with the aid of 
heat metallic salts and oxides, alkaloids, etc. With strong Nitric Acid it forms Nitro- 
glycerin, and it reduces Potassium Permanganate, Chromic Acid and Chlorinated Lime 
with great violence. An impurity frequently present in it is Acrolein, formed by the use 
of too high a heat in its manufacture, and which is very acrid and poisonous. Glycerin 
is a constituent of the 6 Glycerites, Pilulse Phosphori, Mucilago Tragacanthae, Massa 
Hydrargyri, and several extracts and fluid extracts. Dose, £j-ij, diluted. 

Preparations. 

Suppositoria Glycerini, Suppositories of Glycerin, — each has Sodium Carbonate, 
grains 4^, Stearic Acid, grains *]%, dissolved by heat in 90 grains of Glycerin, cooled 
in a mould, and wrapped in tin-foil. Used per rectum in chronic constipation. 

Glycerites of Carbolic Acid, Tannic Acid, Starch, Boroglycerin, Hydrastis, Yolk of 
Egg, — are described under the titles of their respective ingredients. 

Glycozone (Unofficial), — is described under Oxygenium. 

Physiological Action and Therapeutics. 

Glycerin is highly antiseptic, abstracts water from tissues with which it 
comes in contact, and unless pure is often very irritating to the skin. It 
is freely absorbed by all surfaces, cutaneous and mucous, and is decom- 
posed in the system, passing out as formic and other acids. On the 
stomach it has no particular action, but in large quantities it is laxative 
and is said to cause the solution of the red blood corpuscles and hemo- 
globinuria. The urine of persons using glycerin contains a body which 
acts like sugar in the copper and fermentation tests, but is not sugar. 
Glycerin is a good emollient and is considered nutritive by many authori- 
ties. 

Glycerin has been used as a substitute for Cod-liver Oil in wasting dis- 
eases, but with little benefit. It has also been tried as a remedy in dia- 
betes, but with unsatisfactory results so far as reported, except as a 
sweetening substitute for sugar in the dietary of those afflicted with that 
disease. It is said to be fatal to intestinal trichinae, and to be an efficient 
internal remedy in acne and flatulence. In chronic constipation, most 
excellent results are obtained from rectal enemata of Glycerin, or from 
the official suppositories thereof. As a vehicle it is used for many drugs, 
and is a good ingredient of solutions for hypodermic use, promoting the 
solubility of many alkaloids and acting as an antiseptic. It is also em- 
ployed to preserve and aid the action of the digestive ferments, Pepsin 
and Pancreatin, as well as to prevent the decomposition of vaccine lymph. 
Locally it is valuable in many cutaneous affections as an emollient and 
softening agent. In acute coryza it gives great relief if applied by a 
brush or as a spray to the nasal mucous membrane. It is used on cotton 
to the cervix uteri as a depleting agent, and mixed with an infusion of 
flaxseed as an enema to relieve tenesmus in acute dysentery. With tinc- 
ture of Benzoin it is an excellent application to chapped hands or lips 



GLYCYRRHIZA. 293 

and fissured nipples. In the external auditory canal it is usefully em- 
ployed to soften cerumen, diminish the secretion of pus, deplete the 
tissues, and keep the surface moist. 



GLYCYRRHIZA, Glycyrrhiza, Liquorice Root,—\s the root of 
Glycyrrhiza glabra, var. glandulifcra, a plant of the nat. order Legumi- 
nosse, native in southern Europe and Asia, but largely cultivated in many 
other parts. It contains a yellow, amorphous glucoside, Glycyrrhizin, 
C 24 H 36 9 , also Glycyrrhizic Acid, Asparagin, sugar, resin, gum, etc. 
Glycyrrhizin when boiled with dilute acids yield glucose and a very bitter 
substance named Glycyrreti?i. 

Preparations . 

Extractum Glycyrrhizae, Extract of Glycyrrhiza, — is the commercial extract of the 
root, occurring in glossy-black rolls, of sweet, peculiar taste. Xot less than 60 per cent. 
of it should be soluble in cold water. 

Extractum Glycyrrhizae Purum, Pure Extract of Glycyrrhiza, — made with Aqua 
Ammonias and Water, by percolation and evaporation to a pilular consistence. Dose, 
indefinite. 

Extractum Glycyrrhizae Fluidum, Fluid Extract of Glycyrrhiza, — made with 
Aqua Ammonias and diluted Alcohol. Dose, indefinite. 

Mistura Glycyrrhizae Composita, Co??ipound Mixture of Glycyrrhiza, — Brozun 
Mixture, — has of the Pure Extract 3 parts, Syrup 5, Acacia 3, Tr. Opii Camph. 12, 
Vinum Antimonii 6, Spt. .Etheris Xitrosi 3, and Water to 100. Dose, ^ j-^ j. 

Pulvis Glycyrrhizae Compositus, Compound Powder of Glycyrrhiza, — Senna 18, 
Glycyrrhiza 23^, Oil of Fennel 4, Washed Sulphur 8, Sugar 50 parts. Dose,^j. 

Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opiicm, — each has of 
Extract of Glycyrrhiza gr. ij. Powdered Opium gr. J3, Acacia, Sugar and Oil of Anise. 
Dose, j-ij every hour. 

Glycyrrhizinum Ammoniatum, Ammoniated Glycyrrhizin, — the sweet principle of 
Liquorice rendered soluble and therefore tasteable by Ammonia, believed to be the form 
in which Glycyrrhizin exists in the root. Occurs in brownish-red scales, very sweet, and 
soluble in water or in alcohol. Dose, gr.v-xv. Is a constituent of Velatine, for which 
see page 242. 

Physiological Action and Therapeutics. 
Liquorice is demulcent and mildly laxative. It has an agreeable taste, 
and increases the flow of saliva and mucus when slowly chewed or sucked, 
the increased secretions acting as emollients to the throat. It is used in 
many pharmaceutical preparations, covering the taste of Senna, Senega, 
Hyoscyamus, Turpentine, Ammonium Chloride, the bitter Sulphates, and 
to some degree the bitterness of Quinine. The powdered extract or 
root is used as an excipient in pills and troches. The Compound Mixture 
is an efficient expectorant, much employed in acute bronchitis and 
catarrhal laryngitis, but owing its power over cough mainly to the Opium 
contained in it. The Compound Powder is a gentle laxative, of which 
Senna is the most active ingredient. The Troches are used for cough, 
but must be carefully prescribed to children, as each troche contains gr. 
^3 of Powdered Opium. 



294 GOSSYPIUM. 

GOSSYPIUM, Cotton,— is the hairs of the seed of Gossypium 
herbaceum, and of other species of Gossypium (nat. ord. Malvaceae), freed 
from adhering impurities and deprived of fatty matter. In this form it is 
official as Gossypium Purificatum, Purified Cotton, Absorbent Cotton, 
insoluble in ordinary solvents, but soluble in copper ammonium sulphate 
solution. Cotton-fibre is familiar in appearance to every one, but when 
examined microscopically, it shows as flattened, hollow and twisted bands, 
spirally striate, and slightly thickened at the edges. It is a modification 
of Cellulose, C 12 H 10 O 10 , and corresponds therewith in all its ordinary 
chemical properties. 

Preparations of the Cotto?i Plant. 

Gossypii Radicis Cortex, Cotton Root Bark, — thin bands or quilled pieces, brownish- 
yellow exteriorly, white interiorly, of slightly acrid and astringent taste. Dose, gr. xxx— 3 j. 

Extractum Gossypii Radicis Fluidum, Fluid Extract of Cotton Root Bark, — made 
with Glycerin and Alcohol, by maceration and percolation. Dose, rr^xxx-3 j. 

Oleum Gossypii Seminis, Cotton-seed Oil, — the fixed oil expressed from the seeds 
and purified. Is yellow, odorless, of bland taste and neutral reaction, soluble in ether, 
but slightly soluble in alcohol. Is introduced into the pharmacopoeia for the reason that 
it constitutes most of the " Olive Oil " sold in foreign-shaped bottles and under foreign- 
appearing labels. It is used in the official Liniments of Ammonia and Camphor. 

Pyroxylinum, Pyroxylin, Soluble Gun-cotton, Colloxylin, — is official for the purpose 
of making Collodium. It is prepared by macerating Cotton in a mixture of Sulphuric 
and Nitric Acids, washing, draining and drying. 

Collodium, Collodion, — made by dissolving Pyroxylin 3, in Ether 75 and Alcohol 25. 

Collodium Flexile, Flexible Collodion, Collodion 92, Canada Turpentine 5, Castor 
Oil 3, mixed thoroughly. 

Collodium Stypticum, Styptic Collodion, — Ether 25, Alcohol 5, Tannic Acid 20, 
Collodion to 100. 

Collodium Cantharidatum, Cantharidal Collodion, Blistering Collodion, — Canthar- 
ides 60, Flexible Collodion 85, Chloroform q. s. to 100. 

Physiological Action. 
Cotton-root is believed to be an efficient emmenagogue and oxytocic 
by Southern practitioners, also somewhat of a galactagogue, but experi- 
ments on pregnant animals have not confirmed this view of its action. 
The Oil of the seed is very bland and may be applied to all the purposes 
for which Olive Oil is used. Cotton itself, when freed from oily matter, 
is remarkably absorbent of water, and is a good agent for excluding air 
from injured surfaces. Pyroxylin is highly inflammable, and explosive 
at 300 F. Collodion is also inflammable, and rapidly dries on exposure 
to the atmosphere by evaporation of its ether, leaving a transparent film 
of Pyroxylin on the surface to which it has been applied ; which film, if 
the flexible collodion be used, does not contract on drying or readily 
crack, making it an excellent protective application. Styptic Collo- 
dion is a solution of Tannin, and is an excellent hemostatic. Canthari- 
dal Collodion is a convenient blistering agent, suitable for cases where 
the patient is inclined to remove a blister if applied in the ordinary way. 



GRANATUM. 295 

Therapeutics. 

Absorbent Cotton is a valuable agent in surgical practice, being em- 
ployed as an application in burns and scalds, erysipelas, articular rheuma- 
tism, etc., to exclude the atmosphere, allay pain, and when covered with 
oiled silk or rubber cloth to keep up local perspiration. It may be car- 
bolated, borated or salicylated, by soaking in the respective solutions, 
and is then used as an antiseptic dressing for wounds, ulcers, etc. It is 
employed by the pharmacist in funnels to filter oils, and for the prepara- 
tion of the official waters. 

Cotton-root Bark is much employed by the negroes of the Southern 
States in decoction as a supposed abortifacient, oxytocic and emmena- 
gogue. It is used in the south for intensifying uterine action in normal 
labor, in dysmenorrhcea and amenorrhcea. A decoction, of §iv in a 
quart of water boiled to a pint, is the favorite preparation, administered 
in wineglassful doses. 

Collodion is used as a protective covering for superficial burns, ulcers 
and wounds, slight cuts, cracked nipples, anal fissures, and erysipelas. 
For these affections the flexible collodion should be used, but where it is 
desirable to produce pressure on the part the ordinary form is best, as it 
contracts with considerable force in drying. This property makes it 
highly useful in drawing the edges of wounds together, bringing pressure 
on buboes, incipient boils, carbuncles ; etc. Styptic Collodion has 
many uses as a hemostatic and protective which will suggest themselves, 
and the Cantharidal form is a convenient epispastic for uneven surfaces, 
the therapeutics of which are detailed under Cantharis. 

GRANATUM, Pomegranate, — is the bark of the stem and root 
of Pmiica Granatum, a small tree of the nat. ord. Lithrarieae, cultivated 
in subtropical countries. It contains Tannic and Punico-tannic Acids, 
Mannite and an active liquid alkaloid Pelletierine, C 8 H ]3 NO, which is 
soluble in water, alcohol, ether, chloroform, etc., and has strong basic 
properties. There are no official preparations. 

Unofficial Preparations. 

Extractum Granati Fluidum, Fluid Extract of Pomegranate. — Dose, ^ss-jss. 

Decoctum Granati, Decoction of Pomegranate, — 3 xvij of bark from the fresh root 
in ~ xvij of boiling water, boiled down to g xij and strained. Dose, ^ iv-vj every hour, 
preceded and followed in a few hours by a brisk cathartic. The decoction of the Br. 
Pilar, is of I to 8 strength and is given in doses of £ ij_iv. 

Pelletierinae Tannas, Pelletierine Tannate. — Dose, gr.v-xx, taken fasting and fol- 
lowed in 15 minutes by a sharp purgative. 

Physiological Action and Therapeutics. 
Granatum and its alkaloid are taeniafuge, and very efficiently so, rarely 
failing to bring away the whole worm. The decoction is usually em- 



296 GRINDELIA. 

ployed, but lately Pelletierine has been coming into fashion, a proprietary 
form being sold as " Tanret's Pelletierine" in bottles containing one 
adult dose at three dollars each. The decoction, in full doses, causes 
nausea and vomiting, flatulence, purging, and sometimes cramps in the 
legs, giddiness, dimness of vision, general numbness of the limbs and 
increase of the quantity of urine. 

For the expulsion of tape-worm a mixed treatment by Pomegranate-root bark, Pump- 
kin seeds and Oleoresin of Male-fern is preferred by many practitioners. The following 
formula has proved very efficient. R . Granati 31J, Aquas Ojss, boiled to ^ vij ; Pep- 
inis 5J, deprived of outer coats and beaten to a paste with fine powdered sugar; Oleo- 
resinae Aspidii, gr. xxx, made into emulsion with Acacia and the above decoction of 
Granatum, then added to the paste of Pepo, and flavored with Syrups up to j|ix. One- 
third of this to be taken in the morning after a light diet and a laxative on the previous 
day. If not successful the second and third portions may be taken at intervals of 3 hours. 
The worm should be passed sitting in a tepid sitz-bath, to prevent the expelled portion 
tearing off the head by its weight. 



GRINDELIA, — is the leaves and flowering tops of Grindelia robusta, 
and of Grindelia squarrosa, herbaceous perennial plants of the nat. ord. 
Composite, indigenous to the Pacific slope of the United States and 
Mexico, where they are common along the coast and in the mountains, 
having yellow flowers, a balsamic odor and a pungent, aromatic and 
bitter taste. They contain a resin, which is probably the active con- 
stituent, a fixed and a volatile oil, also Robustic Acid and an alkaline 
principle named Grindeline. There is but one official preparation. 

Extractum Grindeliae Fluidum, Fluid Extract of Grindelia, — is alcoholic and 
contains much resin. Dose, n\x— 3 j or more, every 3 or 4 hours, in sweetened water or 
milk, the mixture being well stirred to prevent the resin adhering to the glass. 

Physiological Action and Therapeutics. 

Grindelia has an acrid, bitter taste, and excites the secretion of saliva 
when chewed. Its principal action is that of an antispasmodic, but it is also 
a motor-depressant, somewhat expectorant and decidedly diuretic. Given 
in large doses to small animals it induces paralysis, beginning in the hind 
extremities and affecting the sensory nerve-trunks first, then the sensory 
side of the spinal cord, afterward involving the motor nerve-trunks, and 
finally the spinal motor tract. It stimulates the cardiac inhibitory appa- 
ratus and the vaso-motor centre, slowing the heart and respiration, and 
raising the blood-pressure. In sufficient quantity it causes dilatation of 
the pupils, reduced cutaneous sensibility and sluggish reflexes, even nar- 
cotism in small animals. Its elimination occurs by the bronchial mucous 
membrane and the kidneys, both of which it stimulates, and in large doses 
it has produced renal irritation. 

Grindelia is chiefly employed as a palliative in spasmodic asthma and 
the dyspnoea accompanying bronchitis. In several cases of recurring 
asthma in elderly persons gss of the fluid extract has afforded almost 



GUAIACUM. 297 

instantaneous relief, but has not prevented the return of the paroxysms. 
It is an efficient remedy in chronic bronchitis, especially that of the aged, 
also in whooping-cough and other spasmodic coughs, in hay fever and in 
the dyspnoea of various pulmonary and cardiac affections, and has been 
employed with benefit in chronic cystitis. Locally, it is used with 
advantage as a lotion for the dressing of burns and blisters, in vaginitis 
and uterine catarrh, and to allay the pain of herpes zoster. In the pro- 
portion of 1 part of the fluid extract to 9 of water, as a sedative lotion, it 
is a very efficient application for the cutaneous irritation due to poison-oak 
or ivy, also in skin diseases attended with itching and burning sensations. 

GUAIACUM, Lignum Vitae, — is official in two forms, — Guaiaci 
Lignum, the heart-wood of Guaiacum officinale and of Guaiacum sanctum, 
and Guaiaci Resina, Guaiac, the resin of the wood of Guaiacum offi- 
cinale, a large West Indian tree of the nat. ord. Zygophylleae. The Resin 
is the important constituent, and itself consists of three resins, namely, 
Guaiaconic Acid, C 19 H 20 O 5 , 70 per cent , Guaiac Acid, C 6 H 8 3 , resem- 
bling Benzoic Acid, and Guaiarec Acid, C 20 H 26 O 4 ; also an indifferent 
resin. The wood also contains a yellow coloring matter, gum, etc., and 
yields, by destructive distillation, Guaiacol, (see ante, page 256). 

Guaiaci Lignum, Guaiacum Wood, — generally used in the form of 
raspings of greenish-brown color containing whitish particles, of resinous 
odor, taste slightly acrid. Is a constituent of Decoctum Sarsaparillae 
Compositum. 

Guaiaci Resina, Guaiac, — occurs in large masses of a greenish-brown 
or reddish-brown color, feebly aromatic, taste somewhat acrid, fracture 
having a glassy lustre, insoluble in water, soluble in alcohol, ether, chlo- 
roform and alkaline fluids. Dose, gr.v-xxx, in wafer. Is a constituent 
Of Pil. Antimonii Compositae. 

Preparations. 

Tinctura Guaiaci, Tincture of Guaiac,— 20 per cent. Dose, V\y—%], in mucilage 
or syrups, as the resin is precipitated by water. 

Tinctura Guaiaci Ammoniata, Ammoniated Tincture of Guaiac, — has of Guaiac 
20, Aromatic Spirit of Ammonia to 100. Dose, TTLv-gss. 

Physiological Action and Therapeutics. 
Guaiac is diaphoretic, expectorant and alterative; also laxative and 
purgative, according to the dose administered. Its taste is acrid and 
very disagreeable. Internally it is a local stimulant, producing salivation, 
an acrid sensation in the throat, warmth in the epigastrium, increase of 
the gastric and intestinal secretions and the flow of bile, and reflex stimu- 
lation of the heart. Its continued use causes gastric catarrh, and in large 
doses it is a gastro-intestinal irritant, causing vomiting, purging and 
severe congestive headache. Though a colloidal body it enters the blood, 



290 GUARANA GURJUN BALSAM HjEMATOXYLON. 

stimulates the liver and other excretory glands and the production of 
bronchial mucus, and causes increased circulation and diaphoresis. 
Sometimes it fails to act on the skin and then it is markedly diuretic. 

Mineral Acids and Spirit of Nitrous Ether are chemically incompatible with Guaiac 
preparations. 

Guaiacum was first used as an antisyphilitic, being employed in decoc- 
tion and in large quantity, with a spare diet and external warmth. It 
acquired a great reputation in that disease during the 16th century, but 
it is now abandoned therefor except as an ingredient of the Compound 
Decoction of Sarsaparilla. It is a very efficient remedy in tonsillitis, 
given in ^ss doses of the tincture in emulsion with mucilage or yolk of 
egg, to abate the inflammation and abort the disease. It has considerable 
reputation in neuralgic dysmenorrhcea, amenorrhcea, chronic rheumatism, 
gout, lumbago and sciatica. The ammoniated tincture in water makes a 
cleanly and not very disagreeable gargle. The effectiveness of Guaiac in 
many chronic and obscure complaints is due, partly to its purgative prop- 
erty and partly to its nastiness, a quality which is highly appreciated by 
many patients. 



GUARANA, — is a dried paste chiefly consisting of the crushed or pounded seeds of 
Paullinia Cupana, a climbing plant of the nat. ord. Sapindaceae, growing in Brazil. It 
occurs in brown cakes or sticks, having an odor of chocolate, and a bitter, astringent taste, 
partly soluble in water and in alcohol. It contains 25 per cent, of tannic acid, gum, albu- 
men, starch, and a greenish fixed oil, also an alkaloid Guaratzine (5 per cent.), which is 
thought to be identical with Caffeine. The specimens of Guarana in the market are very 
untrustworthy, unequal in quality and expensive, it being a secret mixture prepared in 
Brazil. Hence it has been omitted from the list of Squibb' s preparations, a fluid extract 
of green coffee being substituted in its place. 

Extractum Guaranae Fluidum, Fluid Extract of Guarana. — Dose, V\x-%i]. 

Guarana has similar actions to those of Coffee, the active principles of both plants being 
perhaps identical, both chemically and physiologically. It is chiefly employed in the 
treatment of nervous sick-headache (migraine) administered in half-drachm doses of the 
fluid extract when the attack is developing. It has been used in the diarrhoea of phthisis, 
convalescence from acute diseases, and generally in conditions requiring tonic treatment. 



GURJUN BALSAM, Balsamum Dipterocarpi, Wood Oil (Unofficial),— is an 
oleoresin obtained from incisions in various trees of the genus Dipterocarpus, growing in 
India. It is thick, opaque and grayish-brown by reflected light, soluble in chloroform 
and partly so in alcohol, ether and volatile oils, odor balsamic, taste bitter. It contains 
from 40 to 70 per cent, of a Volatile Oil, a Resin and Gurjunic Acid. Dose, rr^x-g ij, 
in emulsion, or in capsules. 

The properties of this balsam are similar to those of Copaiba, but it is less disagreeable 
and less apt o upset the stomach, also less actively diuretic. It has been used with good 
success in leprosy, given internally in full doses and used locally at the same time. Mixed 
with 4 parts of Lime-water it is well applied in chronic eczema, lupus and psoriasis. 



HjEMATOXYLON, Log-wood, — is the heart-wood of Hcematoxylon campe- 
chianum, a tree of the nat. ord. Leguminosae, native of tropical America, but naturalized 
in the West Indies. It occurs in chips or powder of a dark brown-red color, often with 
a greenish lustre, and colors the saliva a dark pink when chewed. It contains Tannic 



HAMAMELIS HEDEOMA. 299 

Acid, and a sweet, crystalline coloring principle named Hematoxylin , C ]0 H 14 O 6 , which 
is colorless when pure, but turns red on exposure to light. 

Extractum Hsematoxyli, Extract of Hoematoxylon, — Dose, gr.v-xx. 

Decoctum Haematoxyli, Decoction of Hczmatoxylon (Unofficial), — strength I in 17. 
Dose,3J-ij. 

Logwood is mildly astringent, its properties depending on the Tannin contained in it. 
As it is devoid of irritating qualities it is well adapted to the diarrhoeas and hemorrhages 
of young children. It does not produce constipation nor disorder the bowels, but colors 
the urine and stools blood-red, and has caused phlebitis. It has been used as an hemostatic 
in bleeding of the lungs, and hemorrhages from the uterus and intestines, and as an as- 
tringent in leucorrhcea. 



HAMAMELIS, Witch-hazel, — the leaves, collected in autumn, 
of Har?iamelis virgi?iiana, a shrub of the nat. ord. Hamamelaceae, growing 
in the United States. They contain about 8 per cent, of Tannic Acid, a 
bitter principle and probably some volatile matters, but the chemistry of 
the plant has not been fully studied. 

Preparations. 

Extractum Hamamelidis Fluidum, Fluid Extract of Hamamelis. — Dose, n\j-gj, 
is the only official preparation, and is prepared from the leaves. 

Hamamelin (Unofficial), — is an uncertain extract of very indefinite composition. 
Dose, gr. j-ij. 

Distilled Extracts, so-called, but really Waters distilled from the bark, are sold by 
various manufacturers, and are said by the vendors to contain the volatile principles of 
the plant. Pond's Extract is such a preparation, said to be made by distilling the bark 
with a very dilute alcohol, and is a proprietary medicine of uncertain composition. 

Physiological Action and Therapeutics. 
No trustworthy experimentation has yet been made with this drug. It 
is tonic, astringent, styptic and sedative, owing most of its properties to 
its Tannin, but appears to possess some special influence over the venous 
circulation similar to that of Aconite on the arterial system. In full 
doses it may produce severe throbbing pain in the head. It is used both 
internally and locally with great benefit in hemorrhoids, particularly those 
of the bleeding variety, varicose veins and ulcers, varicocele, venous con- 
gestions and threatening local inflammations. It is highly recommended 
in hemorrhages from the nose, stomach, lungs, rectum and kidneys, in 
threatened abortion, and externally for sprains and bruises, foul ulcers, 
the pruritus of eczema, leucorrhcea and gonorrhoea. An Ointment of 
Witch-hazel is found in the shops, and suppositories may be prepared 
extemporaneously by evaporating the fluid extract and incorporating the 
residue with cocoa-butter. 



HEDEOMA, Pennyroyal, — the'leaves and tops of Hedeoma pulegioides, a plant of 
the nat. ord. Labiatte, common to all parts of the U. S. Its only important constituent 
is the Volatile Oil, which is official. 

Oleum Hedeomae, Oil of Pennyroyal ', — is the volatile oil, readily soluble in alcohol. 
Dose, n\jj-x. 



300 HELLEBORUS. 

Spiritus Hedeomae, Spirit of Pennyroyal (Unofficial), — contains I part of the oil in 
9 of alcohol. Used externally or as spray. 

Hedeoma is a stimulant aromatic, also somewhat carminative and emmenagogue. Its 
odor is extremely repulsive to insects, especially fleas and mosquitoes. In warm infusion 
it is a popular remedy for amenorrhcea and flatulent colic. It may be used as a correc- 
tive with other medicines, and the spirit is well employed on the hands and face to keep 
away mosquitoes. The writer has known death by narcosis to result from an overdose 
of the oil self-taken to produce an abortion. 



HELLEBORUS, Hellebore (Unofficial),— the rhizome and root- 
lets of Helleborus nige?' (Black Hellebore) and Helleborns viridis (Green 
Hellebore), plants of the nat. ord. Ranunculaceae, natives of Europe. A 
third variety, Helleborus occidentalism growing in Greece, is probably the 
true Hellebore of the ancients. Its most important constituents are two 
glucosides, Helleborin and Helleborein, both crystalline and very poison- 
ous. 

Unofficial Preparations. 

Extractum Hellebori Nigri, Extract of Black Hellebore. — Dose, gr. j-x cautiously. 
Extractum Hellebori Nigri Fluidum, Fluid Extr. of Black H. — Dose, mjj-xv. 
Helleborin, C 36 H 42 6 , — insoluble in water, soluble in alcohol and in chloroform. 
Helleborein, C 26 H 44 15 , — crystalline, very soluble in water, slightly so in alcohol, in- 
soluble in ether. Dose, gr. yg- T V 

Physiological Action and Therapeutics. 

Black Hellebore is a drastic, hydragogue cathartic, and an emmen- 
agogue. In overdoses it is a violent gastro-intestinal irritant, producing 
vomiting, hypercatharsis, vertigo, cramps and convulsions, which may 
result fatally. Locally applied, the fresh root is violently irritant to the 
skin, producing inflammation and vesication. 

Helleborin is an active poison, acting on the tongue like Aconite, and 
on the nervous system as a narcotic, producing in animals paresis of 
motion and sensation, cerebral and spinal congestion, dilated pupils and 
death. It is less irritant than Helleborein to the mucous membranes. 

Hellebore'in is less actively toxic to animals, but is very irritant, pro- 
ducing conjunctivitis, sneezing, salivation, nausea, vomiting and purging. 
It affects the heart like Digitalis, small doses frequently repeated slowing 
its action, but large ones quicken it and then suddenly paralyze it through 
the pneumogastric nerve. Respiration is at first accelerated, then slowed 
and rendered laborious. Diuresis is a constant result, the kidneys and 
uterus are congested, gradual paralysis and severe convulsions follow, and 
death occurs by paralysis of the heart. 

Black Hellebore is an old remedy, having been highly esteemed by 
the early physicians in insanity, dropsies, worms, cutaneous affections and 
amenorrhoea. It has at present gone out of fashion, but might be use- 
fully employed in dropsies and as a revulsant in acute cerebral affections. 
Recently Helleborein has come into notice as a substitute for Digitalis in 



HOANG-NAN HUMULUS. 3OI 

cardiac affections, as being of less bulk and more definite composition. 
Its action on the heart is obtained by doses much smaller than those 
necessary for its irritant effects on the gastro-intestinal canal. Its solu- 
bility in water and the freedom with which it can be used hypodermically 
are important qualities to recommend it. 

HOANG-NAN, or Hwang-Nao (Unofficial), — is the bark of Strychnos Gaut/ie- 
riana, Tropical Bind-weed, a creeping vine of the nat. ord. Loganiaceae, found in the 
mountains of Tonquin. It contains the alkaloids Strychnine and Brucine, thus resem- 
bling in composition its congeners Nux- Vomica and Ignatia, but differing from them, as 
they do from each other, in the proportional quantities in which the alkaloids are con- 
tained, — Brucine predominating in this plant, as Strychnine does in the other two. 

Like the other members of the Strychnos family, Hoang-Nan is an active tetanizer, its 
action generally corresponding with that of Nux-Vomica. It was first brought into notice 
by the missionary fathers stationed in the French colonies in Asia, they having found its 
employment general among the natives for leprosy and hydrophobia. Along the coast of 
Tonquin and Cochin-China, and in Pondicherry, Trinidad, Venezuela, etc., it has an 
established reputation in the two terrible diseases mentioned, also as a remedy for the 
bites of venomous serpents and other reptiles, scrofulous and syphilitic ulcers, indolent 
sores, etc. It has been used successfully for malarial fevers, in lieu of quinine, and is 
highly spoken of by Father Brosse, as a stimulant to the intellect, without producing any 
subsequent depression. 

The dose of the powdered drug is about gr. iij-v ; of the aceto-alcoholic Extract, gr. 
Y%—yz ; and of the concentrated Tincture, TT\j— v. 



HUMULUS, Hops, — the strobiles (fruit-cones) of Humulus Lupu- 
/us, a cultivated creeping plant of the nat. ord. Urticaceae. Its constitu- 
ents are wax, resins (50 per cent.), tannin (5 per cent.), a liquid volatile 
alkaloid named Lupuline, a Volatile Oil (2 per cent.) which consists in 
part of Valerol and Trimethylamine, and the crystalline, bitter principle, 
Lupulinic Acid (11 per cent.). These, except tannin, are more abundant 
in the glandular powder of the strobiles, which is named Lupulin. 

Preparations. 

Tinctura Humuli, Tincture of Hops, — strength 20 per cent. Dose, gj-ij. 

Infusum Humuli, Infusion of Hops (Unofficial), — 3 ss to the pint. Dose, Jj-iv. 

Lupulinum, Lupulin, — is the glandular powder separated from the strobiles, of 
bright brownish-yellow color, aromatic and bitter taste. The Volatile Oil resides in the 
Lupulin grains, and contains Valerol, which is changed into Valerianic Acid by long ex- 
posure, giving a disagreeable odor to old hops. Dose, gr.v-xv. 

Extractum Lupulini Fluidum, Fl. Extr. of Lupulin, — alcoholic. Dose, TT^x-^j. 

Oleoresina Lupulini, Oleoresin of Lupulin, — an ethereal extract. Dose, gr. ij-v. 

Tinctura Lupulini, Tincture of Lupulin (Unofficial), — strength^. Dose 3 ss— ij . 

Mineral acids and metallic salts are chemically incompatible with preparations of Hops. 

Humulus is a bitter tonic, and a feeble hypnotic, also somewhat dia- 
phoretic, astringent and anaphrodisiac. It increases the cardiac action 
and the cutaneous circulation. After slight cerebral excitement it pro- 
duces calm and a soporific disposition, especially if the solution adminis- 
tered be strongly alcoholic. The stomachic and tonic effects are due to 
the bitter principle, lupulinic acid, and are found in bitter ale. The 



302 HYDRANGEA HYDRARGYRUM. 

primary stimulant and secondary sedative effects are due to the volatile 
oil and are also possessed by ales and beer. 

Hops are used as a tonic and calmative in delirium tremens, in which 
a combination of the tincture with tincture of capsicum is very efficient 
and is an excellent substitute for alcohol. In dyspepsia of atonic form 
Humulus is an excellent stomachic tonic, and in nervous irritability the 
fluid extract of Lupulin may be used as a calmative and hypnotic, or the 
hop-pillow, which certainly exercises considerable influence, imaginary 
or otherwise. A poultice of hops is a favorite domestic application in 
inflammations and pain. Lupulin has been used with benefit in irritable 
bladder, and alcoholism, and as an anaphrodisiac in the treatment of 
chordee, gonorrhoea, spermatorrhoea and other affections of the genito- 
urinary organs. 



HYDRANGEA (Unofficial), — is the root of Hydrangea arborescens, a plant of the 
nat. ord. Saxifragaceoe, growing in the southeastern U. S. It is a white, tough root, 
containing gum, albumen, starch, resin, and a ferrous salt, with other salts. Dose, 
^ss-^ij, best in fluid extract. A decoction of the root may be prepared and used in 
doses of jfj-ij- 

Hydrangea has been long used by the Cherokee Indians in calculous affections*, and 
reports of cases by competent observers show that it is of unquestionable utility in this 
class of disorders, promoting the removal of gravel from the bladder, and relieving pain 
during the passage of renal concretions through the ureters. Large doses produce ver- 
tigo, oppression of the chest, and considerable cerebral disturbance. 



HYDRARGYRUM, Mercury, Quicksilver, Hg,— is a shining, 
silver-white metal, fluid and slowly volatile at ordinary temperatures, 
solidifies at — 39 F., boils at 675 ° F., volatilizes without residue, 
insoluble in ordinary solvents, wholly soluble in nitric acid, odorless and 
tasteless, sp. gr. 13.558 at 59 F. 

Preparations of Mercury. 

Hydrargyrum cum Creta, Mercury with Chalk (Gray Powder), — has of Mercury 
38, Honey 10, Prepared Chalk 57, Water to 100, triturated together to a uniform gray 
powder. Dose, gr. ss-gr. x. 

Massa Hydrargyri, Mass of Mercury (Blue Mass, Blue Pill), — has of Mercury 33, 
Liquorice 5, Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains gr. y^ of 
Mercury. Dose, gr. ss-gr. xx. 

Unguentum Hydrargyri, Mercurial Ointment (Blue Ointment), — Mercury 50, Lard 
25, Suet 23, Oleate of Mercury 2, triturated together, until globules of Mercury cease to 
be visible under a lens having a magnifying power of ten diameters. 

Emplastrum Hydrargyri, Mercurial Plaster, — Mercury 30, Oleate of Mercury 1.2, 
Lead Plaster to 100. 

Emplastrum Ammoniaci cum Hydrargyro, Ammoniac Plaster with Mercury, — 
see ante, page 121. 

Chlorides and their Preparations. 

Hydrargyri Chloridum Corrosivum, Corrosive Mercuric Chloride (Bichloride of 
Mercury, Corrosive Sublimate), HgCl 2 , — heavy, colorless crystals, of acrid, metallic taste, 
and acid reaction ; soluble in 16 of water and in 3 of alcohol, in 2 of boiling water, 1.2 
of boiling alcohol, 4 of ether and in about 14 of glycerin. Dose, gr. ^-jq. 



HYDRARGYRUM. 303 

Hydrargyri Chloridum Mite, Mild Mercurous Chloride {Subchloride of Mercury, 
Calomel), Hg 2 Cl.,, — a heavy, white, impalpable powder, odorless and tasteless ; insoluble 
in water, alcohol or ether. Is an ingredient of Pil. Antimonii Co. and Pil. Cathartics 
Co. Dose, gr. o^-gr. x. The dose depends on the effect desired. 

Hydrargyrum Ammoniatum, Ammoniated Mercury {While Precipitate, Mercuric 
Ammonium Chloride), NH 2 HgCl, — is a white, insoluble powder, odorless and tasteless. 
Only used externally. 

Unguentum Hydrargyri Ammoniati. Ointment of Ammoniated Mercury {White 
Precipitate Ointment), — Ammoniated Mercury 10, Benzoinated Lard 90 parts. 

Oxides and their Preparations. 

Hydrargyri Oxidum Flavum, Yellow Mercuric Oxide, HgO, — an orange-yellow, 
heavy, impalpable powder, odorless and tasteless, insoluble in water or alcohol, but 
wholly soluble in nitric or hydrochloric acid. Used to prepare : — 

Unguentum Hydrargyri Oxidi Flavi, Ointment of Yellow Mercuric Oxide, — 
strength I to 9 of Ointment (Unguentum). 

Oleatum Hydrargyri, Oleate of Mercury, — has of the Yellow Oxide 20, Oleic 
Acid 80 parts. 

Hydrargyri Oxidum Rubrum, Red Mercuric Oxide [Red Precipitate), HgO, — a 
heavy, orange-red, crystalline powder, having the same properties as the yellow oxide, 
from which it differs only in being crystalline, and in not such a minute state of sub- 
division. Dose, gr. 3 1 q~ tV 

Unguentum Hydrargyri Oxidi Rubri, Ointment of Red Mercuric Oxide, — strength 
I to %}i of Unguentum and )A. of Castor Oil. 

Iodides and their Preparatiotis. 

Hydrargyri Iodidum Rubrum, Red Mercuric Iodide, Red Iodide {Biniodide) of 
Mercury, Hgl 2 , — a scarlet-red, crystalline powder, almost insoluble in water, soluble in 
130 of alcohol, in solution of Potassium Iodide or of Mercuric Chloride. Prepared by 
double decomposition between Potassium Iodide 5, and Mercuric Chloride 4 parts. 
Dose, gr. ^-Jo- 

Liquor Arsenii et Hydrargyri Iodidi, Solution of Arsenic and Mercuric Iodide 
{Donovan' 's Solution), — see ante, page 165. 

Hydrargyri Iodidum Flavum, Yellow Merctirous Iodide {Protiodide of Mercury), 
Hg.,1.,, — a dull green or greenish-yellow powder, insoluble in alcohol or ether and almost 
so in water. Dose, gr. jq-j. 

Acid Combinations and their Preparations. 

Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate, — a liquid containing 
in solution about 60 per cent, of Mercuric Nitrate, Hg(N0 3 ) 2 , with about 1 1 per cent, 
of free Nitric Acid. Prepared from the Red Mercuric Oxide 40, by Nitric Acid 45, and 
Distilled Water 15. Used as a caustic. 

Unguentum Hydrargyri Nitratis, Ointment of Mercuric Nitrate {Citrine Oint- 
ment), — is prepared by dissolving Mercury 7, in Nitric Acid 17^, and adding Lard Oil 
76. 

Hydrargyri Subsulphas Flavus, Yellow Mercuric Subsulphate {Basic Mercuric 
Sulphate, Turpeth Mineral), Hg(HgO).,S0 4 , — a heavy, lemon-yellow powder, practically 
insoluble in water or alcohol, soluble in nitric acid, and in 10 of HC1 without residue. 
Dose, as an emetic, gr. ij-v. 

Cyanide 

Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN) 2 , - colorless, prismatic crystals, 
of bitter, metallic taste, soluble in 12.8 of water and in 15 of alcohol at 59 F. Dose, 

Triturations. 

These may be prepared according to the general formula under " Triturationes " in 
the Pharmacopoeia, 10 parts of the substance to 90 of Sugar of Milk. Mercury itself or 
any of its salts may be so treated with excellent results, the particles being much finer 
and therefore more easily absorbed than if rubbed up with another agent. 



3O4 HYDRARGYRUM. 

Unofficial Preparations. 

Lotio Hydrargyri Flava, Yellow Wash, — prepared by adding Corrosive Sublimate 
gr. xviij to Lime water 3 x, producing the yellow oxide, a favorite application for syph- 
ilitic sores. 

Lotio Hydrargyri Nigra, Black Wash, prepared by adding Calomel gr. xxx, to 
Lime-water ^ x, producing the black oxide, and used as an application to syphilitic sores. 

Unguentum Hydrargyri Nitratis Rubrum, — Red Ointment of Mercuric iVitrate 
(Brown Citrine Ointment), — differs from the official ointment only in being made with 
Cod-liver Oil, which gives it a brown color, and a more agreeable odor. 



Physiological Action. 
Mercury is tonic, purgative, alterative, antiphlogistic and sorbefacient, 
and is not directly cholagogue. Some of its salts are corrosive poisons, 
others are local caustics, all produce by long-continued administration the 
peculiar cachexia termed Hydrargyrism. The metal itself is inert, but 
by combination with the acids and fluids of the body becomes active, and 
is easily absorbed in any form, passing into the blood from the skin, 
mucous membranes, lungs and stomach, in each case probably as an Oxy- 
albuminate of Mercury. Entering the stomach in any form it is first 
converted into a double Chloride of Sodium and Mercury, then uniting 
with the albuminous juices to form a complex molecule of Mercury, Sodi- 
um, Chlorine and Albumen, which being soluble in an excess of sodium 
chloride or albumen, exists in solution, and is easily absorbed, being 
decomposed in the blood and changed to the oxyalbuminate. Entering 
the intestines a purgative action is soon set up, of more or less severity 
according to the preparation used, a small portion only is absorbed, the 
rest being converted into a Sulphide and excreted with the feces, unless 
combined with opium, which delays its progress through the intestines 
and permits of its greater absorption. In the blood its effects, in small 
doses, are tonic, but in quantity it indirectly produces impoverishment 
thereof, impairs the ozonizing function, diminishes the red corpuscles, 
and consequently disorders nutrition and deranges digestion. From the 
blood it enters the tissues, where it remains for an indefinite period, exert- 
ing a peculiar influence, termed •'* alterative," on all processes character- 
ized by growth of young cells, but not producing any definite anatomical 
changes either in the viscera or the nervous tissue, though in the latter a 
low form of inflammation arises, resulting in loss of coordination-power. 
It stimulates most of the glands of the body to the production of patho- 
logical secretions, especially the salivary glands and the pancreas, and 
is excreted with comparative slowness by all the excretory organs, 
being found in the saliva, sweat, milk, urine and bile. It tends to accu- 
mulate in the liver, while stimulating its cells, and is not a cholagogue, 
though stimulating the flow of bile already secreted by reflex action on 
the bile-ducts due to its direct purgation of the duodenum. Its excretion 
is hastened and completed by the use of Potassium Iodide. 



HYDRARGYRUM. 305 

In small doses administered for a short time the mercurial preparations 
are blood-tonics, improving its general condition, increasing the number 
of red corpuscles and the body weight. They soon begin to promote 
waste by stimulating the lymphatic system, and if the small doses are long 
continued or the quantity is increased, symptoms of mercurial poisoning 
begin to manifest themselves. 

The first symptoms of Hydrargyrism are fetid breath, swollen and 
spongy gums having a bluish line along their margins, stomatitis, sore and 
loosened teeth, inflamed and tender salivary glands pouring out a peculiar, 
thin saliva of foul odor in large quantity, and a metallic taste in the mouth. 
Anorexia, diarrhoea and fever follow, also ulceration and in some cases 
even gangrene of the lips and tongue. If the use of the drug be con- 
tinued nutrition will be greatly impaired through the extreme promotion 
of retrograde metamorphosis, and various nervous disturbances will follow, 
the effects being emaciation, pallor, oedema, ulcerated skin, erythematous, 
vesicular or pustular eruptions, headache, insomnia, neuralgia, tremor 
through paresis of the muscles of the head and extremities, epilepsy, coma 
and convulsions. In pregnant women abortion will occur by reason of 
the impoverishment of the blood. Indeed, as Dr. Ringer said in the 
earlier editions of his Handbook of Therapeutics, the phenomena produced 
by mercury are singularly similar to those which will result from syphilis, 
and the serious symptoms known as secondary and tertiary syphilis can 
be produced both by syphilis and by mercury. The drug is a specific 
antagonist to the syphilitic virus, probably by reason of its affecting the 
same organs and tissues of the body on a similar line of action, both 
poisons mutually destroying each other in the organism. It is certainly 
capable of bringing about a radical cure of syphilis, if introduced into 
the system in considerable quantity and its use protracted over a very long 
time, the action of the drug in all cases being kept short of ptyalism or 
any pronounced physiological effects. 

The observations on the antiphlogistic and sorbefacient actions of 
Mercury are clinical rather than physiological, but it is generally agreed 
that exhibited in inflammation mercurials antagonize the increase of the 
haemic fibrin which is so constant an effect of the inflammatory process, 
and that in chronic diseases attended by the formation of semi-organized 
deposits, a mild mercurial course will almost insensibly remove the new- 
formed material. 

Salivation is most readily produced by Blue Mass, next by Calomel, and 
less easily by Gray Powder. Individuals differ greatly in their suscepti- 
bility to the action of Mercury, some persons having been affected after a 
single moderate dose. Children are not easily salivated. Inhalation of 
mercurial vapors is apt to affect the nervous system most ; its internal ad- 
ministration and that by inunction are more likely to produce salivation. 
20 



306 HYDRARGYRUM. 

A not uncommon result of full doses of Blue Pill is an acute coryza of 
very severe character, which the writer has frequently observed to follow 
on neglect of the old-fashioned precaution to " work off" the mercurial 
by a saline cathartic. The symptoms produced are those of a severe 
attack of influenza, — epistaxis, conjunctivitis and obstinate muco-purulent 
discharge from the nasal passages being especially marked. Similar effects 
have been observed during physiological experiments with Mercury on 
animals by Overbeck and Bennett. 

Notes on the Action of the Preparatio?is. 

Metallic Mercury is not used internally except in the finely-divided 
form obtained in Blue Pill and Gray Powder, which are capable of pro- 
ducing all the effects above described. Mercurial Ointment is the pre- 
paration generally used for inunction, a piece the size of a small nut being 
daily rubbed into the soft skin at the flexures of joints. The Oleate painted 
over the surface is a more cleanly method of making the same application. 
Both these preparations are efficient parasiticides. 

The Bichloride is the most actively toxic of the mercurial salts. It is 
probably the most active zymoticide and parasiticide, a solution of i part 
in 2000 being efficiently antiseptic for use as injections or dressings, and 
one of i to 250 being the usual strength for use against epizoa and para- 
sitic skin affections. It is a very active gastro-intestinal irritant, in toxic 
dose producing nausea, retching and vomiting, a metallic taste, constric- 
tion of the fauces, burning pain in the stomach, suppression of urine, 
bloody diarrhoea, collapse and death often preceded by convulsions. It 
affects specifically the lower bowel [Calomel preferring the upper intes- 
tine], and produces inflammation and ulceration of the rectum. It is, 
however, one of the most manageable and efficient of the mercurials 
when used in proper doses. 

The Subchloride (Calomel) is very insoluble and unirritating, tasteless, 
laxative in grain doses, decomposed by the alkaline contents of the intes- 
tines, the Oxide of Mercury being formed, and acts especially on the 
excrementitious glandular appendages of the upper intestine, stimulating 
the liver by indirect reflex action as a duodenal purgative. In the pres- 
ence of alkaline chlorides it is converted into the Bichloride, but not in 
sufficient quantity to render it dangerous in the gastro-intestinal canal. 
Externally applied it is very sedative to the mucous membranes and the 
skin. Calomel is a very efficient diuretic, in small doses frequently re- 
peated. 

Ammoniated Mercury is an Ammonio- Chloride, and a useful stimu- 
lant and parasiticide when used locally in the form of ointment. 

The Iodides are actively poisonous, the Red being much the most 
irritant, in overdoses producing symptoms and results very similar to those 



HYDRARGYRUM. 307 

caused by the Bichloride. The Cyanide is also actively poisonous. The 
Yellow Subsulphate is a prompt and usually harmless emetic, but has 
occasionally produced fatal results by local irritant action. The Oxides 
are irritant, the Red being the most so, and are rarely used internally. 
The Acid Nitrate is a good escharotic, the pain caused by it being tran- 
sient though severe, and its caustic action being comparatively superficial. 
The Ointment of the Nitrate (Citrine Ointment) is more irritant than 
that of the Ammoniated Mercury, and generally needs dilution. All 
these preparations may produce the constitutional effects of mercury, and 
their administration should be carefully watched for the first symptoms of 
mercurialization. 

Antidotes and Incompatibles. 

Albumen in some form, the white of one egg to gr. iv of the Bichloride, forms the 
albuminate, which must be at once evacuated by emesis or the stomach pump, as it is 
soluble in excess of albumen or in the alkaline contents of the intestines. 

The Chlorides are incompatible with very many agents, and the Bichloride should be 
administered in distilled water or pill by itself, being easily decomposed. Calomel is 
decomposed by alkaline Iodides or Bromides. The combination of Calomel with Hydro- 
chloric Acid or Chlorides is apt to produce Corrosive Sublimate. In the " mixed treat- 
ment" of syphilis, a mercurial is combined in solution with Potassium Iodide, and the 
Red Iodide is the preparation usually selected, as the Bichloride is decomposed by the 
Potassium Iodide, Red Iodide of Mercury being precipitated. All trouble regarding 
incompatibility can be avoided by using sugar of milk triturations according to the gen- 
eral official formula therefor. In this form, says Piffard, " a larger proportion of the 
drug is utilized for specific purposes, while but a small amount remains to give rise to 
local irritation." 

Therapeutics. 

Mercury is undoubtedly a specific in syphilis, but is not applicable to 
the tertiary form of that disease. It is best administered in very small 
doses carefully watched and stopped just short of ptyalism, but renewed 
and so continued for a long time. Fumigation by Calomel volatilized by 
heat, or inunction by the Oleate or by Mercurial ointment may be used 
when the stomach will not bear any mercurial. The hypodermic method 
is also used, employing a solution of the Bichloride gr. j to ^j ea ch of 
glycerin and distilled water, of which the dose is nr.x once daily ; or the 
Albuminate in solution with Sodium Chloride. The Yellow Iodide in 
doses of gr. T ^ to \ thrice daily with Opium is the best preparation for 
internal use. Accuracy of diagnosis is an absolutely necessary prelimi- 
nary to the administration of Mercury, for where there is no syphilitic 
virus to be antagonized the constitutional effects of mercurials will become 
manifest sooner and may do great harm in feeble subjects, besides the risk 
of mistaking them for the results of the disease supposed to be present. 

Tonsillitis, parotitis and other acute glandular inflammations of the 
throat and neck may often be rapidly cured by Calomel gr. ^ or Gray 
Powder gr. \ every two hours. In irritable stomach with obstinate vom- 
iting the same small doses of Calomel every half hour are very efficient. 



308 HYDRARGYRUM. 

The dysentery of adults with slimy and bloody stools is best treated by 
small doses (gr. yi^-) of the Bichloride, and in the diarrhoea and dysen- 
tery (ileo-colitis) of infants Gray Powder gr. -J- or Calomel gr. -^ will be 
found very effective. In gastric ulcer and in the first stage of hepatic 
cirrhosis, the Bichloride in doses of gr. -fa to -^ thrice daily is a good 
remedy. Typhoid fever is treated in Germany by daily doses of Calomel, 
gr. x for three days, as an antipyretic. Diphtheria is by many practition- 
ers considered to be best antagonized by Calomel in large doses, and in 
this affection the Cyanide has many advocates given in doses of gr. T ^- 
-J^ every hour, a weak solution being at the same time used as a gargle. 
Asiatic cholera is frequently treated by small, repeated doses of Calomel 
with Opium from the start. Inflammations of sthenic character in the 
stage of exudation, especially when affecting serous membranes, are con- 
sidered by many authorities to be best met by the free use of mercurials, 
but this treatment is fast going out of favor, excepting in cases of iritis, 
which, however, is very often of syphilitic causation, and pneumonia, 
which is frequently treated, according to the best American authorities, 
with sedative doses (gr. xv-xx) of Calomel. 

In the general condition known as "biliousness," manifested by 
whitish or clay-colored stools, constipation, nausea, anorexia, coated 
tongue, slight jaundice, etc., mercurial purgatives have long been a rou- 
tine remedy, but mild saline purgatives are by many authorities considered 
equally efficient. As an antiseptic to the gastro-enteric tract in many 
forms of stomach and intestinal disorders (dyspepsia septica), the admin- 
istration of minute doses of the Yellow Oxide of Mercury will be 
found remarkably efficient. It is best used in trituration with sugar of 
milk, i to iooo, and in daily doses of gr. ^V"A- By the use of these 
small doses failing digestion and nutrition may almost certainly be im- 
proved. 

In membranous laryngitis or true croup the Subsulphate as an emetic 
is by many considered to have some specially beneficial influence. 

Locally, an ointment of Calomel 3J to gj of Lard is an excellent 
antipruritic, and ointments of the Chlorides and Iodides are much used 
in skin diseases, particularly psoriasis, herpes, acne, and pityriasis. In 
parasitic affections a lotion of the Bichloride, gr. ij to Sj of distilled 
water, or a 5 per cent. Oleate with }&\h part of Ether, are very efficient. 
The Oleate is a serviceable application to syphilitic indurations, but is not 
deemed advisable when ulceration exists. In conjunctivitis Calomel may 
be used as a sedative application, or still better an Ointment of the Yellow 
Oxide, gr. ij— x to gj of Vaselin, triturated to the utmost fineness before 
mixing. Goitre and enlarged spleen are often speedily reduced by rubbing 
into the skin covering them the Ointment of the Red Iodide somewhat 
diluted and applied before a hot fire or in the direct sunlight. The Acid 



HYDRASTIS. 3O9 

Nitrate Solution is one of the best caustics for destroying chancroid and 
syphilitic warts and vegetations. Black and Yellow Wash are used as 
applications to syphilitic erosions and ulcerated indurations. 

As an antiseptic injection or application to dressings a solution of the 
Bichloride, gr. vijss in a quart of hot water Cg-oVo")' * s P r obably the most 
efficient that can be used, and still weaker solutions (5-0V0 ) are sufficiently 
antiseptic for most purposes. 



HYDRASTIS, Golden Seal,— the rhizome and roots of Hydrastis 
canadensis, a small plant of the nat. ord. Ranunculaceae, growing in most 
parts of the U. S. It contains an unnamed Resin and 3 alkaloids, 
Hydrastine, C 21 H 2 iN0 6 , white and crystalline, soluble in alcohol, ether, 
etc., Berberine, C 20 H 17 NO 4 , yellow crystals soluble in hot water and 
alcohol, but not in ether (see page 184), and Xanthopuccine, also yellow 
and crystalline. All these alkaloids unite with acids to form salts. 
From Hydrastine is prepared an oxidation product or artificial alkaloid, 
Hydrastinine, C n H n N0 2 , the Hydrochlorate of which is official. 

Preparations. 

Extractum Hydrastis Fluidum, Fluid Extract of Hydrastis. — Dose, TTjv-xxx. 

Tinctura Hydrastis, Tincture of Hydrastis, — strength, 20 per cent. Dose, £ss-ij. 

Glyceritum Hydrastis, Glycerite of Hydrastis, — Hydrastis 2, in Glycerin I, by per- 
colation with Alcohol and Water. Used as a local application. 

Hydrastininae Hydrochloras, Hydrastinine Hydrochlorate, C^H^NOgHCl, — the 
hydrochlorate of an artificial alkaloid derived from Hydrastine. Light yellow, amorphous 
granules, deliquescent, very soluble in water, also in 3 of alcohol. Dose, gr. j in 10 per 
cent, solution, as a hypodermic injection. 

Hydrastin (Unofficial) , — an impure extract precipitated by Hydrochloric Acid from 
the alcoholic solution, chiefly consisting of Berberine Muriate. Dose, gr. ij-v. 

Physiological Action. 
Hydrastis is a simple bitter and a stomachic tonic. It promotes appe- 
tite and digestion and increases the secretions of the gastro-intestinal tract 
and the flow of bile, but if long used it will derange digestion and produce 
constipation. It is possessed of antiperiodic powers, and is a protoplasmic 
poison, arresting the movements of the white blood-corpuscles. By many 
observers it is also considered alterative to the mucous membranes, deob- 
struent to the glandular system, cholagogue, diuretic and antiseptic. The 
alkaloid Hydrastine produces effects on the nervous system somewhat 
similar to those caused by Quinine, but seems to be devoid of toxic 
power, large doses only producing a sense of warmth in the epigastric 
region, and noises of a rushing character in the ears. 

Incompatibles. 

Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incompatible with 
preparations of Hydrastis. 



310 HYDR0C0TYLE. 

Therapeutics. 

Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, a mild 
laxative and an antiseptic. Its alkaloid (Hydrastine) and extract (Hy- 
drastin) are ranked high in the treatment of intermittents and chronic 
malaria, though much less efficient than Quinine. It is an excellent 
remedy locally and internally in all forms of catarrh, especially that of 
the stomach, duodenum, gall-ducts, bladder, uterus and vagina. Internally 
it is efficient in many glandular swellings, in chronic constipation due to 
a sluggish state of the liver or deficiency of the other intestinal secre- 
tions, in chronic dyspepsia, and as a substitute for alcohol in dipsomaniacs 
when a catarrhal state of the stomach has been induced. In gonorrhoea, 
gleet, and chronic nasal catarrh, it is locally employed with much benefit, 
also in syphilitic affections of the mouth, throat and nares. As a local 
alterative and antiseptic application it is highly recommended for unheal- 
thy ulcers and sores, cancerous ulcerations, mercurial and aphthous stoma- 
titis, rectal fissure, fistula and prolapse, internal and external hemorrhoids, 
cracks, fissures and abrasions of the nipples, erosion and ulceration of the 
cervix uteri, and in conjunctivitis with muco-purulent discharge. In 
gonorrhoea a very efficient injection is an infusion of Hydrastis, 3J of the 
powdered root to gviij of boiling water, or the fluid extract diluted in the 
proportion of ^ss or 3J to the pint of water, but it should not be used 
until the acute stage has subsided. 

Hydrastinine has long been known as a uterine vaso-constrictor, and as 
such has been successfully employed in metrorrhagia. It has lately been 
credited with powerful qualities as an antispasmodic, and also as efficiently 
diminishing the excitability of the cerebral cortex. It is considered prefer- 
able to Hydrastine on account of its stimulant action on the cardiac mus- 
cle, and the persistent constriction which it produces in the walls of the 
vessels. The Hydrochlorate is employed in grain doses hypodermically, 
using a 10 per cent, solution ; the injections being best made, for men- 
strual irregularities, during a few days previous to the expected term. It 
has been used with great benefit in uterine hemorrhage and dysmenorrhcea; 
also in metritis, endometritis, myomata and pyo-salpingitis. More re- 
cently it has been employed in the treatment of hydrophobia, strychnine- 
poisoning and epilepsy, in the latter case having been given per or em in 
doses of gr. }£-% up to gr. ij daily ; and with benefit in four cases out of 
six. 



HYDROCOTYLE, Pennywort (Unofficial),— is the leaf of Hydrocotyh asiatica, 
a small plant of the nat. ord. Umbelliferae, a native of southern Africa and India. It 
contains a peculiar, oleaginous substance, Vellarine, which has a bitter, persistent taste, 
and is thought to be the active principle. It has long been used in its native countries 
as an alterative to purify the blood, and has been found of great service in eczema, lupus, 
psoriasis, syphilitic and scrofulous sores, and in leprosy. An ounce of the dried plant or 



HYOSCYAMUS. 3 I I 

leaves is given daily in infusion. It causes great itching over the whole body, ovarian 
pain in females, and urinary irritation. In one case in which the drug was being given 
for lupus of the hand a severe orchitis was set up without any other apparent cause. It 
certainly exerts a markedly special influence on the genito-urinary tract. 



HYOSCYAMUS, Henbane, — the leaves and flowering tops col- 
lected from plants of the second year's growth, of Hyoscyamus niger, 
a biennial plant of the order Solanacese, growing in Europe and the 
northern U. S. It contains an alkaloid, Hyoscyamine, C 17 H 23 N0 3 , which 
is isomeric with Atropine and identical with Daturine and Duboisine, 
occurring as an oily liquid or in tufted crystals of silky lustre and yellow 
color, soluble in hot water, alcohol or ether. Another substance, Hyos- 
cine, C 17 H 21 N0 4 , is by some authorities considered a derivative of Hyos- 
cyamine, by others a second alkaloid. It is semi-liquid, isomeric with 
Atropine, and yields Tropic Acid and Pseudotropine. Hyoscyamus leaves 
also contain a fatty Oil and much Potassium Nitrate, while from their 
destructive distillation an empyreumatic Oil is obtained which is a power- 
ful narcotic. They are ovate, long and broad, glandular-hairy, with promi- 
nent midrib, heavy, narcotic odor, taste bitter and acrid. 

An allied plant is Scopolia carniolica , also of the Solanacece, a common plant in the 
mountains of Bavaria and Hungary, which contains in the root an alkaloid Scopolamine 
(or Scopoleine), C 17 H 21 N0 4 , also found in small quantities in belladonna root, stramonium 
seeds and in duboisia. Nearly all the Hyoscine Hydrobromate supplied by manufactur- 
ing chemists consists of Scopolamine Hydrobromate (Schmidt). The two bases may be 
considered identical (Hesse). 

Preparations. 

Extractum Hyoscyami, Extract of Hyoscyamus, — Dose,gr. j, when active. 

Extractum Hyoscyami Fluidum, Fluid Extract of Hyoscyamus, — Dose, m^v-xx. 

Tinctura Hyoscyami, Tincture of Hyoscyamus, — Strength 15 per cent. Dose, 
^j-iv ; as a hypnotic ^ ss-j is necessary. 

All the preparations of Hyoscyamus are uncertain in strength and activity, so that the 
effective dose of the extract official in U. S. P. 1870 ranged from 2 to 250 grains. 

Hyoscyaminae Sulphas, Hyoscyamine ^/Mtf^,(C 17 H 23 N0 3 ) 2 H 2 S0 4 , — small, yellow 
scales or crystals, which are deliquescent, of bitter taste, and very soluble in water and in 
alcohol. It varies much in purity of the base and consequently in activity. A grain of 
the commercial article, which was formerly very impure, has been given with impunity, 
but gr. jL of the pure alkaloid has produced violent poisoning. Dose, hypodermically, 
should not exceed gr. ^ ; by the mouth gr. %—} may be given in urgent cases. 

Hyoscyaminae Hydrobromas, Hyoscyamine Hydrobromate, C n H 2 ,N0 3 HBr, — a 
yellowish-white, amorphous mass, or prismatic crystals, of tobacco-like odor, and acrid, 
bitter, nauseous taste ; deliquescent, soluble in y 3 of water and in 2 of alcohol. Dose, as 
the Sulphate. Hyoscyamine of good quality is difficult to procure and is very expensive, 
while Duboisine is easily obtained in any quantity, so that if these alkaloids prove to be 
physiologically as well as chemically identical, as is now claimed, the latter will be used 
to the exclusion of the former. 

Hyoscinae Hydrobromas, Hyoscine Hydrobro?nate, C 17 N 21 N0 4 HBr- T -3H 2 0,— color- 
less, transparent, rhombic crystals, odorless, of acrid, slightly bitter taste ; soluble in 2 of 
water and in 13 of alcohol. Dose, gr. y^—oV by mouth, gr. aoo -5? hypodermically. 
Nearly all the Hyoscine Hydrobromate furnished by manufacturing chemists consists of 
Scopolamine Hydrobromate. (See above.) 



312 hyoscyamus. 

Physiological Action. 

Hyoscyamus has similar action to that of Belladonna, Duboisia and 
Stramonium, except that it is the least powerful and irritant of the group, 
but the most calmative and hypnotic. The delirium produced by it is 
never furious and is without hyperemia, but is accompanied by insomnia. 
It is more stimulant to the vaso-motor system and to the cardiac accelera- 
tor apparatus than is Stramonium, but is less active on the pneumogastric. 
It has decidedly laxative and carminative effects on the intestines and a 
very marked sedative influence on the urinary passages. 

Hyoscyamine corresponds in action to the plant and its congeners, 
being considered by many authorities as almost identical with Atropine, 
but less powerful. No death has directly resulted from it. Except in 
very large doses it is more an anodyne or anaesthetic than a narcotic or 
soporific. It is a mydriatic, excites the cerebral functions and de- 
presses the spinal. Many observers deny that it possesses any soporific 
influence whatever. 

Hyoscine is a cerebral and spinal sedative, and a powerful hypnotic, 
directly depressing the higher functions of the brain, and affecting the 
heart but feebly. It is probably the action of this agent which prevents 
Hyoscyamus having the excitation and delirium of Belladonna. After 
the hypodermic administration of a full dose (gr. -g^), there is, in most 
subjects, a period of semi-maniacal delirium, with flushed face and dry 
mouth, lasting from one to two hours, and followed by the sedative action 
of the drug, during which the pulse-rate and frequency of respiration, at 
first quickened, are distinctly lowered. It especially affects the motor 
tract of the spinal cord and the cerebral cortex, slightly depresses the 
heart, but paralyzes respiration. It is free from irritant qualities and 
may be used hypodermically. Its habitual use brings on muscular paraly- 
sis and delirium of violent character. It is coming into use as a hyp- 
notic by alcoholics and nervous subjects, and will probably ere long be 
responsible for many deaths. As a mydriatic its reputation is doubtful, 
some observers claiming greater power for it in this respect than that of 
Atropine, while others say that mydriasis may follow its use but is not 
always produced by even large doses. Severe toxic symptoms have fol- 
lowed the application of 4 drops of a 1 per cent, solution (equal to gr. 
Jg.) to the ocular conjunctivae. In large doses Hyoscine is a dangerous 
depressant of the respiration, but it may be used without unpleasant 
effects in medicinal doses. Whenever full doses are employed the 
respiration should be watched for several hours. 

Dr. Balagopal,of India, has reported a case in which a man suffering from intermittent 
attacks of maniacal delirium was accidentally given gr. ^ of the hydrobromate of hyoscine 
hypodermically. Severe toxic symptoms supervened, which were however antagonized 
by Sulphtiric Ether administered subcutaneously. The patient recovered, and thereafter 
remained free from all mental or cerebral disorder. 



HYOSCYAMUS. 313 

Antagonists and Incompatibles. 

These are the same as for Belladonna (see ante, page 181). Liquor Polassae though 
incompatible is frequently prescribed in combination with Hyoscyamus. All the fixed 
caustic alkalies decompose its alkaloid, as also those of the allied plants. 

Therapeutics. 

Hyoscyamus is a valuable though feeble narcotic and is chiefly used as 
a hypnotic and anodyne when Opium is contraindicated, and for children. 
It is by far the best agent to use in acute mania with high motor excite- 
ment, obstinate insomnia and varied hallucinations. Chronic mania has 
been more benefited by it than by any other drug, and it is very efficient 
in insanity characterized by frequent delusions. In delirium tremens and 
the delirium of fevers it is an excellent hypnotic, and the monomania of 
hypochondriacs is alleviated and often cured by it. Whooping-cough, 
nervous coughs, and especially a dry, tickling night-cough, are greatly 
alleviated by full doses of Hyoscyamus. It is also efficient in colic of 
various forms, to palliate the trembling of paralysis agitans and mercurial 
tremor, and to relieve the pains and disordered coordination of locomotor 
ataxia. In constipation it is a good remedy, the extract being much 
employed in combination with other purgatives to render them more effi- 
cient and less drastic, but the quantity generally used is too small to be 
of any particular benefit. The tincture is an efficient remedy in irrita- 
bility of the bladder from any cause. 

Hyoscyamine may be used for the same purposes as Atropine, but 
being liable to considerable variation in purity and activity, it is not a 
popular agent with the profession. 

Hyoscine has been efficiently used in neuralgia, whooping-cough, acute 
mania, insomnia from cerebral excitement, delirium tremens, asthma and 
enteralgia, also in ophthalmic practice as a mydriatic. The Hydrobro- 
mate is the salt in general use, in doses of gr. y^-g- hypodermically, gr. -^ 
per orem. It efficiently, but temporarily, controls the tremor of paralysis 
agitans ; and is highly useful at times in the treatment of the morphine- 
habit, especially for the extreme restlessness and insomnia resulting from 
the final withdrawal of that drug. In such cases, however, it must be 
used only for extreme cases, and should not be given habitually, as it 
excites a high degree of delirium in most subjects, at first, followed after 
about 2 hours by its secondary sedative influence. Excessively or carelessly 
employed, in such cases, it is liable to seriously derange the mental 
faculties, in the same manner as Atropine ; and is probably responsible 
for many of the impaired intellects which emerge from the so-called 
" Bichloride of Gold Cures " for alcoholism. 

Dr. Lionel Weatherly warns the uninitiated against mistaking Hyoscine for Hyos- 
cyamine, as these two alkaloids have very different characters clinically. He believes 
strongly in the power of Hyoscine as a mental alterative, and has found it to be par- 



3H ICHTHYOCOLLA IGNATIA. 

ticularly useful in that form of mental disturbance which renders the patient violent and 
abusive, restless and domineering — a nuisance to every one who has anything to do with 
him. Under the administration of repeated small doses of hyoscine such a patient 
becomes a changed man. Violence and abusiveness give place to an amiable politeness, 
and instead of indulging himself in the free exercise of an extensive, if somewhat shady 
vocabulary, the patient subsides into silence. 



ICHTHYOCOLLA, Isinglass, — is the swimming bladder oiAcipenser Huso, and 
of other species of Acipenser (Sturgeon). It occurs in horny sheets, semi-transparent, 
iridescent, soluble in 24 parts of boiling water, forming on cooling a transparent jelly. It 
is the purest form of Gelatin known. 

Emplastrum Ichthyocollae, Isinglass Plaster, Court Plaster, — consists of Isinglass 
10 parts, Glycerin I, Alcohol 40, Water and Tincture of Benzoin, spread on taffeta and 
allowed to dry. 

Isinglass is slightly nutritious, but has no advantage over any other form of gelatin. It 
is used for clarifying liquids, and in solution as a test for tannin. The plaster is a common 
protective application. 



IGNATIA, St. Ignatius' Bean (Unofficial),— is the seed of 
Strychnos Ignatii, a small tree of the nat. ord. Loganiacese, native in the 
Philippine Islands, and also called Ignatia Amara. It contains the 
alkaloids Strychni?ie and Brucine, about 1 per cent, of each, for a descrip- 
tion of which see under the title Nux Vomica. 

Tinctura Ignatiae, Tincture of Ignatia (Unofficial), — strength 10 per cent. Dose, 

mjj-x. 

Physiological Action and Therapeutics. 

Ignatia closely resembles Nux Vomica in action, a poisonous dose pro- 
ducing the same exaltation of the spinal functions, with muscular twitch- 
ing, tetanic spasms, and death by asphyxia through tetanic fixation of the 
respiratory muscles, but containing a greater quantity of Strychnine than 
the latter it is more powerful in the same dose. It especially exalts the 
susceptibility of the sensory nerves, and of the nerves of special sense, 
for a time, but an opposite condition soon succeeds, manifested by numb- 
ness and torpor with great mental depression. It causes a feeling of con- 
striction about the throat and a sensation of intense anguish at the pit of 
the stomach. Its antagonists and incompatibles are the same as those for 
Nux Vomica. 

Ignatia is recommended for hysteria, to control the general hyperes- 
thesia, also for insomnia, clavus hystericus, mental excitement or depres- 
sion, aphonia, diseased appetite, and convulsive crying or laughing. It 
will often remove the intercostal neuralgia of hysterical subjects, and the 
sensation as of a ball rising to the throat (globus hystericus). Cerebro- 
spinal irritability is diminished by small doses though excited by large 
ones, Ignatia being probably the most efficient controller of functional 
phenomena of the cerebro-spinal axis. In the convulsions of children 
from intestinal irritation without cerebral congestion, and in insomnia 



ILLICIUM INULA — IODUM. 315 

from nervous erethism, small doses of Ignatia are used with the happiest 
results. It is by many practitioners preferred to Nux Vomica as a stom- 
achic tonic, and is useful in the treatment of dyspepsia, hypochondriasis 
and various nervous affections. 



ILLICIUM, Star Anise, — is the fruit of Illicium verum, an Asiatic shrub of the nat. 
ord. Magnoliace;?e. It contains a Volatile (9// which is chemically and practically identical 
with the Oil of Anise. Another species, Illiciiim anisatum {Illicium religiosuni) , is 
very poisonous, causing vomiting, epileptiform convulsions, dilated pupils and cyanosed 
countenance. Its carpels are more woody, shrivelled and wrinkled, and end in a curved 
beak. Illicium is recognized officially as a source of the Oil of Anise, and has similar 
actions and uses to those of Anisum. (See ante, page 139.) 



INULA, Elecampane, — is the root of Inula Helenium, a plant of the nat. ord. 
Composite, growing in Europe and N. America. It contains a volatile oil, a resin, a 
crystalline substance named Helenin, C 6 H g O, and a peculiar principle resembling starch, 
Inulin, C 6 H 10 O 5 , which is found in Arnica, Taraxacum and other plants. Having the 
same chemical composition as starch, Inulin differs from the latter in being colored yel- 
low by Iodine, and depositing from its solution in hot water as the solution cools. It is 
contained in Elecampane in large quantity, from 19 to 44 per cent., the latter in the 
autumn. There are no official preparations, but a decoction (^ss to Oj) may be given 
in doses of ,^j-ij. Dose of the powdered root, gr. xx-gj. 

Inula is a gentle stimulant to the secretory organs, and is said to be expectorant, dia- 
phoretic and diuretic. In large doses it causes nausea and vomiting. It was formerly 
supposed to be emmenagogue and was much used in amenorrhoea. It is now chiefly 
employed as a domestic remedy in chronic bronchitis and dyspepsia, and to promote the 
eruption in exanthematous fevers. 



IODUM, Iodine, I, — is a non-metallic element, existing in sea-weed, 
sea- water, some fresh waters and fresh-water plants, also in sponge, oys- 
ters, eggs, cod-liver oil, rock salt and several ores. It occurs in bluish- 
black rhombic plates, of metallic lustre, peculiar odor, acrid taste, and 
neutral reaction, sparingly soluble in water (1 in 5000), readily so in 
ether, and in 10 of alcohol, also in a solution of potassium iodide or 
sodium chloride. It volatilizes slowly at ordinary temperatures, and pro- 
duces a dark-blue color with gelatinized starch in a cold solution. In- 
ternally it is generally administered in the form of an Iodide or as the 
Compound Solution of Iodine. Dose, gr. ss-j. 

Preparations of Iodine. 

Tinctura Iodi, Tincture of Iodine, — strength 7 percent. Dose, TT\j-v ; but it is gen- 
erally used as a local application, or for injection into cavities. 

Liquor Iodi Compositus, Compound Solution of Iodine, LugoV s Solution, — has of 
Iodine 5, Potassium Iodide 10, in Distilled Water to 100. Dose, tt\j-x, well diluted. 

Unguentum Iodi, Ointment of Iodine, — has of Iodine 4, Potassium Iodide I, Water 
2, Benzoinated Lard 93. 

Iodized Phenol, Carbolated Iodine (Unofficial), — is a mixture of Iodine and crystal- 
lized Carbolic Acid in varying proportions, generally 1 of the former to 4 of the latter: 
for local use, especially in gynecology. 



316 IODUM. 

Iodides and their Preparations . 

Ammonii Iodidum, Ammonium Iodide, NH 4 I, — a deliquescent, granular, white 
salt; soluble in I of water and in 9 of alcohol at 59 F. Dose, gr.ij-x or more. 

Potassii Iodidum, Potassium Iodide, KI, — a colorless, deliquescent, crystalline salt, 
of saline and bitter taste; soluble in 0.8 of water and in 18 of alcohol. %] of this salt 
dissolved in % j of water makes nearly 25 jss of fluid, so that Tr^vijss of the solution would 
be required to obtain gr.v, a fact to be remembered in prescribing. Dose, gr.v-^j. 

Unguentum Potassii Iodidi, Ointment of Potassium Iodide, — has of the Iodide 12, 
Sodium Hyposulphite I, Hot Water 10, Benzoinated Lard 77. 

Sodii Iodidum, Sodium Iodide, Nal, — minute, deliquescent crystals ; soluble in 0.6 
of water and in 1.8 of alcohol. Dose, gr.v— 3 j. 

Strontii Iodidum, Strontium Iodide, SrI 2 (H 2 0) 6 , — colorless, hexagonal plates, of 
bitter, saline taste ; very soluble in water and in alcohol. Dose, gr.v-xxx. 

Iodoformum, Iodoform {Formy I Iodide), CHI 3 , — small, lemon-yellow, lustrous crys- 
tals, of saffron-like and very penetrating odor ; very slightly soluble in water, soluble in 
about 52 of alcohol, 12 of boiling alcohol, and in 5.2 of ether ; very soluble in chloroform, 
benzin and fixed and volatile oils. Its solutions have neutral reaction. Dose, gr. j-v. 

To remove its odor without forming a compound the best agents are Thymol (gtt. ij ad 
Jj), Oil of Mirbane (gtt. yj ad gr. xv), Oil of Bitter Almonds, or Oil of Rose (gtt. j ad 
3 j). Oil of Turpentine is particularly serviceable in removing the odor from the hands, 
or from spatulas, mortars, etc. 

Unguentum Iodoformi, Iodoform Ointment, — Iodoform, finely pulverized, 10, Ben- 
zoinated Lard 90, thoroughly mixed by trituration. 

Other Iodides and preparations thereof are — Argenti Iodidum, Arseni Iodidum, 
Liquor Arseni et Hydrargyri Iodidum, Hydrargyri Iodidum Rubrum, Hydrargyri Iodidum 
Flavum, Syrupus Ferri Iodidi, Pilulae Ferri Iodidi, Plumbi Iodidum, Sulphuris Iodidum 
and Zinci Iodidum. As these preparations are allied in action and uses less to Iodine 
than to the other elements in their composition, they are described under other titles. 
(See Argentum, Hydrargyrum, etc.) Ethyl Iodide or Hydriodic Ether is described 
under iEther (see ante, page 99). 

Preparation of Hydriodic Acid. 

Syrupus Acidi Hydriodici, Syrup of Hydriodic Acid, — contains I per cent, of abso- 
lute Hydriodic Acid, HI. Dose, 3J-iv, well diluted. 

Physiological Action. 

Iodine is irritant to the mucous membranes and to the skin. Applied 
to the latter it stains a deep yellowish-brown color and combines with 
the albumen of the tissue, causing considerable pain and subsequent 
exfoliation of the epidermis. Vesication may be quickly produced if the 
quantity used be large. Inhaled its vapor irritates the respiratory 
mucous membrane, producing sneezing, cough, dyspnoea, also pain in 
the chest and the frontal sinuses. In the gastro-intestinal canal it is 
equally irritant, but is gradually converted into the iodide or iodate of 
sodium, in which form or as an albuminate it is absorbed into the blood. 
Iodine decomposes organic molecules, and in the presence of phospho- 
retted or sulphuretted gases it acts like chlorine but more feebly, uniting 
with their hydrogen and thus breaking up those noxious compounds it is 
disinfectant and deodorant. 

The Iodides of Sodium, Potassium, etc., are very diffusible and are as 
rapidly excreted ; setting free nascent oxygen (Ozone) and Iodine at the 



IODUM. 317 

points of elimination, they are remotely irritant to the mucous mem- 
branes, setting up violent coryza, with soreness of the throat, acute con- 
junctivitis, profuse mucous discharges, headache and irritation of the 
kidneys and the skin. Intravenous injections of these salts produce at 
first a rapid elevation of arterial pressure with acceleration of the cardiac 
rate; followed by slowing of the heart, and later on, lowered blood-pres- 
sure with increased heart rate. If used for any length of time they 
induce great waste and rapid elimination of waste products, causing 
anaemia, emaciation and mental depression ; but these effects are credited 
chiefly to the metallic constituent, being most severe from the potassium 
salt. They combine with certain poisons in the system, particularly 
Lead, Mercury, and the products of the syphilitic disease, hastening 
their elimination. Iodism is the term applied to the general condition 
.produced by these agents, and comprises the symptoms above noted 
together with frontal headache, ptyalism, a saline taste in the mouthy 
dysphagia, temporary impotence, and an acneform eruption on the face 
and limbs. Sometimes the eruption is furuncular or even purpuric. It 
is less apt to result from the use of the Strontium Iodide than from that 
of the others. The copious dilution of these preparations with water 
promotes their excretion, and to a great extent prevents the development 
of unpleasant results. The ptyalism occasionally produced by iodides is 
not a direct result of their action, and only occurs in persons who have 
previously taken mercurials. In such the mercury, which had been 
deposited in the tissues as an albuminate, is set free by the iodide, and 
coming again into the circulation, it produces its constitutional effects'. 
(Murrell). 

Potassium Iodide occasionally gives rise to some peculiar symptoms 
in certain susceptible persons. Among these are diuresis, cerebral ex- 
citement as from alcohol, hemorrhages from the urethra and the vagina, 
glossitis (Gross), also laryngitis and sudden cedema of the glottis. The 
latter may be of so intense a character as to require the instant perform- 
ance of tracheotomy in order to avert death. On the circulation it pro- 
duces marked and important effects in most cases. It causes acceleration 
of the pulse and vascular dilatation, leading to abundant secretion from 
several glands. It reduces the temperature a degree or more, and slows 
the rate of the respiration. 

Iodoform contains from 94 to 97 per cent, of Iodine and naturally 
resembles the latter in action. Locally its action is anaesthetic and pow- 
erfully antiseptic. It is one of the best agents to prevent decomposition 
and to destroy the germs of putrefaction and of disease, but must be 
carefully employed, as when used in quantity on an extensive raw surface 
it has often produced fatal results with symptoms of narcotic poisoning. 
The first sign of its dangerous absorption is increase of temperature, 



3 18 IODUM. 

which may reach 104 or more, then headache, quick and feeble pulse, 
marked anxiety and restlessness, and suddenly collapse and death may 
supervene. The quantities which have produced fatal results from local 
absorption have varied from 525 to 4500 grains. In small doses inter- 
nally it is considered to be a tonic and alterative, wasting does not occur, 
but the body weight increases and the general condition improves. In 
these respects its action markedly differs from that of Iodine or the Iodides. 
In medicinal doses internally administered for any length of time it may 
cause profuse salivation. 

Ethyl Iodide (see ante, pages 99 and 102) is used by inhalation to 
bring the system rapidly under the influence of Iodine. It is a good anti- 
spasmodic and general stimulant and a very slow anaesthetic. 

Antidotes, Antagonists and Incompatibles. 

Starch is the antidote to free Iodine, but the stomach must be evacuated, as the re- 
sulting iodide is active. Albumen, starch, lime-water, tannin and soap, maybe used in 
poisoning by the iodides, and free emesis should be induced. In chronic iodide poison- 
ing a free salivary flow, brought on by chewing Pyrethrum root, will hasten elimination 
of the drug. Restoratives and vaso-motor tonics, as Quinine, Digitalis, etc., are thera- 
peutically antagonistic. 

Incompatibles with Iodine and the Iodides are the Mineral Acids, Metallic Salts, 
Alkaloids and their salts, Ammonia, etc. If Potassium Iodide is combined in solution 
with Potassium Chlorate a poisonous compound will result. As Potassium Iodide decom- 
poses nearly all the metallic salts, and is incompatible with so many substances, it is best 
prescribed alone, or in some simple vehicle, a favorite one being the Compound Syrup of 
Sarsaparilla. It may be prescribed with Tincture of Cinchona, an ounce of which dis- 
solves 30 grains, or in combination with Liquor Potassii Arsenitis, which prevents the 
iodic eruption to some extent. In the " mixed treatment " of syphilis it is combined with 
the Biniodide of Mercury. It is better borne when combined with Nux Vomica or Po- 
tassium Acetate, or alternately with Iodide of Iron (Squire). Its efficacy is increased by 
uniting it with Ammonium Carbonate, 2 parts of the latter to I or I ]A of the Iodide 
(Gull). 

Therapeutics of Iodine. 
The tincture and the compound solution are much employed locally as 
counterirritants and by injection into cavities as alterative applications, 
instances of which are their use in glandular tumors, hypertrophied ton- 
sils, cervical and ovarian cysts, empyema, hydrocele, etc. In various 
skin diseases, as chloasma, lentigo, lupus, the tincture or a glycerite is 
well applied, and in many splenic and hepatic disorders of chronic type 
the ointment or tincture is a favorite counterirritant application. In 
sores, ulcers, and fissures, the Iodide of Starch or a mixture of Iodoform 
and Tannin are strongly recommended, and the tincture is much used 
locally to promote absorption of the products of acute inflammations. In 
acute catarrh and hay-fever inhalations of Iodine-vapor, or that from 
Iodized Phenol, are very serviceable, and in the vomiting of pregnancy 
i- to 5-drop doses of the tincture every hour are often efficient. The 
compound solution well diluted is given thrice daily in typhoid fever 
with good results in many cases, and in malarial fevers the same prepara- 



IODUM. 319 

tion combined with Carbolic Acid has remarkably curative power. In 
strumous conditions Iodine internally is much more efficient than any of 
the Iodides. 

Therapeutics of the Iodides. 

Potassium Iodide is the most frequently used of the Iodides, and is the 
form in which Iodine is generally administered internally. It is usually 
administered in simple solution or in the compound infusion or syrup of 
Sarsaparilla. Though its mode of action has never been explained satis- 
factorily, it is known by clinical experience to counteract many patholog- 
ical conditions, to promote the absorption of morbid products, and the 
elimination of several metallic poisons. It is almost of specific rank in 
tertiary syphilis and its results, as neuralgias, paralyses from gummata, 
ulcerations, syphiloma of the internal viscera, lupus, chronic rheumatism 
and sciatica, in all of which when of syphilitic origin this iodide in large 
doses (50 to 150 grains daily) to saturation of the system will speedily 
cause improvement. So in mercurial poisoning and other chronic metal- 
lic toxaemias, the best treatment is by rapid saturation with Potassium 
Iodide. The products left behind by pneumonia, pleurisy and pericar- 
ditis often yield to moderate doses (5 grains), which if used for a pro- 
longed period seem to retard the changes of chronic nephritis. It is the 
best remedy for the early stage of hepatic cirrhosis, and acts as a most 
efficient expectorant in chronic bronchitis. Aneurisms are often cured 
by large doses (20 to 30 grains) of Potassium Iodide, the sac becoming 
solid by fibrinous deposit. In acute catarrh and hay-fever, it is useful 
with Arsenic, the Iodized Phenol being at the same time used locally in 
weak solution. In tonsillitis and simple sore throat a weak solution (gr. 
ij-v to the J) is a good gargle, and in large doses it is often efficient in 
spasmodic asthma induced by bronchial catarrh. 

Ammonium Iodide in grain dose repeated frequently is an excellent 
remedy in acute catarrh, hay-fever, duodenal catarrh and its accompany- 
ing jaundice, in chronic and capillary bronchitis, and in catarrhal pneu- 
monia to prevent caseation of the products. In the first stage of hepatic 
cirrhosis and in chronic malarial poisoning it is equally efficient adminis- 
tered in conjunction with Arsenic. Being somewhat more irritating than 
the other iodides it is usually given in smaller quantity, but being less 
stable it is more energetic in action. 

Sodium Iodide may be used instead of the potassium salt, in all affec- 
tions in which the latter is indicated ; but requires to be administered in 
somewhat larger doses, being less active and less toxic. Strontium 
Iodide is still less liable to produce eruptions, and has been used with 
benefit in scrofulous, rheumatoid and cardiac disorders. 

Hydriodic Acid is used as a substitute for Iodine and the Iodides. As 
an alterative it is believed by some to possess all the powers of Iodine 



320 IODUM. 

while it is much less offensive to the taste and the stomach. It has been 
used with benefit in asthma 'and bronchitis. The acid itself is not now 
official, as it is liable to change by the development of free Iodine. 

Iodoform is chiefly employed in local diseases as an antiseptic, anaes- 
thetic and alterative agent. It may be dusted in fine powder over a wound 
or sore, or used in ethereal solution to saturate gauze or absorbent cotton. 
It is particularly useful as an application to sloughing and phagedenic 
ulcers, gunshot wounds, chancroids, fistulae, sinuses and painful affections 
of the rectum or uterus. Internally it may be used as a general tonic and 
alterative in syphilis and other cachexias, also for neuralgia, and is fre- 
quently prescribed with Iron. Triturated with Tannin it forms a useful 
application to the cervix uteri in erosions and ulcerations thereof, or an 
Iodo-tannin may be prepared by saturating the Tincture of Iodine with 
Tannic Acid, and applied on a cotton tent to the uterine mucous mem- 
brane in many chronic affections of that organ. Tuberculosis is success- 
fully treated by Iodoform, which certainly does check the activity of the 
bacillus of that disease. Diabetes has been apparently cured by Iodoform, 
and syphilis may be combated successfully thereby in lieu of Potassium 
Iodide. 

Unofficial Substitutes for Iodoform. 

Aristol, Dithymol Iodide, — is a combination of Iodine and Thymol, containing nearly 
46 per cent, of the former, and is prepared by adding an alkaline solution of Thymol to 
a solution of Potassium Iodide and Iodine. It occurs as an amorphous, odorless, unstable, 
non-toxic powder, of a brown-red or fawn color, insoluble in water or glycerin, sparingly 
soluble in alcohol, freely so in ether, chloroform and fatty oils. As its Iodine leaves it 
readily, no heat should be used in dispensing it, and it should not be mixed with alkalies, 
metallic oxides, or starch. It is used locally as a substitute for Iodoform. 

Aristol is highly praised by those who have used it in the local treatment of ulcers, 
wounds, and other breaches of the tissues ; in which it is considered nearly, if not quite, 
as efficient as Iodoform, with the great advantage of being odorless. Excellent results 
have been obtained with it in the treatment of indolent soft ulcers, lupus, psoriasis, 
syphilitic ulcerative processes, eczema, severe burns, affections of the ear, nose and 
pharynx, as well as in the various cases in gynecological and dermatological practice in 
which Iodoform has hitherto stood supreme. Its prolonged use may give rise to chronic 
iodine poisoning. 

Aristol is best applied in powder, in solutions in Oil or Ether (5 to 10 per cent.), or as 
ointments with a base of Lanolin or Vaselin (5 to 10 per cent.). A useful application is 
a liniment, prepared by dissolving 5 grains of Aristol in 3 i j of a mixture of equal parts 
of Ether and Alcohol, then incorporating ^j of soft Soap therewith. 

Europhen, Isobutyl-orthocresol Iodide, — is produced by the action of Iodine upon 
Isobutyl-orthocresol in. a solution of Potassium Iodide, and contains about 27 per cent, of 
Iodine, which it gives up to metallic oxides and mercury salts, and when brought into 
contact with aqueous liquids. It occurs as a very fine, amorphous, yellow powder, of 
faint, aromatic odor like that of saffron ; insoluble in water and in glycerin, soluble in 
alcohol, ether, chloroform and fatty oils; readily decomposed by heat and by starch, 
slowly by light. It is five times lighter and more bulky than Iodoform, and is used as a 
substitute therefor in all local applications where a dry antiseptic is required. Like 
Aristol, it should be kept in a dry place, and protected from the action of light. 

Europhen is a recent addition to the list of substitutes for Iodoform, and is perhaps 
the most highly vaunted of them all. Compared with the latter substance, its freedom 
from unpleasant odor, its greater bulk and lightness, and its powerful antiseptic and 
bactericidal qualities, make it an ideal application to sores and wounds, as also for the 
many protective requirements of minor surgery. Its virtues are probably due to the 



IPECACUANHA. 32 I 

readiness with which it liberates free, nascent Iodine, when in contact with aqueous 
liquids ; being fully equal in this respect to Iodoform. Used externally, it is dusted on 
in powder, or applied as a 5 to ic per cent, ointment with Lanolin as a base. It must 
not be combined with metallic oxides or mercurials, nor with zinc starch paste. For 
hypodermic use a 3 to 10 per cent, solution in Olive Oil is employed. A mixture of 
Europhen and Aristol, equal parts of each, is highly recommended for adhesiveness. 

Bismuthi Subiodidum, Bismuth Subiodide, BiOI, — isaheavy, amorphous, brick-red 
powder, insoluble in any reagent without decomposition. (See ante, page 185.) 

Bismuthi Subgallas, Bismuth Subgallate {Dermatol), — is a very fine saffron-yellow, 
odorless powder. (See ante, page 187.) 

These are two of the very best among the agents proposed as substitutes for Iodoform 
in local applications. They are non-irritant, powerfully bactericidal, and entirely odor- 
less. In the author's experience the Subiodide is exceedingly efficient in stimulating the 
growth of granulations in a large wound, such as that often necessary in the surgical 
treatment of fistula in ano. They are described under Bismuth [ante, page 186). 

Iodol, Tetra-iodo-pyrrol, — is obtained by treating Pyrrol, ( a coal-tar product), with a 
solution of Iodine in Potassium Iodide, usually known as Potassium Iodo-iodide solution. 
It occurs in very long, minute, delicate, prismatic crystals, of a yellowish tint, sparingly^ 
soluble in water, but readily in alcohol. When even slight decomposition is going on the 
crystals take on a brown tinge, due to the free iodine. Its odor is very slight, it being 
practically odorless when pure; and, unlike Iodoform, it has no toxic properties when 
undecomposed. It contains about 89 per cent, of Iodine. Dose, gr. ss-v, in tablet. 

Though insoluble practically in water, Iodol dissolves readily in the gastric juice, and 
is rapidly absorbed and as quickly diffused throughout the system. It has the same 
general action as Iodoform, except that it is devoid of toxic power. 

Iodol is a very close rival to Iodoform, and is used in almost every instance where the 
latter agent is applicable (Squibb). It should replace Iodoform largely as a topical 
application, on account of its freedom from unpleasant odor. Internally it is highly 
esteemed as a remedy in chronic gastric catarrh, intestinal catarrh, and in ulceration of the 
gastro-intestinal mucous membrane. It has been found to be highly useful in bronchitis, 
bronchial catarrh, and in various respiratory neuroses; and has seemed to render good 
service in the treatment of tuberculosis and syphilis. In eczema of the ear Iodol has 
recently proved very efficient. In moist confluent eczema of the pinna, extending 
within the auditory canal, the powder should be blown into the canal and upon the sur- 
rounding parts, after the surfaces have been thoroughly cleansed. In the dry, external 
form, it is best applied as an ointment with Lanolin. The inflammation disappears 
generally within two weeks, but irrigation should be kept up for a short time afterward 
in order to complete the treatment. (Chatellier.) 



IPECACUANHA, Ipecac, — is the root of Cephae lis Ipecacuanha, 
a small shrubby plant of the nat. ord. Rubiacese, growing in Brazil. It 
contains starch, gum, a trace of volatile oil, a crystalline alkaloid Emetine, 
C 2 oH 30 N0 5 , and a glucoside named Ipecacuanhic Acid. Dose of the 
powdered root, as an expectorant gr. ss-ij, as an emetic gr. xv-xxx. 

Preparations. 

Extractum Ipecacuanhae Fluidum, Fluid Extract of Ipecac , — Dose, Try-v. 

Syrupus Ipecacuanhae, Syrup of Ipecac, — strength 7 per cent. Dose, gj-iv. 

Vinum Ipecacuanhae, Wine of Ipecac, — strength 10 per cent. Dose, rr\j~~3J- 

Pulvis Ipecacuanhae et Opii, Powder of Ipecac and Opium, Dover's Potuder [Pulvis 
Doveri), — has of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, triturated together 
to a tine powder. Dose, gr. ij-xv or xx. 

Tinctura Ipecacuanhae et Opii, Tincture of Ipecac and Opium, — has of Tincture 
of Deodorized Opium 100 evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
to 100. Is a fluid representative of Dover's powder. Dose, n\ij-xx or xxx. 

Trochisci Ipecacuanhae, Troches of Ipecac, — each troche contains of Ipecac about 
gr.)/. Dose, j-iij. 

21 



322 IPECACUANHA. 

Trochisci Morphinae et Ipecacuanhse, Troches of Morphine and Ipecac, — each 
troche contains about gr. -^ of Morphine Sulphate, about gr. T x ? of Ipecac, with Oil of 
Gaultheria, Sugar, etc. Dose, j-iij. 

Emetina, Emetine (Unofficial), — a crystalline alkaloid, white, becoming yellow, odor- 
less, bitter, nearly insoluble in water, but forming with acids salts which are readily 
soluble. Is powerfully poisonous in large doses. Dose as an expectorant, gr. j l - ± ; 
as an emetic, gr. yfc—%. 

Physiological Action. 

Ipecac is nauseant, emetic, expectorant, cholagogue, diaphoretic, hemo- 
static, sternutatory, and counterirritant. Applied to the skin it produces 
pustulation, and used as snuff it excites violent sneezing and reflex 
mucous secretion, in some persons the smallest inhalation of the dust 
exciting an asthmatic paroxysm. Internally, small doses (gr. }£-}{) act 
as a stomachic tonic and increase the gastric secretions ; larger doses 
(gr. v-xx) are nauseant and emetic in from 20 minutes to half an hour, 
but the emesis produced is not violent nor is it followed by much depres- 
sion. If these doses are repeated a tolerance of the stomach to the drug 
becomes established and a cathartic action is produced, the stools having 
a peculiar bilious character. The circulation is only slightly affected by 
Ipecac, but it relaxes the skin and increases the broncho-pulmonary 
mucus, being diaphoretic and expectorant. In large doses it is decidedly 
irritant to the intestinal canal, but here also it is capable of the same tol- 
erance as in the stomach. In poisonous doses it has frequently produced 
hemoptysis and other hemorrhages. 

Emetine, the active principle, causes death in animals by cardiac 
paralysis, and the autopsies show evidences of gastro-intestinal irritation 
and hypersemic lungs with patches of hepatization. 

Antagonists and Incompatibles. 
Narcotics generally antagonize the emetic action, so also do Bismuth, Carbolic and 
Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable Acids and astringent 
infusions are incompatible with Ipecac. 

Therapeutics. 

Ipecac is much used as an emetic, being safe, efficient and non-depres- 
sant, though slow of action. It is the best agent of the kind to relieve 
the stomach in acute indigestion and bilious sick-headache, and an ipecac- 
vomit is frequently very serviceable at the commencement of eruptive, 
continued and periodical fevers. The syrup is a favorite domestic emetic 
to cut short an attack of spasmodic laryngitis, and it may be used bene- 
ficially in membranous croup and capillary bronchitis. 

Dysentery is a disease in which large doses of Ipecac (gr. xx every 4 
hours) are used with great success, especially in the epidemic form, and 
in the summer dysentery of teething children. Tolerance must be estab- 
lished to produce its curative action. In small doses (n\J of the wine) 
frequently repeated, it will relieve many kinds of vomiting, especially 
those of nervous origin, perhaps through a sedative action on the pneu- 



IRIS JALAPA. 323 

mogastric. As an antihemorrhagic, it has been efficiently employed in 
post-partum hemorrhage, menorrhagia, epistaxis, hemoptysis, etc., and it 
is considered very useful in night coughs, acute catarrh and bronchitis, 
spasmodic asthma and hay-fever. In most of these affections slightly 
nauseating doses must be used. 

IRIS, Blue Flag, — is the rhizome and roots of Iris versicolor, an 
indigenous plant of the nat. ord. Irideas, growing in moist meadows and 
on the borders of swamps, having large blue flowers. It contains tannin, 
sugar, starch, gum, an acrid resin, fixed oils and traces of an alkaloid. 
Dose of the powdered root, gr. v-xx. 

Preparations. 

Extractum Iridis, Extract of Iris. — Dose, gr. j-v. 

Extractum Iridis Fluidum, Fluid Extract of Iris. — Dose, rt\v~3J. 

Iridin or Irisin (Unofficial), — is a so-called resinoid found in the shops, of undeter- 
mined composition, but probably an oleoresin precipitated by water from an alcoholic 
preparation. Dose, gr. j-v. 

Physiological Action and Therapeutics. 

Iris when fresh is actively purgative, emetic and diuretic, producing 
severe nausea and prostration. Iridin has been the subject of experimen- 
tation upon dogs, and is shown to be a powerful hepatic stimulant with 
considerable influence on the intestinal glands, being more purgative than 
Euonymin and less irritant than Podophyllm. In very small doses it 
causes obstinate constipation by producing rectal inactivity. 

Iris is very serviceable in duodenal catarrh with obstruction of the bile- 
ducts and consequent jaundice, also in malarial poisoning, bilious remit- 
tents, and jaundice of malarial origin. It is used in many hepatic and 
intestinal disorders as a cholagogue and purgative of mild but efficient 
action, also as a diuretic in dropsies. In small doses (try of a tincture) it is 
strongly recommended in a peculiar blinding headache in the right supra- 
orbital region with nausea or vomiting, supposed to be of hepatic origin. 

JALrAPA, Jalap, — is the tuberous root of Ipomcea Jalafia, a Mexican 
plant of the nat. ord. Convolvulaceae. It contains 15 to 20 per cent, of 
the official Resin, which is composed of two resins, Jalafin, soft, soluble 
in ether, and Convolvulin, C 31 H 50 O 16 , which is hard, insoluble in ether, and 
the most active of the two. 

Preparations. 

Extractum Jalapae, Extj-aci of Jalap. — Dose, gr. ij-x. Is an ingredient of Pil. 
Cathartics Co., and Pil. Cathartics Vegetabiles. 

Resina Jalapae, Resin of Jalap, — prepared from a tincture by precipitation by water. 
Is insoluble in water, soluble in alcohol. Dose, gr. ij-x. 

Pulvis Jalapas Compositus, Compound Powder of Jalap, (Piilvis Purgans), — has 
of Jalap 35, Potassium Bitartrate 65, rubbed together until thoroughly mixed. Dose, 
g r - x "3J- 



324 jambul juglans. 

Physiological Action and Therapeutics. 

Jalap is an active cathartic, producing copious and watery stools, with 
considerable tormina and tenesmus, also sometimes nausea. It does not 
produce hemorrhoids, but does increase the secretions of the intestinal 
canal and the flow of bile. Its action is not due to any one of the con- 
tained principles, but all the active constituents are found in the resin. 
Compared with other agents of the same class its action most resembles 
that of Scammony. It is more drastic than Senna and less irritant than 
Gamboge, but in overdoses may produce dangerous hypercatharsis. 

Convolvulin in sufficient dose is an active irritant poison, producing 
gastro-enteritis and narcotism. Its action as a purgative seems to be 
wholly local, as from its intravenous injection no catharsis results, yet it 
exerts little if any irritant action on the conjunctiva, nasal mucous mem- 
brane or skin. It is not eliminated in the urine or the feces, and is there- 
fore probably destroyed in the system by oxidation. 

In olden bowel-moving times Jalap and Calomel were used together in 
doses of gr. x each (" ten and ten "), as a routine purgative prescription. 
Less ponderous doses are now considered equally efficient, and one grain 
of each agent with the same quantity of Extract of Hyoscyamus as a cor- 
rective may be used with advantage at the onset of fevers and inflam- 
mations. As the compound powder it is much employed to produce free 
watery evacuations in ascites and anasarca. Being nearly tasteless it is a 
useful cathartic for children, and may be administered in Syrup of Rhubarb 
(gr. ij-v in §ss). As a vermifuge it is efficient as an adjunct to more 
powerful agents, and is employed with Calomel and Santonin for the 
expulsion of lumbrici. Jalap is contraindicated in all inflammatory con- 
ditions of the intestinal mucous membrane, but in proper doses it is one 
of the most manageable and efficient cathartics. 



JAMBUL, Jamun (Unofficial), — the seeds and bark of the Eugenia Jambolana, a 
native tree of India, has a very varied history of successes and failures in the treatment 
of diabetes. The British Medical Association has directed its Committee on Therapeutics 
to investigate thoroughly the claims made for and against this agent, so that some reliable 
information may be expected concerning this very important question. One writer con- 
tends that any efficient preparation should be made from the fresh seeds, discarding the 
pericarps, and avoiding the application of heat ; also that a weak alcoholic menstruum 
exhausts the drug and gives a stable preparation. 

Late reports, from observers abroad and in this country, show that favorable results are 
obtained with Jambul in many cases of diabetes, even after the unsuccessful use of all the 
usual remedies. In two severe cases, in which 7 and 3 per cent, respectively of glucose 
was excreted, the urine was brought back to normal and kept there for two years, by the 
use of this remedy. It should be given with or after meals, in water or wine sweetened 
with a small quantity of saccharin, and accompanied by general treatment. 



JUGLANS, Butternut, — is the bark of the root, collected in autumn, of Juglans 
cinerea, the Butternut or White Walnut, an indigenous forest tree of the nat. ord. 
Juglandacese. It contains an orange-yellow, crystalline and acrid substance named 



JUNIPERUS. 325 

Juglandic Acid or Xucin, resembling Ckrysophanic Acid, also some resin, volatile acid, 
etc., but neither tannin nor any alkaloid. 

Extractum Juglandis, Extract of Juglans. — Dose, gr.v-xx or more. 

Juglans is a mild cathartic operating without the production of pain or irritant symp- 
toms. It is never used in substance, but the extract is a good laxative in doses of gr.v-x, 
and a purgative in larger doses. It has considerable reputation in dysentery and chronic 
constipation. 



JUNIPERUS, Juniper, — the source of the official Oleum Juniperi, 
is the fruit of Juniperus communis, an evergreen shrub of the nat. ord. 
Coniferae, growing in Europe and N. America. It contains a Volatile Oil, 
which consists of terpenes and camphors in complex combination, also a 
non-crystallizable principle named Juniperin, and grape sugar, resin, 
formic, acetic and malic acids, etc. The Oil, a Spirit, and a Compound 
Spirit are official. 

Preparations. 

Oleum Juniperi, Oil of Juniper, — is the volatile oil, a colorless or faintly greenish- 
yellow liquid, sp. gr. 0.850 to 0.890; of terebinthinate and sweetish taste, and the odor 
of juniper ; soluble in 4 times its vol. of alcohol, and in an equal vol. of carbon disul- 
phide. Dose, TT\v-xv. 

Spiritus Juniperi, Spirit of Jtmiper, — has of the Oil 5 in Alcohol 95. Dose, ^j-iv 
or more, according to the quantity of alcohol desired. 

Spiritus Juniperi Compositus, Compound Spirit of Jtaiiper, — has of the Oil 8, Oil 
of Caraway I, Oil of Fennel 1, Alcohol 1400, Water to 2000. It approximates closely 
to a good grade of Gin. (See a?tte, page 108.) Dose, 3 j-iv, or more, according to the 
quantity of alcohol desired. 

Oleum Cadinum, Oil of Cade {Empyreumatic Oil of Junipe?-), — is a product of the 
dry distillation of the wood of Juniperus Oxycedrus. It is a tar-like substance, of un- 
certain composition and purity : a dark-brown, clear, thick liquid, of tarry odor and a 
somewhat bitter, burning taste ; insoluble in water, partially soluble in alcohol, com- 
pletely so in ether, chloroform or carbon disulphide. Used locally as a stimulant in pso- 
riasis and chronic eczema. 

Infusum Juniperi, Infusion of Juniper (Unofficial), — has of Juniper Berries ^j in 
Oj of boiling water. Dose, 3 j-ij. 

Juniper is a stomachic tonic, diaphoretic, diuretic and aphrodisiac. 
The oil is the active principle, and is readily diffused, exciting increased 
cardiac action, stimulating the renal functions and the action of the skin, 
and causing a subjective sense of heat throughout the system. It is elimi- 
nated chiefly by the kidneys, and may set up renal irritation, in large 
doses producing strangury, priapism, hematuria, suppression of the urine, 
and uraemic convulsions. It imparts a violet odor to the urine, and will 
produce diuresis when inhaled. 

The Oil of Juniper is used to flavor gin and to impart the diuretic power 
popularly ascribed to that liquor. The medicinal use of the juniper 
preparations (spirit and compound spirit) is restricted to their employ- 
ment as vehicles for less irritant diuretics. The oil acts therapeutically 
like the Oil of Turpentine, and may be used in chronic pyelitis and cys- 
titis, prostatorrhcea, gleet, etc., but it is contraindicated in all cases where 
acute inflammation of the kidneys exists. 



326 KAMALA KAVA-KAVA KINO — KRAMERIA. 

Oil of Cade is used locally in chronic skin diseases as a stimulant appli- 
cation. It is too active for acute eruptions, but has been used with benefit 
in chronic eczema and psoriasis. The Oil of Tar (see under Pix) is equally 
efficient for all the purposes to which the Oil of Cade has been applied. 



KAMALA, Rottlera, — the glands and hairs from the capsules of Mallotus philip- 
pinensis, or Rottlera tinctoria, a small tree of the nat. ord. Euphorbiaceoe, growing in 
Abyssinia, Arabia, India, China, etc. It occurs as a granular, mobile, brick-red powder, 
inodorous and nearly tasteless, partly soluble in alcohol and ether. It contains several 
resins, one of which is named Rottlerin, C n H 10 O 3 , also tannin, starch, gum, red coloring 
matter, etc. There are no official preparations. Dose, gss-iij. 

Kamala is anthelmintic and purgative, sometimes causing nausea and colic, seldom 
vomiting. It is used as a taeniafuge, and to expel lumbrici and ascarides vermiculares. 
One or two drachms are given suspended in water, mucilage or syrup, and repeated in 4 
hours if necessary. A tincture ( J vj in xvj of alcohol) may be used in doses of 3 j- 3 ss. 
In India it is used locally in scabies and other skin affections and has been found of 
especial service in herpetic ringworm. As a remedy against tapeworm it is perhaps next 
after Male-fern in efficiency and requires no preparatory treatment. 



KAVA-KAVA, Ava-Kava (Unofficial), — the root of Piper methysticum, a shrub 
of the nat. ord. Piperacese, growing in South America and the South Sea Islands. It 
contains a crystalline principle, Kavahin or Methysticin, which is analogous to Piperin, 
an acrid, greenish-yellow resin, Kawin, which is probably the active principle, also a 
Volatile Oil. Dose, ^ss-j, macerated in water, or the same quantity of a fluid extract. 

Kava is intoxicant, diuretic and motor-depressant. A beverage is prepared in the 
Sandwich Islands by chewing the root and then infusing it in water or cocoanut milk, 
which produces a drowsy intoxication with pleasant dreams often of erotic character, and 
followed by severe headache. A moderate dose is tonic and stimulant, lessening the 
sense of fatigue and sharpening the mental faculties. It is highly recommended in 
gonorrhoea and gout, also in chronic gleet and obstinate cystitis. 



KINO, — is the inspissated juice of Pterocarpus Marsupium, a tall tree of the nat. ord. 
Leguminosae, growing in India. It contains 75 per cent, of a variety of tannin named 
Kino-tannic Acid, C 18 H 18 8 , which gives a greenish precipitate with persalts of iron, also 
a crystalline, neutral substance, Kinoin, C u H 12 6 , and Kino-red, formed from Kino- 
tannic Acid by oxidation, besides gum, pectin, etc. There are several other varieties of 
Kino in the market, brought from S. America, Africa, Australia, etc., which are products 
of other trees than the official one. 

Tinctura Kino, Tincture of Kino, — strength 10 per cent. Dose, TT^x-^ij. 

Pulvis Kino Compositus (Unofficial). — Kino 15, Opium I, Cinnamon 4 (has of 
Opium I in 20). Dose, gr.v-xx. 

The action of Kino is the same as that of Tannic Acid, though less powerful (see ante, 
page 94), and it may be used for the same purposes, both internally and locally. It is 
chiefly employed as an astringent gargle and as a constituent of diarrhoea- mixtures. The 
tincture, in drachm doses, is one of the most efficient means of combating the atonic 
diarrhoea which results from disuse of opium or morphine. 



KRAMERIA, Rhatany, — is the root of Krameria triandra and Krameria Ixina, 
shrubs of the nat. ord. Polygaleae, growing in S. America, the first-named in Peru and the 
latter in New Granada. It contains 20 to 45 per cent, of Rhatania-tannic Acid, C 54 H 24 21 , 
and Rhatanine, C 10 H 13 NO 3 , an alkaloid, — also, wax, gum, etc. 

Extractum Krameriae, Extract of Krameria, — aqueous. Dose, gr. v-x. 

Extractum Krameriae Fluidum, Fluid Extract of ICrameria. — Dose, rr\v- ^ ss. 

Tinctura Krameriae, Tincture of Krameria, — 20 per cent. Dose, TT^v-^j. 



KUMYSS. 327 

Syrupus Krameriae, Syrup of Kra??ieria, — Fluid Extract 45, Syrup 55. Dose, 
5jss-|; ss. 

Trochisci Krameriae, Troches of Krameria, — each troche contains gr. j of the extract, 
with Tragacanth, Sugar and Orange-Flower Water. 

Krameria possesses the same astringent qualities as Tannic Acid (see ante, page 94), 
and may be employed for the same purposes, except as an antidote to Antimony. It has 
long had a high reputation as an injection for fissure of the anus, as a local application to 
spongy gums, and as a tonic for debilitated subjects. 



KUMYSS, Koomiss (Unofficial), — is an effervescing fermented 
liquor originally prepared by the Tartars from mare's milk, but now- 
imitated with cow's milk by adding sugar of milk, fermenting in open 
tanks, skimming off the casein and butter, then bottling during active 
fermentation. Its successful preparation depends on its undergoing slow 
fermentation in a cold room, at 50 F. or less. If the temperature be 
higher, the fermentation will be of the acetous variety, and will result in 
sour milk with heavy curd, feeble effervescence and repulsive taste. 

Wolff's Formula, for its preparation in small quantity, is as follows : — Dissolve % ss 
(a tablespoonful) of grape sugar in % iv of water. Dissolve gr. xx (a teaspoonful) of 
Fleischmann's compressed yeast or well washed and pressed out brewer's yeast in !§ i j of 
cow's milk. Mix the two solutions in a quart champagne bottle, and fill to within two 
inches of the top with good cow's milk. Cork well, secure the cork with wire, keep it in 
a cellar or ice chest, maintaining a temperature of 50 F. or less, and agitate twice daily. 
In three or four days it is ready for use, but should not be kept longer than four or five 
days. Draw it with a champagne tap. 

Kumysgen is a powder containing the elements necessary for the preparation of 
Kumyss, for which a special bottle and tap are also furnished by the manufacturers. It is 
a very convenient manner of making this preparation, and the product tastes just as well 
as that made in the ordinary way. Whether it acts as well therapeutically remains to be 
ascertained. 

Physiological Action and Therapeutics. 

The taste of Kumyss is acidulous and peculiar. In large quantity it 
takes the place of food, each quart equalling four ounces of solids. It is 
said to be a powerful diuretic, especially in cold weather, and in warm 
weather to produce free diaphoresis. It is stimulating and tonic, increases 
the body nutrition and produces considerable somnolence. The stomach 
is very tolerant of it, and retains it when any other food will be rejected. 
It is easily assimilated and very nutritious. 

Kumyss is an invaluable article of diet in many wasting diseases, espe- 
cially phthisis. It is also of great benefit in dyspepsia, the diarrhoea of 
children, convalescence from acute maladies, chronic affections of the 
kidneys, chronic bronchitis, and other cachexias. In cases of feeble 
digestive power gj every hour is sufficient, but as its digestion and assimi- 
lation increase it may be given almost ad libitum, and when used with 
other food a half-pint may be taken after each meal. Each quart is esti- 
mated to contain four ounces of solid food, besides from 1 to 3 per cent, 
of alcohol. 



Kumyss. 
II. 2 


Kefir. 
38 


20.5 


20 


22. 


20 


n-5 

16.5 


9 

8 


918.3 


905 



328 LACTUCARIUM— -LAPPA. 

Kefir is the name of a fermented drink prepared from the milk of a cow or mare by 
the addition of a mushroom-like ferment found near the snow-line in the Caucasian Moun- 
tains. It is used by the natives of the Asiatic plains as a remedy for struma, anaemia, 
lung and stomach diseases. Kefir is richer in albumen than Kumyss, is less alcoholic 
and less acid. 

The following table of analysis shows the average composition of Milk, Kumyss and 
Kefir: — 

Cow's milk. 

Albumen, 48 

Butter, 38 

Sugar of milk, 41 

Lactic acid, — 

Alcohol, — 

Water and salts, 873 



LACTUCARIUM, Lettuce, — is the concrete milk -juice of Lactuca 
virosa, or Acrid Lettuce, a biennial European plant, of the nat. order 
Compositse. It is partly soluble in alcohol and in ether, and yields a 
turbid mixture when triturated with water. Lactucarium is a mixture of 
several substances, the most important being Lactucerin, 42 per cent., a 
crystalline, tasteless body, resembling caoutchouc, insoluble in water and 
probably inert; Lactucin, 0.3 per cent., a neutral principle, crystallizing 
in pearly scales, insoluble in cold water, persistently bitter; Lactucic Acid, 
bitter, amorphous, but crystallizes after long standing. 

Tinctura Lactucarii, Tincture of Lactucarium, — 50 per cent. Dose, TT^x-^ij, 
according to the activity of the drug. 

Syrupus Lactucarii, Syrup of Lactucarium, — has of the Tincture 10 per cent. 
Dose > 3J-3J- 

Lactucarium is feebly hypnotic, somewhat sedative and diuretic. It is 
supposed to act similarly to Opium, but very feebly and without depressing 
after-symptoms. Its preparations are very uncertain in activity, and are 
chiefly used as placebos, to allay cough and quiet nervous irritability. The 
syrup is a good vehicle for expectorants and antispasmodics. 



LAPPA, Burdock, — is the root of Arctium Lappa, and of some other 
species of Arctium, the common Burdock, a coarse-looking biennial weed 
of the nat. ord. Compositse, found in waste places and along roadsides in 
Europe, Asia and N. America. Three varieties are recognized, formerly 
known as Lappa major, L. tomentosa, and L. minor, of which the first- 
named is most frequently met with in this country. It contains a bitter 
principle, traces of a volatile oil, also inulin, resin, tannin, mucilage, 
sugar, etc. 

Extractum Lappse Fluidum, Fluid Extract of Lappa, — made with diluted alcohol. 
Dose, 3J-ij. 

Dr Squibb recommended a Tincture of the seed ; lb. j of ground seed to gall, j of 
whiskey, allowed to stand for two weeks before decanting, and used in doses of 3 ij-iij 
before meals. 



LAVANDULA LEPTANDRA LICOPERDON. 329 

Lappa promotes all the secretions and is considered aperient, diuretic 
and diaphoretic, without irritating qualities. In decoction it has been a 
popular domestic remedy for many morbid conditions, especially rheuma- 
tism, gout, pulmonary catarrhs, and chronic cutaneous affections. By 
several practitioners it is praised as an alterative in constitutional diseases, 
as syphilis and scrofula, also as an external application to swellings, 
hemorrhoids and chronic sores. A tincture of the seed has proved re- 
markably efficient as a stomachic tonic and has cured several cases of 
psoriasis inveterata. [See Squibb's Ephe??ieris, vol. i, page 116.] 



LAVANDULA, Lavender, — the source of the official Oil of Lavender Flowers, is 
the fresh flowers of Lavandula officinalis, a small European shrub of the nat ord. 
Labiate, largely cultivated in England. They have a bluish-gray tubular calyx, a violet- 
blue corolla, a fragrant odor, and an aromatic, camphoraceous taste ; and contain resin 
and tannin, also a Volatile Oil. 

Oleum Lavandulae Florum, Oil of Lavender Flowers, — is a volatile oil distilled 
from fresh Lavender, and having the fragrant odor of the flowers. It is soluble in alco- 
hol in all proportions, also in 3 times its volume of a mixture of alcohol 3 and water I, 
also in glacial acetic acid. Sp. gr. 0.885 to °-897 at 59 F. Dose, rrL j-v. 

Spiritus Lavandulae, Spirit of Lavender, — has of the Oil 5, in Deodorized Alcohol 
95. A perfume and flavoring. Dose, £ss-j. 

Tinctura Lavandulae Composita, Con/pound Tincture of Lavender, — an aromatic 
stimulant, composed of the Oil 8, Oil of Rosemary 2, Cassia Cinnamon 20, Cloves 5, 
Xutmeg 10, Red Saunders 10, Alcohol 700, Water 250, Diluted Alcohol to 1000. Is a 
constituent of Liquor Potassii Arsenitis. Dose, ^ss-ij. 

Lavender is aromatic, stimulant and carminative, but is rarely used alone as a medicine. 
It is an agreeable flavoring and perfume, in the form of the official spirit, which is sold 
under the name of " Lavender-water " after the addition of Oil of Bergamot and Essence 
of Ambergris. The compound tincture, formerly called the compound Spirit of Laven- 
der, is a very agreeable compound of spices, and is much used as a remedy for gastralgia, 
nausea, flatulence, etc., and as an adjuvant or corrigent of other medicines. 



LEPTANDRA, Culver's Root, — is the rhizome and rootlets of Veronica virginica, 
an indigenous perennial plant of the nat. ord. Scrofularineae. It contains a glucoside 
named Leptandri7i, which is probably the active principle, also Saponin, resin, tannin, 
etc. The Leptandrin of the shops is an impure alcoholic extract. 

Extractum Leptandrae, Extract of Leptandra , — is a constituent of Pil. Catharticae 
Veg. Dose, gr. j-iij. 
Extractum Leptandrae Fluidum, Fluid Extract of Leptandra. — Dose, n\xx-3J. 

Leptandra is tonic, laxative, and like other resin-bearing purgatives is decidedly chola- 
gogue. The recent root is a violent cathartic, but in the dried state it is less active. It 
is indicated in duodenal indigestion and chronic constipation with insufficiency of the 
biliarv and intestinal secretions. 



LICOPERDON GIGANTEUM, Puff-Bali (Unofficial),— is a common fungus of 
the nat. ord. Trichogastres, found in hilly and wooded districts. The dust, which con- 
sists of the capillitium and spores, is a valuable hemostatic, and dusted over bleeding 
surfaces acts promptly in arresting hemorrhage. It has been proposed as a surgical 
dressing, but while useful in emergencies where other agents are unattainable, the fetor 
which results from its application to wounds will prevent its use becoming general for 
this purpose. It may prove of value as an internal hemostatic in hematemesis and the 
hemorrhage of typhoid fever. 



330 LIMON. 

LIMON, Lemon, — is the fruit of Citrus Li??ionum, a tree of the nat. 
ord. Rutaceae, native in Asia, but cultivated in southern Europe and 
many other countries. It is official in the two forms described below. 
The Orange {Citrus Vulgaris and C. Aurantiuni), the Citron {Citrus 
medico), and the Lime ( Citrus acris), all belong to the same genus as the 
Lemon {Citrus Limonutri). 

Limonis Cortex, Lemon Peel, — is the rind of the recent fruit, and 
contains a Volatile Oil, C 10 H 16 , which is official, and a bitter crystalline 
glucoside, Hesperidin, C 22 H 26 12 , chiefly contained in the white portion of 
the rind. 

Limonis Succus, Lemon Juice, — is the freshly expressed juice of the 
ripe fruit, each lemon yielding from ^ to i fluid ounce. It contains 
about 7 per cent, of free Citric Acid, besides Phosphoric and Malic Acids, 
Citrates of Potassium and of other bases, etc. Dose, j|ss— iv. 

Acidum Citricum, Citric Acid, H 3 C 6 H 5 7 + H 2 0, — is obtained 
from the juice of the Lemon or the Lime by adding chalk to form Calcium 
Citrate, which is then decomposed by dilute Sulphuric Acid. It occurs 
in colorless, rhombic crystals which are very soluble in water. A solution 
of gr. xvij in £ss of water corresponds to ^ss of fresh lemon-juice, and this 
quantity of either will neutralize of Potassium Bicarbonate gr. xxv, of 
Sodium Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. 
Dose, gr. x-xxx. 

Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and Ammonium, Iron and 
Quinine, Iron and Strychnine, Lithium, Magnesium, Potassium, nine in all, are official. 
They are described under their respective bases, to which their medicinal qualities are due. 

Preparations. 

Oleum Limonis, Oil of Lemon, C 10 H 16 , — is the volatile oil, isomeric with oil of tur- 
pentine, and extracted from fresh lemon peel by mechanical means. It is used for flavor- 
ing and is an ingredient of Spiritus Limonis, Spiritus Aurantii Compositus, and Spiritus 
Ammonite Aromaticus. Dose, tt\j-v. 

Spiritus Limonis, Spirit of Lemon, Essence of Lemon, — is prepared by macerating 
5 of the Oil and 5 of the Peel, freshly grated, in Deodorized Alcohol to ioo. Used for 
flavoring. Dose, according to the amount of alcohol desired to be given. 

Syrupus Acidi Citrici, Syrup of Citric Acid, — has of Citric Acid io, Water io, 
Spirit of Lemon io, Syrup to ioo. Dose, indefinite. 

Physiological Action and Therapeutics. 
Lemon-peel is bitter and probably tonic to the stomach, but is only 
used for flavoring purposes. Lemon-juice, on the other hand, is refrig- 
erant and antiscorbutic, entering the blood as alkaline citrates, potassium 
salts and phosphoric acid, the citrates being therein partly oxidized into 
C0 2 and H 2 0, while the potassium salts and phosphoric acid probably act 
upon the red corpuscles. Citric Acid has the same general action as 
Acetic and the other vegetable acids. [See under Acidum Aceticum, 
ante, page 70.] It is wholly decomposed in the blood, and appears to be 



LI NUM. 331 

non-toxic in man, but used internally it may precipitate uric acid and thus 
promote the formation of calculi. 

Lemon-juice is employed largely in the treatment and prevention of 
scurvy, in which disease it possesses powers of specific rank, but whether 
its action therein is due to the citric acid, the phosphoric acid or the salts 
of potassium is not known. Lime-juice is equally efficient but Citric Acid 
itself is not so. 

As refrigerants and diuretic mixtures in fevers, Lemon-juice and Citric 
Acid are much used, entering into the composition of lemonades, effer- 
vescing draughts, etc., to allay thirst and subdue restlessness, and to pro- 
mote the action of the skin and the kidneys. For acidity of the stomach 
they are efficient if given in small doses before meals, but the mineral 
acids are usually preferred for this purpose. Long-continued they will 
impair digestion and impoverish the blood. Atheromatous degeneration 
of the vessels is said to be retarded by the daily use of lemon-juice, which 
is supposed to dissolve the excess of inorganic matter and to aid its ex- 
cretion. Obesity may be reduced by using the juice of limes or lemons in 
large quantity, but it will be done at the expense of the digestion. Lemon- 
juice has been found of service in acute rheumatism, probably through 
the alkalies which it conveys into the blood. As a local application it 
has been found efficient in pruritus scroti, sunburn, post-partum hem- 
orrhage, and as a gargle in diphtheritic sore throat. 



LINUM, Linseed, Flaxseed, — is the seed of Linu??i usitatissimum 

(flax), a cultivated annual plant of the nat. ord. Linese. It contains 
15 per cent, of Mucilage in the epithelium, also 30 to 40 per cent, of 
Fixed Oil in the embryo. Ground Linseed should yield not less than 25 
per cent, of the fixed oil. 

Preparations. 

Oleum Lini, Linseed Oil, — the fixed oil expressed from Linseed without the use of 
heat. A yellow, oily liquid, of slight odor, bland taste, and neutral reaction, soluble in 
about 10 of absolute alcohol and in I l / z of ether. Consists chiefly of the Glyceride of 
Linoleic Acid, C 16 H 28 4 , which having a powerful affinity for oxygen becomes resinoid 
on exposure to the air, making it a " drying oil." Dose, ^ss-ij. 

Infusum Lini, Linseed Tea (Unofficial), — Linseed .^iij, Liquorice-root gj, Boiling 
Water 3 x, infused for four hours and strained. Dose, indefinite. 

Linimentum Calcis, Lime Liniment, Carron Oil, — consists of equal volumes of 
Linseed Oil and Lime-water, emulsified by agitation. A favorite application for burns. 

Physiological Action and Therapeutics. 
Linseed is demulcent, emollient, expectorant and diuretic. The oil is 
laxative in a dose of 3J, and in smaller doses is oxidized in the system 
and excreted as a resinoid body by the kidneys, which it stimulates 
slightly. The Infusion contains the mucilaginous principle and a small 
portion of the oil, and is advantageously used in inflammations of the 



332 LITHIUM. 

mucous membrane of the throat, the gastro-intestinal tract and the urin- 
ary passages. It is an excellent demulcent in coughs of various kinds, 
and will be found very serviceable in cystitis, irritable bladder, renal 
colic, strangury, etc. The Oil may be administered internally as a laxa- 
tive, and has considerable reputation as a remedy for hemorrhoids in 
doses of ^ij twice daily. For laxative purposes (especially in children) 
it is usually administered as an enema. Externally it is a favorite appli- 
cation to burns, when made into an emulsion with lime-water, as in the 
official Linimentum Calcis. The ground seed (linseed or flaxseed meal), 
is one of the best agents for making poultices, and is universally employed 
for that purpose. [Compare the article on Poultices in Part III.] 



LITHIUM, Li, — is represented in the Pharmacopoeia by five of its 
salts, of which the Carbonate is but slightly soluble while the others are 
readily so. The low atomic weight of this metal (7) makes its saturating 
power greater than that of other alkaline metals, hence the value of its 
salts in medicine. 

Salts of Lit hit an. 

Lithii Benzoas, Lithium Benzoate, LiC 7 H 5 0. 2 , — is classed with the Benzoates and 
described under BENZOINUM. (See ante, page 184.) 

Lithii Bromidum, Lithium Bromide, LiBr, — is classed with the Bromides and de- 
scribed under Bromum. (See ante, page 187.) 

Lithii Carbonas, Lithium Carbonate, Li 2 C0 3 , — a light, white powder, permanent 
in the air, odorless, of alkaline taste and reaction, soluble in 80 of water, insoluble in 
alcohol. Dose, gr. ij-xv. 

Lithii Citras, Lithium Citrate, Li 3 C 6 H 5 7 , — a white, deliquescent powder, odorless, 
of faintly alkaline taste and neutral reaction, soluble in 2 of water, almost insoluble in 
alcohol. Dose, gr.v-xxx. 

Lithii Citras Effervescens, Effervescent Lithium Citrate, — prepared from the Car- 
bonate 7, with Sodium Bicarbonate 28, Citric Acid 37, and Sugar to 100. Dose, gj-ij, 
in water, as an effervescent drink. 

Lithii Salicylas, Lithium Salicylate, 2LiC-H 5 3 , — is classed with the Salicylates and 
described under Salix. 

Physiological Action and Therapeutics. 
The Lithium salts have strong alkaline qualities and act on the system 
in the same manner as other alkalies (see under Potassium). The high 
saturating power of this metal makes its salts more alkaline than those of 
Potassium, Sodium or Calcium, hence more efficient in alkalinizing the 
urine. Lithium Urate is the most soluble of the alkaline urates, hence 
the value of lithium salts in the uric acid diathesis. The Carbonate and 
Citrate are the salts referred to in this connection, the others partaking 
more of the qualities of their acid factors. Both these salts are antacid 
and strongly diuretic ; the Carbonate being but slightly soluble should be 
given in carbonic acid water, and the Citrate in dilute solution. The 
latter may be extemporaneously prepared by adding citric acid to an 



LOBELIA. 333 

aqueous solution of the carbonate, and in the organism is decomposed, 
the citric acid being oxidized and the carbonate formed. Many mineral 
waters contain small quantities of the carbonate, varying from a mere 
trace to grain o.oi to a pint, an amount so minute as to be practically 
inert in comparison with the much greater quantities of potassium and 
sodium salts in the same waters. 

Lithium Carbonate and Citrate are extensively used in gout and the 
lithsemic diathesis, for the purpose of holding the uric acid in solution as 
lithium urate, and preventing its deposit in the tissues as sodium urate 
which is less soluble. Their prolonged administration is so efficient in 
this affection that they have been credited with the power of dissolving 
uric acid calculi and called lithontriptics. They are also highly useful in 
the indigestion and rheumatism of obese subjects, and in irritable bladder 
from excess of acid in the urine. Lithiated Arsenical Water has been 
lately praised as a remedy in diabetes. 



LOBELIA, Lobelia, Indian Tobacco, — the leaves and tops of 
Lobelia inflata (nat. ord. Lobeliaceae), collected after a portion of the 
capsules have become inflated. The plant is a common annual weed 
growing on roadsides throughout the United States, having pale-green 
alternate leaves, and small, pale-blue flowers. It contains gum, resin, 
fixed oil, wax, lignin, salts of lime, potassium and iron, a liquid alkaloid, 
Lobeline, which is the narcotic principle of the plant, also Lobelic Acid, 
and an acrid substance named Lobelacrin. 

Preparations. 
Extractum Lobelia? Fluidum, Fluid Extract of Lobelia. — Dose, HI j-x. 
Tinctura Lobeliae, Tincture of Lobelia, — 20 per cent. Dose, TT\v-xxx. 
Infusum Lobeliae, Infusion of Lobelia (Unofficial), — ^j to a pint. Dose, <5J-]fj. 
Lobelinum, Lobelin (Unofficial), — an impure resinoid. Dose, gr. ss-j. 

Physiological Action and Therapeutics. 

Lobelia has an acrid, nauseous taste, and a heavy, unpleasant odor. It 
is expectorant, diaphoretic, emetic, purgative, antispasmodic, motor-de- 
pressant and narcotic. It excites an abundant flow of saliva, much gastric 
mucus, profuse urination and sweating, with nausea, vomiting and great 
depression. The heart's action is enfeebled, and the blood-pressure, at 
first increased, soon falls ; muscular debility, reduced temperature and 
coma follow, and death occurs by paralysis of the respiratory apparatus. 
The drug produces paralysis of the motor nerve-trunks, the peripheral 
vagi, and probably the respiratory and vaso-motor centres also. It strongly 
resembles tobacco in its action, and is highly dangerous in full medicinal 
doses, having caused many deaths when administered therapeutically, the 



334 LYCOPODIUM MAGNESIUM. 

most important instance of its fatal results being the case of Ezra 
Lovett, Jr., who in 1809 was poisoned by Lobelia administered by the 
founder of the Thomsonian sect of medical practitioners. The responsi- 
ble party escaped conviction on the plea that he gave the drug in igno- 
rance of its qualities. 

Antidotes and Incompatibles. 

Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and Thebaine 
antagonize its action on the nervous system ; the vaso-motor excitants, as Alcohol, 
Digitalis, Belladonna, Ergot, etc., antagonize its effects on the circulation. Caustic 
alkalies are incompatible, decomposing the alkaloid. 

Lobelia was a favorite remedy with the Indians at the time of the first 
settlement of the United States, and was introduced into regular practice 
as an anti-asthmatic, after having served as the main stock-in-trade of 
irregular practitioners for many years. Its principal therapeutic action is 
that of an antispasmodic, and in cautious hands it is extremely useful in 
paroxysmal spasmodic asthma, as well as in dry cough with constant tick- 
ling in the throat. As an enema in cases of strangulated hernia the infu- 
sion is much safer than Tobacco and fully as efficient, and may overcome 
the obstruction in intussusception, while the tincture in 2-drop doses 
every hour will often relieve a case of impacted caecum. In constipation 
from atony and deficient secretion a 10-minim dose of the tincture at bed- 
time acts excellently, and in the poison-oak eczema the infusion is a good 
local application. As an emetic it is entirely too depressant for children's 
use. 



LYCOPODIUM, — is a very mobile, pale-yellow, fine powder, consisting of the spores 
of the Club-moss, Lycopodium clavatum, and of other species of Lycopodium (nat. ord. 
Lycopodiacese), a native of Europe and the U. S. Lycopodium is odorless, tasteless, 
floats on water, which does not wet it, and burns quickly when thrown on a flame. It 
should be free from pine-pollen, starch, sand and other impurities, which are detected 
by means of the microscope, the lycopodium spores being about gig- of an inch in diame- 
ter, four-sided and reticulated, with short projections on the edges. They contain about 
47 per cent, of a bland, fixed oil. 

The plant was formerly considered to be diuretic and anti-spasmodic, and was used in 
rheumatism, epilepsy and pulmonary and renal disorders. The powder is now employed 
quite extensively in pharmacy to facilitate the rolling of a pill-mass and to prevent adhe- 
sion of pills to each other. It makes an excellent absorbent and protective powder when 
dusted over an excoriated surface, as seen between the thighs of infants. 

By the homoeopathic practitioners Lycopodium is elevated to the rank of an active 
drug when triturated with sugar of milk sufficiently long to break up the seeds and liber- 
ate their oily contents. In their first centesimal trituration ( t ^q) it is said to have pro- 
duced symptoms of high excitement of the circulation and irritation of the urinary organs, 
and they profess to use it with benefit in many affections of the mucous tracts, dyspepsia, 
pyrosis, flatulence, constipation, ileo-colitis of infants, hepatic congestion, aneurism, 
chronic affections of the lungs and bronchi, diphtheria, lithiasis, intertrigo, porrigo capitis, 
plica polonica and pruritus ani, in all of which as an internal remedy and in high attenua- 
tion. 



MAGNESIUM, Mg. — This metal is represented by its Oxide, 
Carbonate, Citrate and Sulphate, of which the latter occurs native in sea- 



MAGNESIUM. 335 

water, caves, etc., the others being prepared from it. The first two are 
almost insoluble in water or alcohol. Its salts are either white or color- 
less, and those which are official are as follows : — 

Official Salts of Magnesium. 

Magnesia, Magnesia, Magnesium Oxide, MgO, — made by heating the light carbon- 
ate in a crucible to expel nearly all the carbonic acid. A white, light and very fine 
powder, almost insoluble in water, insoluble in alcohol, and gelatinizes with 15 of water 
after standing ^ hour, having become hydrated. Is a constituent of Pulvis Rhei Com- 
positus, Massa Copaibae and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-^j. 

Magnesia Ponderosa, Heavy Magnesia, Magnesium Oxide, MgO, — is a white, 
dense and very fine powder, corresponding in other properties and reactions with Mag- 
nesia, except that it does not gelatinize with water. It is made by calcining the heavier 
variety of the carbonate, and is much slower in action than the light magnesia. Dose, 

g r - x ~3J- 

Magnesii Carbonas, Magnesium Carbonate, (MgC0 3 ) 4 Mg(HO") 2 -j- 5H 2 0, — light, 
friable masses, or powder, odorless and tasteless, insoluble in alcohol, almost insoluble in 
water. Dose, gr. x-gj. 

Magnesii Sulphas, Magnesium Sulphate, Epsom Salt, MgS0 4 + 7H 2 0, — colorless 
prisms or acicular needles, slowly efflorescent, odorless, of cooling, saline taste, and neu- 
tral reaction, very soluble in water, insoluble in alcohol. Is a constituent of Infusum 
Senna? Compositum. Dose, SJ-^fj- 

Preparations . 

Magnesii Citras Effervescens, Effervescent Magnesium Citrate, — is prepared from 
the Carbonate 10, Citric Acid 46, Sodium Bicarbonate 34, Sugar 8, Alcohol and Distilled 
Water, as required. A coarsely granular, white, deliquescent salt, of acid taste and 
reaction, soluble in 2 of water, insoluble in alcohol. Dose, ^j-^j- 

Liquor Magnesii Citratis, Solution of Magnesium Citrate, — prepared from the Car- 
bonate 15, Citric Acid 30, Syrup of Citric Acid 60, Potassium Bicarbonate 2 x / 2 , Water to 
360. Dose, ^iv-vj, repeated for catharsis. 

Mistura Magnesiae et Asafcetidae, Magnesia and Asafelida Mixture, Dewees' Car- 
minative (Unofficial), — contains of the Carbonate 5, Tincture of Asafcetida 7, Tincture 
of Opium I, Sugar 10, and Distilled Water to 100. Dose, £ss-iv. Used for flatulent 
colic and diarrhoea in infants. 

Physiological Action. 

Magnesia and the Carbonate are mildly laxative and antacid, neu- 
tralizing free acids in the stomach and forming therewith laxative salts. 
If used in large quantity for any length of time Magnesia may become 
hydrated and produce intestinal concretions. The freshly-precipitated 
Hydrate (see above under Mag7iesia) is an antidote to arsenic in solution, 
but less effective than the Hydrated Sesquioxide of Iron, with which it is 
combined in the official Ferri Oxidum Hydratum cum Magnesia. (See 
ante, page 282.) Magnesia may also be used in poisoning by acids or 
phosphorus. 

The Citrate and Sulphate are saline cathartics, the Sulphate being 
the most powerful, on account of its bitterness. If administered in plenty 
of water it usually produces a prompt and free discharge from the intes- 
tines, with but little irritation or griping, but often accompanied by a 
sense of coldness and depression. The purgative action is chiefly due to 



336 MAGNOLIA. 

its causing a greatly increased secretion of intestinal fluids, not by out- 
ward osmosis from the vessels, as was formerly taught, but by stimulation 
of the intestinal glandular appendages. If the purgative action should 
not take place a diuretic one may result, but to secure the desired cathar- 
sis the drug should be administered in a considerable quantity of water. 
Magnesium Sulphate is the principal aperient constituent of many of the 
popular laxative mineral waters, as Friedrichshall, Piillna, Hunyadi, etc. 
When injected into the circulation it is powerfully toxic, paralyzing first 
the respiration and then the heart. It abolishes sensation and paralyzes 
the sensory-motor reflex centres (Murrell). 

Therapeutics. 
Magnesia and the Carbonate are used as antacids and laxatives, in acid- 
ity, sick headache, flatulent colic, etc., and as antidotes in poisoning by 
acids, arsenic, phosphorus, mercuric and cupric salts. The Citrate is an 
agreeable laxative, cooling and acceptable to the stomach. The Sulphate 
is one of the most efficient of the saline cathartics and has a wide field of 
application. In acute inflammatory conditions, renal and cardiac dropsy, 
ascites from obstruction of the portal circulation, increased blood-pressure 
within the cranium, intestinal obstruction without acute inflammation, the 
constipation of lead poisoning, and habitual constipation from deficiency 
of the intestinal secretions, this agent will be found to be exceedingly 
serviceable. As it has but little influence on intestinal peristalsis it is 
usually combined with Senna, as in the official Black Draught, which in- 
creases its purgative action. Acute dysentery is well treated by Magne- 
sium Sulphate combined with diluted Sulphuric Acid, and followed by 
Opium and starch enemata. Bleeding from hemorrhoids and uterine 
hemorrhage are often relieved by the same combination when other agents 
fail. In acne vulgaris and other obstinate eruptions due to derangement 
of the stomach and intestinal canal, good results are often obtained by a 
purgative dose of the Sulphate daily before breakfast, or by doses of 5 
grains in water three or four times a day. The same salt, finely triturated, 
makes an excellent dusting powder for cases of acne rosacea. The ferro- 
saline mixture (see ante, page 284) is a very useful laxative in the consti- 
pation of anaemic women. The bitter taste of Epsom Salt is best covered 
by coffee. 



MAGNOLIA (Unofficial), — is the bark of Magnolia glanca (Sweet Bay, Swamp 
Sassafras), M. acuminata (Cucumber-tree), and M. tripetala (Umbrella-tree), all of which 
belong to the nat. ord. Magnoliaceae, and are indigenous to the Eastern and Southern 
States. It contains a crystalline principle named Magno/in, which is insoluble in water, 
but soluble in alcohol, ether, etc. Dose of the powdered bark, .^ss-j. 

Magnolia is an aromatic bitter tonic and diaphoretic, usefully employed in chronic 
rheumatism, remittent and intermittent fever. In the latter affection it will arrest the 
paroxysms if used freely. 



MALTUM MANACA MANGANUM. 337 

MALTUM, Malt (Unofficial), — is the seed of Hordeum distichum, Barley (nat. ord. 
Graminacese), caused to enter the incipient stage of germination by artificial means and 
dried. The germination is allowed to go far enough to develop the maximum amount 
of Diastase, the peculiar ferment by which the starch of the grain is converted into Glu- 
cose. Malt is the source of beer, ale and whiskey, and is composed of the germinated, 
dead grains with their acrospires and radicles. It should be fresh, not darker in color 
than a pale amber, and of agreeable odor and sweet taste. 

Extractum Malti, Extract of Alalt (Unofficial), — is a liquid of the consistence of 
thick honey, containing all the soluble principles of malt in permanent form. It consists 
chiefly of diastase and glucose. Dose, ,5J-iv. 

Horlick's Food (Unofficial), — is like Mellin's and many other foods for children, a 
granulated Extract of Malt. ffojfs Malt Extract is another such preparation, contain- 
ing alcohol, and corresponding to a concentrated beer. 

Malt Extract is directly nutritive, containing good food elements, and indirectly so from 
the presence of the ferment Diastase, which converts the starch of bread or other farinas 
into sugar. It is usefully employed in wasting diseases, and mixed with milk or olea- 
ginous foods it aids their digestion and assimilation. It may be used to form a syrupy 
mixture with preparations of Iron or Cinchona. 



MANACA (Unofficial), — is the root of Franciscea uniflora, a shrub of the nat. ord. 
Scrophulariacese, indigenous to Brazil, where it is known as Mercurio-vegetal, or Vege- 
table Mercury, a name applied by charlatans to a number of widely differing plants. 
Very little is known about Manaca, but it has been extensively advertised as an unfailing 
remedy for sub-acute and chronic rheumatism. It is also considered purgative, diuretic, 
emmenagogue and antisyphilitic, being official in the Brazilian Dispensatories, and 
noticed as follows in the Diet, de Botan. Brazileira. 

" This whole plant, but especially the root, excites powerfully the lymphatic system, 
eliminating morbid matter by the skin and kidneys. It is antisyphilitic ; the interior 
bark is nauseating and stimulates the throat. In small doses it is resolvent; in larger 
purgative, diuretic and emmenagogue. In large doses it is an acrid poison." 

A fluid extract is on the market, the average dose of which is IT^x three or four times 
daily. 



MANGANUM, Manganese, Mn. — This metal is represented in 
the Pharmacopoeia by three of its salts, the native Black Oxide, the Sul- 
phate, and the Permanganate of Potassium. 

Mangani Dioxidum, Manganese Dioxide [Black Oxide of Manganese), — is the 
native, crude Dioxide of Manganese, containing at least 66 per cent, of the pure Dioxide, 
Mn0 2 . A heavy, grayish-black powder, odorless and tasteless, insoluble in water or alco- 
hol, giving off oxygen gas at a red heat, and if heated with hydrochloric acid it causes 
the evolution of chlorine gas. Is used in preparing Chlorine Water. Dose, gr. ij-x. 

Mangani Sulphas, Manganese Sulphate, MnS0 4 -)- 4-H 2 0, — colorless prisms, of 
slightly bitter and astringent taste, faintly acid reaction, very soluble in water, insoluble 
in alcohol. Dose, gr. ij-v. 

Potassii Permanganas, Potassium Permanganate, KMn0 4 , — deep, purple-violet 
prisms, of sweet and astringent taste, neutral reaction, soluble in 16 of water with a 
scanty, brown residue, decomposed by alcohol and by heating to 464 F. It should be 
kept in well-stoppered bottles, and should not be triturated nor combined in solution with 
organic or readily oxidizable substances. Dose, gr. ss-ij, in pill. 

Unofficial Preparations. 

Syrupus Mangani Iodidi, Syncp of Manganese Iodide, — contains about ^j of the 
iodide in each ^. Dose, TTLx-xxx. For formula see U. S. Dispensatory. 

Syrupus Ferri et Mangani Iodidi, Syrup of Iron and Manganese Iodide, — each 5 
contains gr. 50 of the mixed iodides in the proportion of 3 of the Iodide of Iron to I of 
that of Manganese. Dose, rr L x-xxx. For formula see U. S. Dispensatory. 
22 



338 MANGANUM. 

Ferri et Mangani Carbonas Saccharatus, Saccharated Iron and Manganese Car- 
bonate, — is a tasteless, reddish-brown powder. Dose, gr.v-xx. For formula see U. S. 
Dispensatory. 

Pepto-mangan, Liquor Mangano-ferri Peptonatus, — a proprietary preparation, 
advertised to contain in each half-ounce " the equivalent of 3 grains of metallic Iron and 
I grain of metallic Manganese (as Peptonates) in organo-chemical combination." It is 
claimed for this preparation that it does not have the astringent effect of the inorganic 
salts of these metals upon the glands of the stomach, and that it does not affect the alka- 
linity of the bowels. Dose, 2; ss, three to four times a day, in white wine or milk, or alone. 

Condy's Red Fluid, — is a solution of Potassium Permanganate in Distilled Water, of 
about 2 per cent, strength, namely gr.viijss to the % , or gr. 176 in J 20. It is used as a 
deodorant and disinfectant, for closets, bed-pans, and to wash the hands and utensils. Is 
non-irritant, and has the advantage of showing by its change in color when it has lost its 
efficacy. 

Physiological Action. 

The salts of Manganese in small doses improve the appetite and the 
digestion and stimulate the action of the heart. Used in larger doses and 
for considerable length of time they lower the heart's action, paralyze the 
muscular system, especially the muscular coat of the arteries, causing pro- 
gressive wasting, paraplegia, and acute fatty degeneration of the liver. 
They are gastro-intestinal irritants, and the Sulphate is emeto-cathartic 
and decidedly cholagogue. Maganese is closely associated with Iron in 
the blood, bile, etc., in the proportion of about 1 to 20. The Black 
Oxide is an efficient emmenagogue. 

Potassium Permanganate is an active oxidizer, containing as it does a 
large proportion of oxygen which it yields very readily in the form of 
ozone, and then becomes manganese dioxide. This property gives it the 
qualities of an antiseptic, a disinfectant and a deodorant. It is considered 
by some authorities to be an efficient emmenagogue. Used internally it 
is probably not absorbed in its own state, as it must be quickly decomposed 
by the contents of the stomach ; at the same time oxidizing any oxidizable 
substance therein. 

Therapeutics. 
The salts of Manganese are used by those practitioners who affect to see 
a manganese-anaemia in cachectic subjects, but they are always combined 
with ferric preparations. In amenorrhcea, gastrodynia and pyrosis the 
dioxide is a good remedy, and the same salt is used as an ointment in 
many skin diseases. In jaundice of malarial origin or catarrh of the 
biliary passages the sulphate gives good results. Manganese is becoming 
more of an acknowledged remedy in derangements of the menstrual 
function, as irregular or scanty menstruation, amenorrhcea, menorrhagia, 
and even metrorrhagia. By some authorities, the emmenagogue power 
of potassium permanganate is ascribed to its large proportion of oxygen, 
which it is supposed to give up to the uterus ; as, until recently, potassium 
chlorate was supposed to do to the system at large. According to the 
views of others who have studied its action, Manganese should be classed 



MANGANUM. 339 

with the excito-motors, increasing arterial tension, and specifically acting 
upon the uterus. The best preparation is the Dioxide, in freshly-made 
pills of two grains each, of which 1 to 3 or 5 pills may be taken twice or 
thrice daily. Potassium Permanganate has generally been the preparation 
given when the effects of Manganese were desired ; but as it causes great 
gastric irritability, with abdominal pains and burning sensations, besides 
other decidedly unpleasant symptoms, it is a difficult matter to get patients 
to take it for any length of time. 

Potassium Permanganate is employed as an antiseptic and oxidizing 
agent in such affections as diphtheria, scarlatina, septicaemia, erysipelas, 
etc., in which it may be given internally and used locally at the same 
time. It is given with apparent benefit in dyspepsia, flatulence, lithaemia 
and obesity, and has often seemed to be of service in acute rheumatism. 
In amenorrhcea it is reported to be very efficient, and has lately been used 
with success as a remedy for the bites of venomous serpents and for other 
animal poisons. For internal use it should be given in pill, as the taste 
of a solution is very disagreeable. Locally it is frequently employed (3J 
to the pint) to correct fetor in cancer, ulcer, caries, abscesses, ozaena, and 
it will destroy the odor of a foul breath or that of the fetid perspirations 
of the feet. It is used both as a test and as a corrigent for organic im- 
purities in drinking water. The stain left by it on fabrics may be re- 
moved by sulphurous acid, but, as sulphuric acid is formed in the reaction, 
the fabric should be immediately washed or rinsed in water. 

Potassium Permanganate has lately come into use as an antidote against 
morphine or opium in the stomach, for which purpose it was recom- 
mended in 1884 by an English physician, Mr. J. Barker Smith. Little 
attention was paid to his suggestion until it was practically tested by Dr. 
William Moor, of New York, on himself, in 1895. After a light supper 
he swallowed 3 grains of morphine sulphate, followed almost immediately 
by 4 grains of potassium permanganate dissolved in water, and expe- 
rienced no ill effects, although, being highly susceptible to the drug he 
would have been affected if even gr. yi of morphine had been absorbed. 
On another occasion, two hours after breakfast, he took 5 grains of mor- 
phine sulphate in an ounce of water, and also 8 grains of the permanganate 
in 8 ounces of water soon afterward, without experiencing any symptoms 
of morphine action. It was long known that morphine is readily deoxid- 
ized and rendered innocuous by this agent, but it was supposed that the 
presence of albumen in the stomach would prevent this reaction. It is 
now shown that the permanganate reduces morphine sulphate more rapidly 
than it does albuminous matter, and, in fact, exhibits a marked selective 
affinity for morphine and also for physostigmine (eserine), but gives up 
its oxygen more quickly to albuminous substances than to strychnine, 
oxalic acid, colchicum or hydrocyanic acid. It exerts no oxidizing effect, 



340 MANGO MARRUBIUM — MASTICHE MATICO. 

in the presence of albumen, on atropine, hyoscyamine, hyoscine, caffeine, 
cocaine, aconitine, veratrine, pilocarpine, muscarine or phosphorus. 
(Murrell.) 



MANGO (Unofficial), — is the bark of Mangifera indica, an Indian tree of the nat. 
ord. Guttiferae. It is supposed to be an astringent with special tonic action upon mucous 
membranes. It is highly recommended by its vendors for nasal catarrh, hemorrhages, 
and muco-purulent discharges from the intestines, uterus, vagina and bronchi. A fluid 
extract is sold, which may be used in doses of tt\, x-^j. 

Mango- Fruit, ox Mango ste en, is the fruit of Garcinia mangostana, nat. ord. Gutti- 
ferae, also from India. It is a powerful astringent, and is used for nasal catarrh, diarrhoeas, 
dysentery, leucorrhcea, etc. 



MANNA, — is the concrete, saccharine exudation of Fraxinus Ornus , or Flowering 
Ash, a tree of the nat. ord. Oleaceoe, growing in Southern Europe. Manna is produced 
also by several other trees, and substances resembling it are exuded by many plants. It 
contains from 40 to 90 per cent, of Mannit, C 6 H I4 O fi , or Manna-sugar, which does not 
undergo vinous fermentation, and is chemically allied to the alcohols and to glycerin. 
Manna also contains glucose, mucilage, some acrid resin, and a small quantity of the 
fluorescent glucoside Fraxin, C lfi H ]8 O 10 . There are no official preparations, but Manna 
itself may be given in doses of 3 j-ij. 

Manna is a mild laxative, with some tendency to produce flatulence and colic. It is 
usually combined with other purgatives, as Senna, Rhubarb, Magnesia, etc., to disguise 
the taste and increase the effect. It is a constituent of the official Infusum Sennae Com- 
positum. Manna may be eaten by children if of good quality, or may be readily dissolved 
in milk and so administered. 



MARRUBIUM, Horehound, — the leaves and top of Marrubium vulgare, a plant 
of the nat. ord. Labiates, native in Europe, but naturalized in America. It contains a 
bitter principle named Alarrubiin, also a volatile oil, resin, tannin, lignin, etc. There 
are no official preparations. Dose, ^ss-j. 

Horehound in large doses is laxative, diuretic and diaphoretic, and in ordinary dosage 
it is a gentle tonic and stomachic. It is generally used in catarrhal states of the air- 
passages, over which it seems to have a soothing effect, and is much employed in confec- 
tionery as an ingredient in " cough drops." 



MASTICHE, Mastic, — is a concrete, resinous exudation from Pistacia Lentiscus, 
a tree of the nat. ord. Anacardieae, growing in the island of Scio. Alcohol dissolves 
about 90 per cent, including the resin Mastichic Acid,C 2Q ll Z2 O z , the remainder consisting 
of another resin Mastichin, which is soluble in ether and resembles copal. There are 
no official preparations, but Mastic is an ingredient of the official Pil. Aloes et Mastiches 
(see ante, page 119). 

Mastic was formerly used for supposed properties analogous to those of other oleore- 
sins, but now its application is confined to dentistry, being employed as a temporary fill- 
ing for carious teeth. A solution in ether is applied on cotton with moderate pressure^ 
and remains as a firm plug after evaporation of the solvent. 



MATICO, — the leaves of Piper angustifolium, a Peruvian shrub of the nat. ord. 
Piperaceae. It contains a crystallizable acid Artanthic Acid, also resin, tannin, and a 
volatile oil. Its odor is aromatic, and its taste astringent, spicy and somewhat bitter. 

Extractum Matico Fluidum, Fluid Extract of Matico. — Dose, £ss-ij. 

Tinctura Matico, Tincture of Matico, — 10 per cent. Dose, ^ss-ij. 

Matico is an aromatic tonic and stimulant, also aphrodisiac, vulnerary and hemosta- 
tic. It acts, like cubeb, on the urinary passages, and is an excellent alterative stimulant 



MATRICARIA MEL. 341 

to mucous membranes. It has been used with considerable success in mucous catarrhs, 
as gonorrhoea, leucorrhcea, chronic cystitis, etc., also in epistaxis, hemorrhoids, menor- 
rhagia, hemoptysis, hematemesis and other hemorrhages. The under surface of the leaf 
is so formed as to promote coagulation of blood if applied to a bleeding surface, and it is 
a good local hemostatic for trivial cuts or wounds. 



MATRICARIA, German Chamomile, — the flower-heads of Matricaria Chamo- 
milla, a European annual plant of the nat. ord. Composite. They contain *^th per cent, of 
a blue Volatile Oil (the color of which is due to Azulen), also a bitter extractive, tannin, 
etc. There are no official preparations, but the flowers may be eaten or a decoction used 
almost ad libitum. 

Matricaria is a mild tonic, in large doses emetic, anthelmintic and antispasmodic. It 
is much used in Germany, and in this country is a popular domestic remedy among Ger- 
man people, who use it in infusions as a diaphoretic, etc. This plant is the " Chamo- 
milla " of the homoeopaths, who find in it remarkable power over morbid impressionability 
of the sensory and excito-motor nerves, and administer it in various pains, aggravated at 
night and by warmth, clonic spasms of pregnancy, irritability of teething children, flatu- 
lent colic, etc. 



MEL, Honey, — is a saccharine secretion deposited in the honey- 
comb by Apis mellifica, the honey-bee; occurring as a pale-yellowish, 
syrupy liquid, gradually becoming crystalline and opaque, of peculiar and 
heavy odor, and a very sweet, faintly acrid taste. It is a strong aqueous 
solution of several sugars (cane and grape sugar, levulose), with wax- 
pollen, coloring and odorous matters, etc. The sugars, which may be 
resolved into Levulose and Dextrose, amount to 70 or 80 per cent. 
Honey is frequently adulterated with starch and artificial glucose, which 
may be detected by the official tests (see U. S. Phar.). Dose, indefinite. 

Preparations. 

Mel Despumatum, Clarified Honey, — is honey heated, skimmed and strained, with 
Glycerin added in the proportion of 5 per cent. It is an ingredient of Confectio Rosse, 
Mel Rosre, and Massa Ferri Carbonatis. Dose, indefinite. 

Mel Rosae, Honey of Rose. — Fluid Extract of Rose 12, Clarified Honey to 100. 
Dose, indefinite ; generally used as a local application to the throat for its astringency 
and flavor, in combination with more active agents. 

Honey is emollient, nutritive and laxative, in some persons giving rise 
to pyrosis, flatulence and colic, and in others to an eruption of urticaria, 
but generally constituting an agreeable article of diet. It is sometimes 
actually poisonous from the presence of toxic agents extracted by the bee 
from certain plants, in this country generally the Mountain Laurel {Kahnia 
latifolia). Honey is chiefly used as an emollient in diseases of the throat, 
to relieve dryness, pain, cough and dysphagia. A mixture of Honey 8 
parts to 1 each of Acetic Acid and Water is official in the Br. Phar. 
under the title Oxymel, and forms a pleasant addition to gargles or a 
vehicle for expectorant medicines. Honey of Rose is somewhat astringent, 
and is used in gargles and in washes, for the treatment of inflammation 
and ulceration of the mucous membrane of the nasal passages, the mouth 
and the throat. 



342 MELISSA MENISPERMUM MENTHA PIPERITA. 

MELISSA, Balm, — the leaves and tops of Melissa officinalis, a European plant of 
the nat. ord. Labiatse, growing also in America. It contains gum, tannin, bitter extrac- 
tive, and a fragrant essential oil in very small quantity [y% to y( per cent.). There are 
no official preparations. 

Balm has little or no action, except to flavor hot water for use as a beverage or a mild 
diaphoretic. 



MENISPERMUM, — is the rhizome and rootlets of Menispenmim canadense, the 
Yellow Parilla, or Canadian Moonseed, a woody, climbing plant of the nat. ord. Menis- 
permaceae, native of the eastern U. S. It contains starch, Berberine, and a white alka- 
loid, which is soluble in alcohol and in ether. 

Extractum Menispermi Fluidum, Fluid Extract of Menispermum, — is %rds 
alcohol. Dose, rr\v-xx. 

Menispermum is reputed to have tonic properties, and is used in some of the Southern 
States in domestic practice as a substitute for Sarsaparilla in scrofulous conditions. Little 
is known about it of a definite character. 



MENTHA PIPERITA, Peppermint,— the leaves and tops of 
Mentha piperita, a perennial herbaceous plant, of the nat. ord. Labiatae, 
a native of Britain, but largely cultivated elsewhere. They contain i to 
i}£ per cent, of a Volatile Oil, which is official, and a little tannin. 

Menthol, C 10 H 19 OH, — is a stearopten (having the character of a sec- 
ondary alcohol), obtained from the official oil of peppermint, or from 
Japanese or Chinese oil of peppermint (from Mentha arvensis and Men- 
tha canadensis) ; by deposit therefrom on exposure to cold. It occurs in 
colorless, acicular crystals, of the odor of peppermint, and a warm, 
aromatic taste, followed by a sensation of cold when air is drawn into 
the mouth. Soluble only slightly in water, freely in alcohol, ether, 
chloroform, carbon disulphide or glacial acetic acid. Dose, gr. ss-iij, in 
pill or spirituous solution, several times a day. 

Preparations. 

Oleum Menthae Piperitae, Oil of Peppermint, — is the volatile oil distilled from the 
fresh herb ; a colorless or pale yellow fluid, having the odor of peppermint, and a strongly 
aromatic taste followed by a cold sensation when air is drawn into the mouth. It consists 
of a liquid terpene, and the stearopten Menthol (see above). Dose, TT\j-v. 

Aqua Menthae Piperitae, Peppermint Water, — has of the oil 2 parts in iooo of Dis- 
tilled Water. Dose, indefinite. 

Spiritus Menthae Piperitae, Spirit of Peppermint, Essence of Peppermint, — is an 
alcoholic solution containing io per cent, of the Oil and I per cent, of the powdered herb. 
Is an ingredient of Mistura Rhei et Sodse. Dose, TT\,x-xxx. 

Trochisci Menthae Piperitae, Peppermint Troches, — each troche contains I per 
cent. of the Oil, with Sugar and Mucilage of Tragacanth. Dose, indefinite. 

Physiological Action and Therapeutics. 
Peppermint is an aromatic stimulant, also carminative and antispas- 
modic. The oil possesses these qualities in greater degree and is also a 
local anodyne and anaesthetic when applied locally, especially if its evap- 
oration be prevented. The Chinese oil contains a large quantity of 



MENTHA VIRIDIS METHYLENE BLUE. 343 

Menthol and is particularly anodyne. Menthol is antiseptic and locally 
anaesthetic, but not corrosive, and acts also as a vascular stimulant when 
applied to the surface. 

Peppermint is used internally for the relief of nausea and colic, 
and to expel flatus by its local stimulant and after sedative action on the 
bowels. It is an agreeable corrigent for combination with purgatives to 
prevent griping, and efficiently covers the taste of many nauseous sub- 
stances. The spirit is the best form for internal use. The oil is used 
locally to relieve the pain of superficial neuralgia, a cloth being wet with 
it, laid along the course of the affected nerve and covered with oiled silk 
to restrain evaporation. It is also efficient in rheumatism as an anodyne 
and counterirritant. 

Menthol is highly praised as an external application in various neural- 
gias, sciatica, pleurodynia, toothache, etc. For neuralgia it is used in 
saturated alcoholic solution painted over the affected nerve. For tooth- 
ache a crystal introduced into the carious cavity is promptly anodyne. 
As an antiseptic it promises well as an application in parasitic skin diseases. 
As the Chinese have used their Oil of Peppermint for ages as an applica- 
tion in neuralgise, and as this oil contains a large quantity of Menthol, 
the latter preparation will probably prove a very efficient agent in these 
affections if the cupidity of the manufacturers will allow of its being 
obtained pure. A spray containing 5 to 20 per cent, of Menthol is highly 
recommended in epidemic influenza, also in tubercular laryngitis. Men- 
thol is of marked value in almost all cases of pruritus, from whatever 
cause. It possesses high power as an anti-emetic, stopping nausea and 
vomiting after all the usual remedies had failed. For this purpose ten 
drops of a 20 per cent, solution in olive oil are given on sugar. 



MENTHA VIRIDIS, Spearmint— the leaves and tops of Mentha viridis, the 
" mint" of the kitchen garden, a plant of the nat. ord. Labiatae, indigenous to England, 
but naturalized in many countries. Its constituents and properties are identical with 
those of peppermint, but its odor and taste differ therefrom. 

Oleum Menthae Viridis, Oil of Spearmint, — is the Volatile Oil distilled from the 
plant. Dose, TTVij-v. 

Aqua Menthae Viridis, Spearmint Water, — has 2 parts of the Oil in 1000 of Distilled 
Water. Dose, indefinite. 

Spiritus Menthae Viridis, Spirit of Spearmint, Essence of Spearmint, — is an alco- 
holic solution containing 10 per cent, of the Oil and I per cent, of the powdered herb. 
Dose, nvx-xl. 

Spearmint corresponds in action to Peppermint, but is generally less powerful. It is 
usually employed to correct flatulence and to relieve colic, and makes an agreeable flavor- 
ing for many mixtures. 



METHYLENE BLUE, Tetramethyl-Thionine Chloride, NS(C 6 H 3 ),2X- 
(CH 3 ) 2 C1 (Unofficial), — is an anilin derivative, which when pure is seen in small, dark 
blue, scaly crystals, having a copper bronze tinge, soluble in water. Dose, gr. j-iij, four 
or five times a day. 



344 MEZEREUM MORRHU/E OLEUM. 

This substance imparts a blue color to nerve tissue and to the urine. From the facts 
that it manifests a strong affinity for nerve tissue, especially for the axis cylinders of sen- 
sory nerves, and that it is the best staining agent for the microbe found in the blood of 
malarial subjects, this agent has been expected to possess anodyne power over neuralgic 
and rheumatic affections and to act as an antiperiodic in malaria. It has been employed 
by several observers as an antipyretic and internal antiseptic for rheumatism of the joints 
and muscles, for malarial fever, diphtheria, acute nephritis and cancer, with varying 
results. Its best action in malarial affections has been obtained in children, and being 
tasteless may be administered to them with greater ease than quinine, besides being free 
from the vomiting and headache which so often result from the latter drug. In diphtheria 
and in simple, non-diphtheritic ulceration of the throat a ten per cent, solution is used 
locally with great benefit so far as yet reported. It has lately been employed successfully 
in two cases of chronic cystitis. 



MEZEREUM, Mezereum [Mezereon), — is the bark of Daphne Mezereum and of 
other species of Daphne, plants of the nat. ord. Thymelceaceie, growing in mountainous 
districts of Europe and Asia and cultivated as a garden shrub in Britain. It contains an 
inert, fixed oil, an inactive glucoside, Daphnin, and an acrid Resin, which is the anhy- 
dride of a resinous acid named Mezereinic Acid. Mezereum is an ingredient of the com- 
pound decoction and the compound fluid extract of Sarsaparilla. Dose, gr. j-x. 

Extractum Mezerei Fluidum , Fluid Extract of Mezereum^ — is too acrid for internal 
use. It is an ingredient of the Linimentum Sinapis Compositum. 

Mezereum is a sialogogue, and an intensely acrid, irritant poison, producing violent 
vomiting, purging, nephritis and gastro-enteritis. In small closes it is laxative and diu- 
retic, and has had considerable reputation as an alterative. Externally the recent bark is 
a powerful local irritant, speedily producing vesication. 

Mezereum is rarely used internally by itself, but is employed in mixtures with Sarsa- 
parilla, etc., as an alterative in syphilis, rheumatism and some skin diseases of chronic 
type, but with doubtful efficacy. It has been used with good effect in toothache and as a 
masticatory in paralysis of the tongue. Its principal use is as a local irritant to keep up 
the discharge from issues or blisters, and to stimulate indolent ulcers. 



MORRHUiE OLEUM, Cod-liver Oil {Oleum Jecoris Aselli),— 
is a fixed oil obtained from the fresh livers of Gadus Morrhua (Cod-fish) 
or other species of Gadus. It is a colorless or pale yellow, thin, oily 
liquid, of slightly fishy odor and taste, and faintly acid reaction, soluble 
in ether. It consists chiefly of Olein and Margarin, with a peculiar prin- 
ciple named Gaduin, also Trimethy famine, free fatty Acids (oleic, palmitic, 
stearic), traces of Iodine, Bromine, Sulphuric and Phosphoric Acids, the 
ordinary inorganic salts of animal tissue and products, and perhaps bile 
constituents. When saponified it does not yield Glycerin, but Oxide of 
Propyl. Three kinds or varieties are found in the market, the pale, the 
light-brown and the dark. The pale is the official oil and the purest. 
Dose, 3J-ij on a full stomach, increased as assimilated. 

Unofficial Preparations. 

Glyconin Emulsion of Cod-liver Oil, — 01. Morrhuse %iv, Glyceritum Vitelli £ix, 
Aromatic Spirit of Ammonia %], Sherry Wine ^ij, Diluted Phosphoric Acid £iv, Es- 
sence of Bitter Almond ( 3 j of the A r olatile Oil in Oss Alcohol) 3 ij. The Cod-liver Oil 
is to be added to the Glyconin very slowly with brisk stirring, and the other ingredients 
added in the order named. 

Hydroleine, Hydrated Oil, — is said to contain, in each dose of 5jij, Cod-liver Oil 
n\8o, Distilled Water rr^ 35, Pancreatin gr. 5, Soda gr. 1/3, Salicylic Acid gr. %. 



morrhile oleum. 345 

Physiological Action. 

The action of Cod-liver Oil is that of any other fat, except that it is 
more easily assimilated than any member of the class. Fats in small 
quantity are necessary for the digestion of nitrogenous food, and form the 
molecular basis of the chyle, being prepared for absorption by the pancre- 
atic juice and the bile, especially the latter. Fat is an essential con- 
stituent of the products of tissue formation, whether physiological or path- 
ological, and is the principal material concerned in the production of 
force. After oxidation it is excreted as carbonic acid and water. Lo- 
cally applied fats reduce the body temperature. 

Cod-liver Oil is the most easily digestible of fats, penetrating animal 
membranes with comparative ease after being emulsified by the pancreatic 
and biliary secretions, hence entering the lacteal vessels readily and ap- 
pearing to bring with it the oily and nitrogenous elements of the food. 
The result is facilitation of the digestive process, increase of the red 
blood-corpuscles and of the body-weight, and stimulation of healthy cell- 
formation throughout the tissues. The properties of this oil have been 
ascribed to its contained biliary constituent, Iodine, free Oleic Acid, etc., 
but no satisfactory explanation has been offered until recently for the dif- 
ference between its action and that of other animal or vegetable oils. 

Gautier and Mourgues of Paris have made an exhaustive series of analytical researches 
upon Cod-liver Oil, and find that it contains — (i) Fixed Bases, Aselline and Morrhuine , 
the latter constituting about y^ of the total alkaloids, and being probably one of the most 
efficient principles in the oil. (2) Volatile Bases, Butylamine, ]/& of the total bases ; 
Amylamine, y^ of the whole; Dihydrotolnidine, T ^ of the total alkaloids; Hexylamine, 
a small amount. (3) Acids, Morrhnic Acid, \y z per cent., also a mixture of Formic 
and Butyric Acids ; and a small proportion of Phosphoric Acid, derived from the phos- 
phates, phospho-giycerates and lecithins of the extracts. As to the properties of these con- 
stituents they state that Butylamine, Hexylamine, and particularly Amylamine increase 
the urinary secretions. Dihydrotolitidine is a convulsivant toxic base. Aselline in suf- 
ficient doses produces dyspnoea, stupor, convulsive disturbances, and, if continued, death. 
Morrhtnne, the most important of the extractive principles, is a powerful stimulant of 
the functions of nutrition and assimilation, promoting metabolic changes ; it produces a 
rapid circulation of the extractive residues of cell life toward* the excretory organs, 
where they are eliminated, provoking in their way indirectly a powerful movement of 
assimilation correlative of the losses consequent upon the inverse movement of de-assimi- 
lation. This is considered to be proved by the super-excitation of appetite in animals 
brought under its influence. The physiological experiments with these substances dem- 
onstrate that cod-liver oil is a reconstituent of the tissues through its richness in phos- 
phates, phospho-glyceric acid, and organically combined phosphorus. Bromine and 
iodine, which are present in small quantities, also contribute to the reparative action, but 
chiefly to the active principles butylamine, amylamine, and especially morrhuine and mor- 
rhuic acid does the oil owe its true medicinal value. 

Therapeutics. 

The value of Cod-liver Oil is wholly that of a nutrient, its action being 
most marked in wasting diseases. In high febrile states or catarrhal con- 
ditions of the gastro-intestinal tract its use is contraindicated, but in 
phthisis a slight degree of fever will not interfere with its beneficial em- 



346 MOSCHUS. 

ployment. It is found to be of most value in the chronic forms of phthisis, 
in chronic bronchitis and emphysema, chronic rheumatic disorders, 
atheroma of the arteries, strumous skin diseases and diarrhoea, syphiloder- 
mata, neuralgia, chorea and epilepsy. In many disorders referable to 
exhaustion or debility of the nervous centres it is of great value as a nerve 
tonic, and in convalescence from acute diseases it is of marked benefit. 
It should always be considered as a supplementary food, and if its use en- 
dangers the appetite for other food it should be abandoned. 

The administration of this valuable agent is a serious matter, as many 
patients cannot overcome their repugnance to its taste and smell. Various 
emulsions are on the market, but they are objectionable because in no case 
do they conceal the taste, and the efficacy of the oil is seriously impaired 
by the processes used in their preparation. Moreover, the temptation is 
very great to employ an inferior grade of the oil or to adulterate it with 
other fish-oils in the manufacture of these preparations, and when the 
commercial spirit of gain is remembered one can never be sure of the 
quality of the oil so prepared. The oil itself is the best form for use, in 
small doses, say a teaspoonful thrice daily for an adult, after meals, in 
black coffee, beer or lemon-juice. The essential Oil of Eucalyptus in the 
proportion of 1 part to 100 of cod-liver oil will effectually extinguish the 
odor and taste to many persons. Alkaline stomachics given before meals, 
the oil after, and a teaspoonful of the " Liquor Pancreaticus " given half 
an hour afterward, would be a good routine in most cases, the latter 
agent preventing the fishy eructations which often give so much trouble. 
Extemporaneous emulsions may be prepared with Glyconin (see ante, 
page 344), White of Egg, Mucilage of Tragacanth, Extract of Malt, or 
any syrup, and flavored with Lemon, Cinnamon or Bitter Almond. The 
addition of rq^iv of Ether to each 3 of the oil promotes its digestion by 
stimulating the pancreatic secretion, and enables a patient to take it with 
whom it had previously disagreed. 

Inunction by Cod-liver Oil is a method of value in the wasting diseases 
of children. A tablespoonful may be rubbed into the skin of the abdo- 
men twice a day, and covered with a flannel binder with oiled silk or 
mackintosh-cloth outside. It readily passes through the skin and is 
absorbed, producing valuable and lasting results. 



MOSCHUS, Musk, — is the dried secretion from the preputial follicles of Moschus 
moschiferus (the Musk Deer), an animal inhabiting the mountainous region of Central 
Asia. It occurs in irregular, unctuous grains, of a reddish-brown color, peculiar and 
penetrating odor and bitterish taste, contained in oval sacs about 2 inches in diameter, 
membranous on one side, hairy on the other. About 10 per cent, is soluble in alcohol, 
50 per cent, in water. Chinese Musk in the pods or sacs is the most valuable, but all 
varieties are much adulterated, the price of the drug being very high. The odor is 
destroyed by drying, but returns again on the addition of moisture. Trituration with 
Camphor or Hydrocyanic Acid also destroys it. The odorous principle has not been 



MYRCI.dE OLEUM MYRISTICA. 347 

isolated, but is probably a product of decomposition which is constantly being formed. 
The constituents of Musk are a bitter resinous substance, ammonia, fat, cholesterin, etc. 
Dose, gr. ij-x. 

Tinctura Moschi, Tincture of Musk, — 5 per cent. Dose, TT^xx-^jss. 

Musk is a very diffusible stimulant, acting directly on the nervous and circulatory 
systems, but without much energy. It is also an antispasmodic, and is employed with 
benefit in general prostration of the system with nervous agitation or irregular muscular 
action. It has been used with advantage in laryngismus stridulus, insomnia, the collapse 
of typhoid and typhus fevers, spasmodic affections of the stomach, obstinate hiccough 
and convulsions of children due to intestinal spasms. The pure Musk is very difficult to 
obtain, and its high price makes it an extremely expensive medicine, so that it is seldom 
used except as a perfume. 

MYRCIA OLEUM, Oil of Myrcia {Oil of Bay),— is a volatile oil distilled 
from the leaves of Myrcia acris, or Bayberry, a tree of the nat. ord. Myrtaceae, native of 
the West Indian Islands. It is a yellowish brown liquid, of aromatic odor, pungent 
taste, slightly acid reaction, and soluble as a slightly turbid solution in an equal weight 
of alcohol. It contains a hydrocarbon and Eugenic Acid. Used only as a perfume. 

Spiritus Myrcise, Spirit of Myrcia, Bay Bum, — contains Oil of Myrcia 16, Oil of 
Orange-peel I, Oil of Pimenta I, Alcohol 1220, Water to 2000. 

The Oil of Bay is an agreeable perfume used to prepare bay-rum and in other cosmetic 
preparations. The spirit, known as " Bay-rum." is used principally as a refreshing per- 
fume, and is thought to relieve headache, faintness, etc., by application to the forehead 
or to the nostrils. 



MYRISTICA, Nutmeg, — is the seed of Myristica fragrans de- 
prived of its testa. The Nutmeg-tree is cultivated extensively in the East 
and West India Islands, belongs to the nat. ord. Myristicacese, and is a 
native of the Banda Islands in the Malayan Archipelago. The nutmeg 
contains 4 to 9 per cent, of the official Volatile Oil, and 30 per cent, of a 
concrete oil, commonly called Oil of Mace, which is a compound of fluid 
glycerides of oleic and butyric acids, and the solid glyceride of Myristic 
Acid, some resin and volatile oil. Dose, gr. v-xx. 

Macis, Mace, — is the arillode (or fleshy covering) of the seed of 
Myristica fragrans, the Nutmeg-tree. It occurs in narrow bands about 
an inch long, branched and lobed, of brownish-orange color, fragrant 
odor, warm and aromatic taste. It yields a fixed oil by pressure and a 
volatile oil by distillation, the latter being probably identical with Oil of 
Nutmeg. Dose, gr. v-xx. 

Preparations. 

Oleum Myristicae, Oil of Nutmeg, — is the volatile oil, and consists chiefly of a ter- 
pene and an oxygenated oil, Myristicol. It is colorless or pale-yellow, of hot, spicy taste 
and neutral reaction, and is soluble in alcohol. Dose, n\j-v. 

Spiritus Myristicae, Spirit [or Essence) of Nutmeg, — is a 5 per cent, solution of the 
oil in alcohol. Dose, £j-ij. 

Nutmeg is an ingredient of Aeetum Opii, Pulvis Aromaticus, Tr. Lavandulae Co., 
Trochisci Cretce, and Trochisci Sodii Bicarbonatis. 

Physiological Action and Therapeutics. 
Nutmeg is an aromatic stomachic of agreeable flavor. In small doses 
it stimulates the production of gastric juice, and thus promotes digestion 



348 MYRRHA MYRTI OLEUM. 

and increases appetite. It also relieves intestinal spasm and flatulence. 
In large doses it is powerfully narcotic, acting directly on the cerebrum, 
and producing stupor and delirium. It is used chiefly for flavoring 
purposes, and generally in substance, grated as required, but has been 
employed as a carminative, anodyne and astringent in diarrhoeas and dys- 
entery, as well as to relieve nausea and vomiting. Strangury is efficiently 
treated by small doses of powdered nutmeg given several times a day ; 
and the same remedy is often used in the south of Germany to relieve the 
uncomfortable feeling experienced after drinking an excessive quantity of 
new beer. The Volatile Oil is decidedly rubefacient when used exter- 
nally, and has narcotic powers if used internally in sufficient quantity. 
It is occasionally employed as an external stimulant in paralysis and 
chronic rheumatism. 

Mace is stimulant, carminative and aromatic. It is used solely as a 
spice or condiment. 



MYRRHA, Myrrh, — is a gum resin obtained from Commiphora Myrrha,na. Arabian 
tree of the nat. ord. Burseracere, collecting spontaneously upon the bark, and occurring 
in roundish tears, having a waxy fracture, a balsamic odor, and an acrid and bitter taste. 
Triturated with water it yields a brownish-yellow emulsion ; with alcohol it yields a 
brownish-yellow tincture which turns purple on the addition of nitric acid. It contains 
60 per cent, of gum, 35 per cent, of Myrrhin, a resin, and about 2 per cent, of an 
oxygenated ethereal oil, Myrrhol, C^H^O. Dose, gr. x-xxx. 

Tinctura Myrrhae, Tincture of Myrrh, — 20 per cent. Dose, TT^x-xxx. 

Myrrh rs also contained in Mistura Ferri Co., Pil. Aloes et Myrrha?, Pil. Rhei Co., and 
Tinctura Aloes et Myrrhre. 

Myrrh in small doses stimulates the gastro-intestinal mucous membrane ; in large doses 
it is an irritant thereunto, producing vomiting and purging. It quickens the action of the 
heart and diminishes the bronchial secretion. It is a uterine stimulant and emmena- 
gogue, a stimulant expectorant, and is thought to increase the number of leucocytes in the 
blood. Locally it is stimulant and disinfectant to mucous membranes and ulcerated 
surfaces. 

Myrrh is used internally in the various combinations noted above for anaemia and 
amenorrhcea, bronchial catarrh, etc. It has been supposed to diminish excessive secretion 
from the mucous surfaces of the uterus, vagina, bladder, and bronchi, and to have an 
especially beneficial influence on chronic pharyngitis. Locally, the tincture has a good 
tonic action on diseased mucous surfaces, and is applied to spongy gums, relaxed throat, 
aphthous patches and unhealthy ulcers. The tincture diluted with water makes an ex- 
cellent disinfectant and stimulant gargle in ulcerated sore-throat. Myrrh has long been 
used as an ingredient of dentifrices. 



MYRTI OLEUM, Oil of Myrtle, J/y;^/ (Unofficial) — is a volatile 
oil distilled from the leaves of Myrtus communis, the Myrtle, nat. ord. 
Myrtacese ; and consists of a mixture of Pinene, another hydrocarbon, 
and Cineol ; the latter being identical with eucalyptol, and probably the 
active medicinal ingredient. Dose, x^ j-iij in capsules, several times a day. 

Myrtol is a very active antiseptic and parasiticide. Applied to a raw 
surface it is sufficiently irritant to excite inflammation, but it does not so 
affect the unbroken skin. Internally, in small doses, it excites a sense of 



NAPHTALINUM. 349 

warmth in the mouth, increases the saliva, and acts as a tonic to the 
stomach. Full doses are sedative to the nervous system, but large ones 
act as an irritant. It is eliminated by the lungs and kidneys, acting as 
an expectorant and as an antiseptic and stimulant to the mucous mem- 
branes at the points of elimination. It imparts a smell like that of violets 
to the urine of the person taking it. 

Administered in small doses, Myrtol aids digestion, and is an efficient 
disinfectant and alterative in bronchorrhcea, fetid bronchitis and gan- 
grene of the lung; and in cystitis and urethritis it acts similarly through 
the urine on the local mucous membrane. It may be expected to give good 
results in chronic and capillary bronchitis, whooping-cough and humid 
asthma. It has rendered good service in hematuria not due to acute 
congestion, and in passive hemorrhages generally. Locally it has proved 
curative in favus, herpes, pityriasis and parasitic skin diseases ; also in 
otorrhcea, ozsena and other foul discharges from ulceration of the mucous 
membranes. It has been employed successfully against ascarides and the 
round worm. 

Chekan (Unofficial), — the leaves and shoots of Myrtus Chekan, nat. ord. Myrtacere, 
a native of Chili. They contain a Volatile Oil resembling that of eucalyptus, also 
Chekanine a volatile alkaloid, and tannin. Chekan is antiseptic, tonic, expectorant and 
diuretic ; and is chiefly used in catarrh of the mucous membranes, especially those of the 
bronchi and the bladder. It has been employed with benefit in cases of phthisis, and in 
bronchitis with thick, purulent expectoration. The expressed juice diluted with water 
makes a good lotion for conjunctivitis, and a decoction of the bark is valued as an astrin- 
gent in dysentery. A fluid extract is marketed, the dose of which is 3 j-iij. 

NAPHTALINUM, Naphtalin, {Naphtalene), C 10 H 8 ,— is a hy- 
drocarbon product formed during the manufacture of ordinary coal gas. 
Chemically, it is one of the benzene derivatives, being formed by the 
union of two benzene groups in an overlapping ring. (See ante, page 
239). When redistilled, it crystallizes in colorless, rhomboid plates, of 
slightly tarry but strong odor, and burning, aromatic taste ; insoluble in 
water, soluble in 15 of alcohol, very soluble in boiling alcohol, ether, 
chloroform, carbon disulphide, and fixed or volatile oils. It is seen 
frequently in the form of moulded blocks, under such names as Alabastrine 
and Camphytene, for preserving furs and flannels from moths, and for 
placing in urinals for disinfectant purposes. 

The dose of Naphtalin is from gr. ij to gr.viij, up to gr. lxxx per diem 
for adults ; — and for children gr. j to gr. iij, every three hours. Being quite 
insoluble in water it must be given in emulsion, or as a powder with sugar 
in wafers or capsules. It is best flavored with oil of bergamot. 

Derivatives. 

Naphtol, Beta-{orIso-)napktol ', C 10 H 7 OH, — a phenol occurring in coal-tar, but usually 
prepared artificially from Naphtalin. It is one of" several naphtols, and occurs in color- 
less, shining, crystalline laminae, or a whitish, crystalline powder, of faint, phenol-like 



350 NAPHTALINUM. 

odor, and sharp taste. Soluble at 59 F. in j( of alcohol, and in about 1000 of water, 
in 75 of boiling water, and very soluble in boiling alcohol, in ether, chloroform, olive oil 
and petrolatum. Used as ointment, I to 5 for adults, but for children should be not over 
2 per cent, strength. 

Hydronaphtol, C 16 H 7 OH (Unofficial), — glistening, micaceous scales, sparingly solu- 
ble in water, freely soluble in alcohol, oils, etc. Used as an antiseptic, and in ointment 
or powder locally, diluted with oxide of zinc, I to 50. 

Naphtolum Camphoratum, Camphorated Naphtol, A T aphtol Camp/wr (Unofficial), — 
is prepared by heating carefully one part of beta naphtol with two of camphor ; the 
product being a homogeneous, oily fluid, which is insoluble in water, and decomposes 
readily on exposure to light and air. Used as parenchymatous injection, the undiluted 
fluid being well borne, or in Olive oil, in doses of rtvij-v. 

Physiological Action. 
Naphtalin is destructive to all forms of low life, and hence is anti- 
septic in a high degree, but must be intimately mixed with the substances 
upon which it is to act. Internally it is a stimulant expectorant of decided 
power, and disinfects the contents of the intestinal canal. Being so 
sparingly soluble, but little of it is absorbed, and hence it does no injury 
to the organism. What is taken up by the blood is excreted by the 
urine, partly unchanged, partly as naphtol and perhaps some as phenol. 
Naphtol is more easily absorbed, and may induce vomiting, hematuria, 
convulsions and unconsciousness. An ointment containing 2 per cent, 
applied with friction for scabies to two brothers, aged 6 and 8 years 
respectively, caused nephritis in both and death in one, the diagnosis of 
nephritis being verified at the autopsy. Hydronaphtol is a powerful and 
non-irritating antiseptic, non-poisonous, non-corrosive, freely soluble in 
alcohol, glycerin, fixed oils, etc., in cold water, 1 to 2000; and in hot 
water 1 to 100, precipitating as the water cools, but leaving a saturated 
solution of 1 to 1000, which is perfectly inhibitive of the germs of putre- 
faction in all putrescible fluids (Levis). The claims made for it are that 
it is 12 times as effective as carbolic acid, 30 times as potent as salicylic 
acid, 60 times as efficient as boric acid, 600 times as antiseptic as alcohol, 
and that it is entitled, as a true antiseptic, to stand next to mercuric 
chloride in the comparative tables (Levis)* 

Therapeutics. 
Naphtalin is employed as an antiseptic for the intestinal canal in 
typhoid fever, diarrhoea, both acute and chronic, tubercular diarrhoea, 
dysentery, etc. It renders the urine aseptic and may be employed in 
vesical catarrh. It is also used internally for humoral asthma, verminous 
affections, and the chronic pulmonary catarrh of the aged. It has recently 
come into prominence as an all-round anthelmintic, having been given 
for all kinds of intestinal worms, with prompt and complete results invari- 
ably obtained (Mirowicz). In pertussis the best possible results have been 
obtained from the burning of this agent in the patient's room ; giving 



NUX VOMICA. 351 

force to the belief that the well-known benefit resulting from taking 
children to gas-works for whooping-cough, is due to the naphtalin fumes 
rather than to the gas-tar. Locally, Naphtalin has high value as an anti- 
septic for indolent ulcers, sloughing wounds, open cancers, pus cavities, 
etc. Painted over organic remains it effectually prevents the ravages of 
insects. Naphtol is employed like tar for therapeutic action upon the 
skin in hyperidrosis, scabies, eczema and local sweating, in ^ to 5 per 
cent, alcoholic solution, or as a 10 per cent, ointment, but is a dangerous 
application. Hydronaphtol is also highly esteemed for antiseptic pur- 
poses generally by those who have used it, and is of benefit as an external 
application in many skin diseases. Its non-toxic and non-irritant qualities 
render it the most useful and most generally available of the three. 

Camphorated Naphtol has been employed hypodermically in tuberculous adenitis, 
with permanent improvement in nine cases, and improvement in six others, out of a series 
of 32 cases so treated by Reboul, of Marseilles. In five cases of tuberculosis of the testis, 
so treated by the same observer, very gratifying results were obtained ; the injection 
appearing to be perfectly harmless, and to act beneficially, both locally and generally.. It 
has also been extensively used in the irrigation of joints, bony cavities, tendinous sheaths, 
cold abscesses in the pleural and uterine cavities, and also in tuberculosis of the bladder: 
all which localities seem to bear the undiluted fluid well. (Squibb.) 



NUX VOMICA, Nux V omica, {Poison Nut, Quaker Button),— -is 
the seed of Strychnos Nux-vomica, a tree of the nat. ord. Loganiaceae, 
growing in India, Cochin-China, and the neighboring countries, all parts 
of which are bitter and poisonous. The seeds are flattened and nearly 
circular, about one inch in diameter, ashy-gray in color, covered with 
short, satiny hairs, internally translucent, tough and horny, with a large 
cavity, inodorous, but of intensely bitter taste. They contain the alka- 
loids Strychnine and Brucine (see below), in combination with Igasuric 
(or Strychnic) Acid, also the glucoside Logani?i, a yellow coloring matter, 
a concrete oil, gum, starch, wax, and earthy phosphates. 

Preparations of Nux Vomica. 

Extractum Nucis Vomicae, Extract of Nux Vomica, — has of total alkaloids 15 per 
cent. Dose, gr. ]/%-}{, up to a maximum in 24 hours of gr.ij. 

Extractum Nucis Vomicae Fluidum, Fluid Extract of Nux Vomica, — has 1]A, per 
cent, of total alkaloids. Dose, rr\j-v. 

Tinctura Nucis Vomicae, Tincture ofA T ux Vomica, — has 0.3 per cent, of total alka- 
loids. Dose, TTlv-xx. 

Alkaloids and their Salts. 

Strychnina, Strychnine, C 21 H 22 X 2 2 , — is an alkaloid obtained from Nux Vomica. 
Tgnatia, and other plants of the order Loganiacete ; crystalline, intensely bitter even in 1 
to 700,000 solution, of alkaline reaction, soluble in 7 of chloroform, no of alcohol, 6700 
of water, almost insoluble in ether. It is a constituent of Ferri et Strychnine Citras, and 
of Syrupus Ferri Quinine et Strychnine Phosphatum. Dose, gr.^Q-,^-. 

Strychninae Sulphas, Strychnine Sulphate (C 21 H 22 X 2 0.,),H.,S0 4 + 5 H 2 0, — crystal- 
line, efflorescent, odorless, of intensely bitter taste, even in 1 to 700,000 solution, neutral 



35 2 NUX VOMICA. 

reaction, soluble in 50 of water, 109 of alcohol, and in 2 of boiling water, but is almost 
insoluble in ether. It contains 75 per cent, of Strychnine. Dose, gr. ^"rV* ^ ut a ^ ter 
tolerance is attained much larger doses may be safely used. 

Strychninae Nitras, Strychnine Nitrate (Unofficial), — forms colorless needles of a 
silky lustre and very bitter taste, soluble in 90 parts of cold water, 3 of boiling water, 70 
of alcohol, and in 26 of glycerin, but is insoluble in ether. It contains 84 per cent, of 
Strychnine, and is preferred to the sulphate for hypodermic use, being less irritant. Dose, 
gr. sV-T2> or more after tolerance is attained. The Phar. Ger. gives the maximum single 
dose as gr. \, the daily maximum as gr.|. 

Strychninae Hydrochloras, Strychnine Hydrochlorate (Unofficial), — is used in the 
form of Liquor Strychninae Hydrochloratis (B. P.), which is about I per cent, solution. 
Dose, Tr\v-x. 

Strychninae Arsenis, Strychnine Arsenite (Unofficial), — is soluble in 35 parts of cold 
water, in 10 of boiling water, also in alcohol, less so in ether. Dose, gr. g^-^V? but as 
it is highly toxic, the initial dose should never exceed the minimum given. 

Brucina, Brucine, C 2: di 26 N 2 4 (Unofficial), — occurs in colorless prisms, pearly flakes 
or masses, bitter, soluble in 850 parts of water and in \]/ 2 of alcohol. It is separated 
with difficulty from Strychnine, in many samples of which it occurs as an impurity. It 
is seldom used. Dose, gr. jjj-\. 

Tests for Strychnine and Brucine. 


Strychnine and its salts dissolve without color in concentrated Sulphuric Acid, but, on 
adding to the solution some deoxidizing substance, a play of colors results, Lead Peroxide 
producing a beautiful blue, passing into violet, then red, and finally yellow (Marchand). 
A minute quantity of Potassium Bichromate produces similar results (Otto), while 
Ceroso-ceric Oxide causes a blue, changing to violet and then to a permanent cherry-red. 
If these tests are carefully applied, as minute a quantity as I part in 900,000 of the solu- 
tion may be detected (Wenzell). 

Brucine is detected by the red color which it yields with Nitric Acid. Neither 
Nitric nor Sulphuric Acid colors Strychnine unless Brucine is present as an. impurity, a 
test which distinguishes this alkaloid from several others. Brucine does not decompose 
Iodic Acid, and is thereby distinguished from Morphine. 

Physiological Action. 
The action of Nux Vomica is that of its principal alkaloid Strychnine. 
Externally, the latter is a very powerful antiseptic, but is too poisonous 
for safe use ; and in concentrated solution, hypodermically, it has a de- 
cided irritant action on the tissues. Internally, in small doses, its bitter 
quality makes it a good stomachic tonic. Increasing the vascularity of 
the gastric mucous membrane and promoting the secretion of gastric 
juice, also the pancreatic and biliary secretions, it aids digestion and 
sharpens the appetite ; but, like all other bitter tonics, it deranges 
digestion when used excessively or for a long time. It stimulates the 
muscular coat of the intestines increasing peristalsis, and thus acts as a pur- 
gative, but it restrains the fecal discharges when their frequency is due 
to atony of the bowel. It stimulates the motor nerve-cells of the spinal 
cord, the cardiac motor ganglia, the respiratory and vaso-motor centres 
in the medulla, contracting the arterioles all over the body (though by full 
doses they are relaxed), also the excitability of the sensory nerves and 
their terminal elements. The result is that respiration is deepened 
and quickened, the action of the heart is increased and the blood-pressure 
raised, the field of vision is enlarged, the sight and hearing are sharpened, 



nux vomica. 353 

and the sense of touch is rendered more acute, but the cerebral con- 
volutions are not affected. Excreted chiefly by the kidneys, it causes 
increased frequency of urination, and when taken in excess produces 
spasm of the neck of the bladder. It probably excites some degree of 
uterine contraction, but undoubtedly promotes menstruation, disposes 
to sexuality, and provokes erections of the penis. 

The most marked feature of the action of Strychnine is the great in- 
crease which it causes in the reflex excitability of the spinal cord and 
other reflex centres, such as the vaso-motor and respiratory centres in the 
medulla. When the dose is'large this increase is so great as to induce 
convulsions and cause death by asphyxia. After a full dose (gr. y 1 ^) the 
pupils become dilated, the limbs take on jerking movements, respira- 
tion becomes spasmodic and the lower jaw stiff, a sensation of cerebral 
tension may be felt, and sudden shuddering and anxiety follow, the 
face taking on an unmeaning smile, the risus sardo?iicus. A toxic dose 
(gr. \ to gr. ij) produces powerful and characteristic convulsions of a 
tetanic character. Within an hour after its administration, sometimes after 
only a few minutes, the patient feels a sudden sense of suffocation and 
dyspnoea, the head and limbs begin to shudder and jerk, the limbs are 
suddenly stretched out rigidly, with hands clenched and feet arched, then 
the head is bent backward, and at last the whole body becomes stiffly 
arched, resting on the head and the heels, the belly hard and tense, the 
chest muscles fixed and the breathing all but arrested. In the height of 
the paroxysm the face is dusky and congested, and the eyeballs project. 
Nearly all the muscles of the body are affected, but those of the jaw are 
not seriously implicated until near the end, and never so powerfully as in 
tetanus. The pulse is very rapid and the body temperature is above nor- 
mal, but the intellect remains unclouded and the patient often expresses a 
sense of impending dissolution. After the paroxysm has lasted a minute 
or two it usually relaxes for a time. In the interval the patient suffers 
from soreness of the muscles, feels exhausted and sweats profusely, but be- 
fore long becomes aware that the spasm is returning and may cry out for 
some one to hold him or to rub his limbs. The convulsions rapidly in- 
crease in severity, a breath of wind, the slightest noise, even a bright 
light, being sufficient to bring them on, and in one the patient may jerk 
himself out of the bed. At last the respiration stops in the middle of a 
fit, and the heart soon after ceases to beat. Death occurs, after two or 
three hours at most, by exhaustion and asphyxia from tetanic fixation of 
the muscles of respiration, consciousness being preserved until carbonic- 
acid narcosis sets in. 

Strychnine exalts all the functions of the spinal cord — reflex, motor, 
vaso-motor, and sensory, the latter being the least affected. It has selec- 
tive action on the large multipolar ganglia in the anterior columns, which 

23 



354 NUX vomica. 

it first stimulates and finally paralyzes by over-stimulation, in this respect 
illustrating the rule that small and large doses of an active agent act 
antagonistically to each other. A massive dose seems to destroy the 
spinal and medullary functions as by a single blow. The spasms of 
Strychnine may be distinguished from those of tetanus by their intermit- 
tency (the latter being constant), by the meaningless smile, the less-marked 
trismus, the absence of a wound, and the rapid course of the symptoms. 
Thebaine, the tetanizing alkaloid of opium, is also a spinal exaltant, and 
acts much the same as strychnine. 

Strychnine does not directly affect the muscular tissue, the motor nerve- 
trunks or nerve-endings, or the cerebral convolutions. Occasionally, 
however, large medicinal doses cause a greatly heightened sensibility of 
the optic and auditory nerves, so that brilliant lights and loud sounds pro- 
duce painful impressions ; and in a few cases there occurs a true cerebral 
intoxication resembling a slight degree of drunkenness. It probably 
affects all the nervous centres in some degree, the sensory, however, much 
less than the motor and vaso-motor ones. It is to some extent oxidized 
and destroyed in the body, the remainder being eliminated by the urinary, 
salivary and cutaneous channels. As it contracts the renal arteries, it 
hinders its own excretion by the kidneys, and, being rapidly absorbed, it 
may accumulate in the system if even a small dose is frequently and con- 
tinuously administered. It is much more poisonous when injected into 
the rectum than when swallowed. 

The fatal dose of Strychnine is placed by Taylor at gr. -J- to gr. ij for 
an adult, but recovery has taken place after larger doses, even 7 and 8 
grains, cases probably of imperfect absorption, due, perhaps, to the pres- 
ence of fat or tannin in the contents of the stomach. A child, aged 2 x / 2 
years, died in four hours from a dose of gr.^. After death from this 
poison cadaveric rigidity is marked, with opisthotonos, clenched hands, 
and arms flexed across the chest. The muscular rigidity may persist for 
several months after death. The face is usually pale, but sometimes livid, 
the internal organs are gorged with dark blood, and the bladder is gener- 
ally contracted. The cause of death is primarily asphyxia produced by 
rigidity of the muscles of respiration, with possible factors in spasm of the 
heart or exhaustion thereof. 

On animals Strychnine acts as it does upon man, but in different de- 
grees. Birds, guinea-pigs and perhaps monkeys, are comparatively insus- 
ceptible to it, while ruminants are less easily affected than other quadrupeds, 
and cats resist it singularly. Very minute portions in the soil will destroy 
the life of growing plants. 

Antidotes, Antagonists and Incompatibles. 
The antidotes are Tannic Acid to form the very insoluble tannate, and Iodine in dilute 
solution, or a soluble Iodide. Animal Charcoal should be given freely, also Fats and 



nux vomica. 355 

Oils, to retard absorption. Potassium Permanganate has been used successfully after 
the ingestion of gr. ^ of strychnine without any symptom of strychnine poisoning result- 
ing (Fahr. ). Evacuation of the stomach should follow the administration of any antidote, 
and the bladder should be emptied frequently to prevent reabsorption. The most reliable 
antagonist is Chloral Hydrate, of which gr. xxx should be given at once, and doses of 
gr. xx may be repeated at hourly intervals as long as reflex exaltation continues. Quiet, 
as perfect as possible, is an antagonistic measure of great importance. Other antagonists 
are Hydrastinine Hydrochlorate, gr.j, hypodermically, Nicotine, Chloroform, Amyl 
Nitrite, Physostigma (dangerous), Veratrum Viride, Oil of Chamomile, and Valerian. 
Potassium Bromide is antagonistic, but too slow of action to be of service. Curare has 
been recommended, but its value is doubtful. 

Incompatibles are Bromides, Iodides and Chlorides in the same solution, precipitating 
the strychnine as a hydrobromide, etc. Strychnine salts in solution are decomposed by 
Alkalies and their Carbonates, and by Tannic (not by gallic) Acid, but are not affected 
by ferric salts. Oils and fats retard their absorption. 

Therapeutics. 

Nux Vomica and its chief alkaloid, Strychnine, are exceedingly useful 
remedies, having a wide range of therapeutic efficacy.- They are chiefly 
employed as stomachic tonics, and as stimulants to the heart, the respira- 
tory apparatus, and the muscular and nervous systems. As the quantity of 
strychnine in nux vomica varies greatly, it is best to use the alkaloid when 
its physiological action is desired, as more definite dosage may be thus ob- 
tained. The tincture in 5-drop doses is excellent in atonic dyspepsia and 
gastric catarrh, especially in drunkards, and in constipation from atony of 
the bowels it may be given in 10-drop doses with good results, not as a 
purgative but to increase peristalsis. The extract is much used in laxative 
pills for habitual constipation. In the vomiting of pregnancy the tincture 
is frequently an efficient remedy, and in the vomiting of phthisis Strychnine 
is one of the very best agents. In the condition clinically known as that 
of torpid liver, where the stools are of pale color and very offensive odor, 
showing absence of bile therein, the tongue coated with a thick, perhaps 
yellowish fur, and the patient complaining of headache, lassitude, anorexia, 
and a bad taste in the mouth ; small doses of Strychnine (gr. -fa) twice or 
thrice daily, will frequently act as well as a mercurial, restoring the bile to 
the stools, and correcting the other symptoms. Epidemic diarrhoea and 
dysentery are often controlled by Strychnine, and in anaemia and chlorosis 
it is an invaluable remedy, especially when combined with iron and qui- 
nine. In intermittents, as an adjunct to quinine it is always useful, and 
in neuralgia, especially of the viscera, and infraorbital and other forms 
accompanying anaemia and general debility, it is highly efficient, but in 
these affections very small doses (gr.y^-Q-) should be employed. 

Headaches are often controlled by Nux Vomica, especially the sick 
headache of gastric origin, in which minim-doses of the tincture every ten 
or fifteen minutes frequently give marked relief, and a dose of rr^x before 
each meal will prevent frontal headache in many persons liable thereto. 
A sense of heat and weight on top of the head, accompanied or not by 
flatulence, and usually occurring in women at the climacteric, will often 



356 NUX VOMICA. 

yield to the tincture in doses of n^v before each meal. Its undoubted in- 
fluence on the pneumogastric makes it a most valuable remedy for many 
kinds of cough, even those of phthisis, bronchitis, pneumonia or emphy- 
sema, but it is particularly efficient in coughs of neurotic origin, such as 
periodical cough, night cough, and the paroxysmal laryngeal cough with- 
out lung or bronchial symptoms, but characterized by a persistent tickling 
sensation in the throat. In all these, drop-doses of the tincture frequently 
repeated are much more serviceable than larger doses at longer intervals. 
In bronchial asthma, and asthma of neurotic origin, in the dyspnoea of 
pulmonary affections and that with cardiac palpitation in hysterical sub- 
jects, in irregular action and over-action of the heart, in functional anaes- 
thesia, hypochondriasis, abdominal cramps, nervous movements accom- 
panying pregnancy, cold hands and feet due to languid capillary circula- 
tion, prolapsus ani and urinary incontinence in children, and paralysis 
of the bladder in old people, small doses of strychnine or nux vomica 
frequently repeated are remarkably beneficial. In many of these affections 
the therapeutic action of the drug is unmistakably that of an antispas- 
modic, illustrating the opposite effects of large and small doses of an active 
agent, a thoroughly established fact in many cases, though not one of uni- 
versal application. 

Nux Vomica is a most efficient remedy in impending cardiac failure 
from almost any cause. Even with the pulse imperceptible, the extremi- 
ties cold, and death apparently imminent, the administration of a drop of 
the tincture every five minutes has frequently given renewed strength to 
the cardiac contractions after five or six doses, and initiated an improve- 
ment which resulted in eventual recovery. Local paralyses of various 
forms are well treated by the hypodermic injection of Strychnine into the 
substance of the affected muscles, and diphtheritic paralyses are almost in- 
variably cured by its internal administration. It may prove useful in 
hemiplegia when degeneration has not set in, and when the paralyzed 
muscles are completely relaxed ; but it is of no avail in recent cases or 
when electrical contractility is lost. If used early in cerebral paralyses, 
especially when due to hemorrhage, it may do serious harm ; and in the 
early stage of organic spinal lesions it may be decidedly injurious, par- 
ticularly if given in large doses. It should never be used in spinal 
paralysis when there are symptoms of congestion or inflammation of either 
the cord or its membranes. In hysterical paralysis and that caused by lead 
it is decidedly beneficial, and also in the form which is limited to one or 
two groups of muscles, especially infantile paralysis of long standing, even 
when the atrophic process has gone so far as to greatly impair the electri- 
cal sensibility. In multiple peripheral neuritis the hypodermic injection 
of strychnine has proved eminently serviceable. 

Strychnine is very useful in cases of nervous impairment of the sight, 



nux vomica. 357 

especially in amblyopia from lead, tobacco or alcohol, from atrophy of 
the optic nerve, and from functional disorders of the retina without ap- 
parent lesion, also in muscular asthenopia. In these affections it maybe 
used internally, but it is usually administered by injection into the tissues 
around the temple, beginning with gr. ^, and gradually increasing the 
dose up to gr.^s or y§. Improvement may not be apparent until the 
larger doses are reached. 

In acute and chronic alcoholism, Strychnine is undoubtedly of great 
service. In small doses it is an effective remedy for the morning vomit- 
ing and dyspepsia of drunkards, for the tremor of chronic dipsomaniacs, 
in the forming stage of delirium tremens, and for the depression due to 
enforced abstinence from alcohol. The nitrate, in doses of gr. -^ to^g-, 
hypodermically three or four times daily for a week, and less frequently 
for two weeks longer, removes the craving for stimulants, counteracts the 
vaso-motor paralysis to which most of the injurious effects of alcohol are 
due, and is probably in other respects a true antagonist to the action of 
that narcotic poison on the human organism. The published reports of 
its efficacy in dipsomania, by Luton, Dujardin-Beaumetz, Portugaloff and 
others, have been fully confirmed by recent observers, so that Strychnine 
is now the acknowledged remedy for inebriety, and the efficient con- 
stituent of the numerous "cures " therefor so widely advertised in the 
religious and secular press. 

Strychnine is a physiological antagonist to Chloral, Physostigmine and 
Morphine, and may be used as a respiratory stimulant in poisoning by 
these drugs, also in narcotic poisoning by any agent when the respiration 
is failing. It has been employed in Australia as an antagonist to serpent 
venom with great success in the hands of Mueller and others, and with 
doubtful efficacy in the experience of many observers. From the results 
of experiments made by Dr. Elliot, of the Indian army, it would seem 
that its use in poisoning by cobra venom is of no service whatever and 
may actually hasten death. 

Strychnine Arsenite possesses strong antiperiodic power, and may 
prove to be an efficient remedy for any intermittent disease rebellious 
to the influence of quinine. As it is highly toxic, the minimum dose 
(gr. gL) should not be exceeded at first, and its effects should be care- 
fully watched upon repetition. 

Brucine was formerly supposed to have an action analogous to that of 
strychnine though weaker. Dr. Mays has shown that pure Brucine is a power- 
ful local anaesthetic in 5 to 10 per cent, solutions on mucous membranes, 
and in a 20 per cent, solution on the skin. In the latter strength it has been 
employed with satisfaction for chronic pruritus, and in a weaker solution 
(5 per cent.) for inflammations about the external ear, in which Dr. Burnett 
claims for it more satisfactory results than are obtained with cocaine. 



358 NYMPH^EA ODORATA OLIV^E OLEUM. 

NYMPH^A ODORATA, Sweet-scented Water-lily (Unofficial),— is a well- 
known American plant of the nat. ord. Nymphaeaceae, the root of which is very bitter and 
highly astringent, containing much Gallic and Tannic Acids, to which its actions and 
uses are due. A decoction of 3J to the pint may be used in doses of 5jss— j, or a fluid 
extract in doses of ^ss-j. For the physiological actions and therapeutics of this vege- 
table astringent see under Tannic Acid, ante, page 94. 



OLIV^E OLEUM, Olive Oil, {Sweet Oil, Salad Oil), is a fixed oil 
expressed from the ripe fruit of Olea europcea, the olive tree (nat. ord. 
Oleacese), which is cultivated in southern Europe, California and Austra- 
lia. It is a pale-yellow or greenish-yellow, oily liquid, of nutty, oleagin- 
ous taste, and neutral reaction, sparingly soluble in alcohol but readily 
soluble in ether. Sp. gr. about 0.916. 

Olive Oil consists of 72 per cent, of Olein (a fluid oil) and 28 per cent, of Palmitin 
(a solid oil or stearopten), which are compounds of the base Glyceryl, C 3 H 5 , with Oleic 
Acid, C 19 H 34 2 , and Palmitic Acid, C 17 H 31 2 , respectively. It is frequently adulterated 
with cheaper fixed oils, especially poppy oil, lard oil, and cotton-seed oil, quantities of 
the latter being exported every year to Italy, whence it is returned to us as Olive Oil 
under a French label. (See Gossypium.) It is an ingredient of Ceratum Cetacei, Em- 
plastrum Plumbi, and Unguentum Diachylon, and is the source of the official Soap. 
Dose, ^ ss-j. 

Physiological Action and Therapeutics. 

Externally used Olive Oil is a good protective from the air, and ren- 
ders the skin soft and flexible. If rubbed into the integument it is ab- 
sorbed by the lymphatics and is directly nutritive in effect. Internally it 
is also nutritious and mildly laxative, and in quantity acts as a protective 
to the mucous membrane against acrid or poisonous substances. Like 
other oils it is partly emulsified, partly saponified in the intestines, its gly- 
cerin being set free and its fatty acids combining with the free alkalies to 
form soap, which with the emulsion forms the molecular basis of the chyle, 
entering the blood through the lacteals and being finally oxidized into 
carbonic acid and water, though an excess will appear unchanged in the 
urine. Oils are therefore a food within certain limits, increase the fat of 
the tissues, furnish heat and force, and lessen the waste of nitrogenous 
tissue, but are unable of themselves to support life. 

Olive Oil possesses no very marked therapeutic power above any other 
bland oil or fat. It is a good laxative for infants administered internally, 
and may be used as an enema followed by warm water. There is much 
clinical evidence to prove that, administered internally, it is a very effi- 
cient remedy in both nephritic and biliary colic ; but how it acts therein 
has not been explained. It is chiefly employed as a local application. 
Applied to burns and acute inflammatory affections of the skin it is an ex- 
cellent protective, coating the surface and excluding the air ; and as an 
ingredient of liniments it acts as a diluent for more active agents. It is 
used to facilitate friction over enlarged or stiff joints, and in the desqua- 
mative stage of scarlet fever is a very useful and grateful application. As 



opium. 359 

an antidote in corrosive poisoning it acts mechanically by protecting the 
mucous membrane of the stomach and preventing absorption. In phar- 
macy its bland, unirritating qualities have procured its common employ- 
ment as an ingredient of liniments, plasters, ointments and cerates, but 
the foreign article is so frequently adulterated with inferior oils that Cot- 
ton-seed Oil is now directed in its place in many official preparations. 

OPIUM, — is the concrete, milky exudation, obtained by incising the 
unripe capsules of the White Poppy, Papaver somniferum, an annual herb 
of the nat. ord. Papaveraceae, indigenous to Western Asia but cultivated 
extensively elsewhere. Its capsules are globular, two or three inches in 
diameter, and are crowned by a sessile, stellate stigma, which distin- 
guishes them from Colocynth and Bael fruits. Opium occurs in irregular 
lumps or cakes, of dark-brown color, sharp, narcotic odor, and bitter 
taste ; and in its normal, moist condition should yield not less than 9 per 
cent, of Morphine when assayed by the official process. 

Composition of Opium. 
Opium contains 17 alkaloids, 2 neutral substances and 2 organic acids, 
together with sugar, gum, resin, pectin, extractives, odorous principles, 
water and other constituents of plants. Its most important alkaloids are 
the following : — 

Morphine, C 17 H 19 X0 3 , — 5 to 20 per cent. — the principal alkaloid, occurring in the 
drug in the form of trie tribasic meconate. Its properties are anodyne, hypnotic and nar- 
cotic. From it by a process of dehydration by heat and hydrochloric acid is prepared 
the artificial alkaloid Apomorphine, a powerful emetic and expectorant. 

Codeine, C 1S H 21 X0 3 , — 0.3 to 0.5 per cent., — is calmative and when pure a not very 
active alkaloid, but is frequently contaminated with other alkaloids. Apomorphine may 
be prepared also from it. 

Narcotine, C 9 . 2 H 23 N0 7 , — 2 to 10 percent., — is antiperiodic and a tetanizer, but wholly 
devoid of narcotic properties. 

Thebaine or Paramorphine, C 19 H 01 X0 3 , — o. 15 to 0.20 per cent., — is a powerful spinal 
exaltant and tetanizer, resembling Strychnine in its action. 

Narceine, C 22 H 29 X0 9 , — 0.02 per cent., — closely resembles Morphine in action, but is 
probably more hypnotic, and is not followed by many of the disagreeable after-effects of 
Morphine. It is extremely difficult to obtain this alkaloid pure. 

Papaverine, C 21 H 91 NO + , — I per cent., — is reported inert on man by some observers, 
a narcotic and convulsant by others. 

Other Alkaloids at present acknowledged are — Cryptopine, Pseudomorphine, Protopine, 
Hydrocotarnine, Laudanine, Codamine, Rhoeadine, Meconidine, Laudanosine, Lanthopine 
and Gnoscopine. Many of them are probably to be regarded as derivatives of Morphine. 

Besides the above-named alkaloids the most important of the constit- 
uents of Opium are the following acids and neutral principles, viz. : — 

Acids are — Meconic Acid, C 7 H^O T , 4 per cent., and Lactic Acid, C 3 H t; 3 , l}£ per 
cent., which exist in combination with the alkaloids as meconates, bimeconates, etc. The 
second acid is generally called Thebolactic, but has been recently shown to be identical 
with lactic acid. 



360 OPIUM. 

Neutral Principles are — Meconin, C 10 H 10 O 4 , 0.01 per cent., is white, crystalline, 
neutral, but very acrid ; Meconoiosin, C 8 H 10 O 9 , also crystalline, and Porphyroxin, which 
is now said not to be a proximate principle but a very complex combination of several 
alkaloids. 

Official Preparations of Opium. 

Opii Pulvis, Powdered Opium, — is Opium dried at a temperature not exceeding 185 
F. , and reduced to a very fine powder. It should contain not less than 13 nor more than 
15 per cent, of crystallized Morphine, when assayed by the official process. Dose, gr. 
ss-iij, an average adult dose being about I grain. 

Opium Deodoratum, Deodorized Opium [Denarcotized Opium), — is powdered Opium 
freed from the constituents thereof which are soluble in Ether, namely Narcotine and the 
odorous principles, which are supposed to cause the unpleasant after-effects of the drug. 
It should yield 14 per cent, of Morphine, and is a good preparation, being a purified 
opium with a fixed morphine standard. The proprietary article named Svapnia is a 
similar preparation. Dose, gr. ss-iij ; an average adult dose being about I grain. 

Extractum Opii, Extract of Opium, — an aqueous extract containing '1 8 per cent, of 
Morphine, and freed from some disturbing principles which are insoluble in water. Dose, 

Pilulae Opii, Pills of Opium, — each pill contains about gr. j of powdered Opium 
incorporated with Soap. Dose, j-iij pills. 

Tinctura Opii, Tincture of Opium [Laudanum), — Opium-strength 10 per cent., 
average Morphine-strength gr.vj (equaling gr.vijss of the Sulphate) to the fl % . Has 
about gr.xliv of Opium to the 3 . TT^xj (gtt.xxij) = gr. j of Opium or gr. ys of Morphine 
Sulphate. Sixty minims yield on the average 120 drops. Dose, niv-xxx, according to 
the effect desired. 

Tinctura Opii Deodorati, Tincture of Deodorized Opium, — an aqueous extract is 
prepared and shaken with ether, which being separated the residue is dissolved in water, 
and enough alcohol is added to preserve it. An excellent liquid preparation, being freed 
from all the noxious and useless ingredients soluble in alcohol and ether. McMunn 's 
Elixir is a similar preparation, so also is another proprietary nostrum named Papine. 
Opium-strength 10 per cent., average Morphine-strength gr.vj to the fl 3 . Dose, as of 
Tinctura Opii. Drops of this preparation nearly equal minims. 

Vinum Opii, Wine of Opium [Sydenham" 1 s Laudanum'), — Opium-strength 10 per 
cent., with the aromatics Cinnamon and Cloves of each I per cent., in Alcohol and White 
Wine. A vinous tincture decreased somewhat in strength from the wine of 1870. Dose, 
as Tinctura Opii. Drops of this preparation are larger than those of the tincture. 

Acetum Opii, Vinegar of Opium [Black Drop), — Opium-strength 10 per cent., with 
Nutmeg and Sugar in Dilute Acetic Acid. Is now y^ weaker than formerly, having the 
same strength and dose as Tinctura Opii. 

Tinctura Opii Camphorata, Camphorated Tincture of Opium [Paregoric), — has of 
Powdered Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, Diluted 
Alcohol to 1000. ^ ss contains nearly one grain of powdered Opium, and is about ^jfb. 
the strength of Laudanum. Dose, for an infant gtt.v-xx, for an adult £j-iv. Is an 
ingredient of Mistura Glycyrrhizte Composita. 

Emplastrum Opii, Opium Plaster, — contains of Extract of Opium 6 parts, Burgundy 
Pitch 18, Lead Plaster 76, Water 8. 

Pulvis Ipecacuanhae et Opii, Powder of Ipecac and Opium [Dover's Powder), — 
has of Ipecac 10, Powdered Opium 10, Sugar of Milk 80, rubbed together into a very 
fine powder. Dose, gr.v-xv; ten grains equalling I grain each of Ipecac and Opium. 

Tinctura Ipecacuanhae et Opii, Tincture of Ipecac and Opium, — has of Tincture of 
Deodorized Opium 100 evaporated to 80, Fluid Extract of Ipecac 10, Diluted Alcohol 
to 100. Is intended to represent Dover's Powder in liquid form. Dose TT^v-xv. 

Trochisci Glycyrrhizae et Opii, Troches of Glycyrrhiza and Opium, — each troche 
contains of powdered Opium gr. Jj, with Extract of Glycyrrhiza, Acacia, Sugar and Oil 
of Anise. Dose, j-iv troches. 

[Note. — According to the U. S. Pharmacopoeia of 1890 the official dried Opium should 
contain 13 to 15 per cent, of Morphine instead of 10 per cent, as required by the Phar- 
macopoeia of 1870. The liquid preparations, except Paregoric, are now directed to be of 



OPIUM. 361 

the uniform Opium-strength of 10 per cent., and to yield, on being assayed, 1.3 to \y z 
per cent, of crystallized morphine, making the Wine less strong by 2 per cent., the 
Acetum fully y^ less in strength, and the other liquid preparations stronger by y z in Mor- 
phine than formerly. So that if the full anodyne dose of Tincture (1870) be taken at 
24 minims, equalling gr. l{ of Morphine Sulphate, the corresponding dose under the 
present system will be 16 minims.] 

Official Preparations of Morphine. 

Morphina, Morphine, C 17 H 19 N0 3 -f- H 2 0, — white, prismatic crystals, or fine needles, 
or a crystalline powder, odorless, of bitter taste and alkaline reaction, almost insoluble in 
water, soluble in 300 of alcohol. Its comparative insolubility makes the salts preferable 
for use, and as a very small proportion of acid neutralizes it, the dosage is about the same for 
the alkaloid and its salts, viz., gr. ^o - § r - J- Gr. \—\ is about equal to one grain of Opium 
of medium Morphine-strength. [Compare Morphines Sulphas, below.] 

Morphinae Acetas, Morphine Acetate, — a white, crystalline or amorphous powder of 
faintly acetous odor, bitter taste, neutral or faintly alkaline reaction, soluble when fresh in 
2^ of water and in 47.6 of alcohol at 59 F. Dose, gr.^-j. 

Morphinae Hydrochloras, Morphine Hydrochlorate, — white, feathery crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 62 of alcohol at 
59 F. Dose, gr. ^-j- 

Morphinae Sulphas, Morphine Sulphate, — white, feathery, acicular crystals of silky 
lustre, of bitter taste and neutral reaction, soluble in 21 of water and in 702 of alcohol 
at 59 F. , and in o. 75 of boiling water. Contains about 80 per cent, of Morphine. Dose, 
S r - lo-g 1 "- J '■> t^~Y% being a small dose for an adult, }i~/4 a moderate one, %- l /z a full 
dose, and Y~) a large one. 

Pulvis Morphinae Compositus, Compound Powder of Morphine [Tull/ 's Pow- 
der), — has of Morphine Sulphate I part to 19 of Camphor and 20 each of Liquorice and 
Calcium Carbonate. A similar preparation to Dover's Powder minus the Ipecac. Dose, 
gr.v-xv, ten grains containing gr. y^ of Morphine Sulphate. 

Trochisci Morphinae et Ipecacuanhae, Troches of Morphine and Ipecac, — each 
troche contains gr. ^ of Morphine Sulphate with about gr. ^ of Ipecac, also Sugar, Oil 
of Gaultheria and Mucilage of Tragacanth. Dose, one every hour or so ; cautiously with 
children. 

Injectio Morphinae Hypodermica, Hypodermic Injection of Morphine (B. P.), — 
is a solution of the Acetate, containing gr. j. in each ten minims, being thrice as strong 
as Magendie's solution. Dose, rr^ j-iij. 

Tinctura Chloroformi et Morphinae, Tincture of Chloroform and Morphine, (B. 
P.), — a substitute for Chlorodyne. See ante, page 227 and also the table on Chlorodyne 
in the Appendix. 

Unofficial Preparations of Opium and Morphine . 

Liquor Opii Compositus, Compound Solution of Opium (Squibb), — has the same 
strength as the official tinctures, namely gr.yj of Morphine (equalling gr.vijss of the 
Sulphate) to each fluidounce. n\.xvj = g r -X °^ Morphine Sulphate. 

Tinctura Opii Composita, Compound Tincture of Opium (Squibtf s Diarrhcea Mix- 
ture), — has of Tinct. Opii, Spt. Camphors and Tinct. Capsici %] of each, Purified 
Chloroform .^iij, Stronger Alcohol q. s. ad % v. Each fl 3 or teaspoonful contains 
about 100 drops or TT\ xij of each of the first three ingredients and nyvss or 18 drops of 
Chloroform. Dose, for infants gtt. j-x, for children gtt.x-xxx, for adults gj. 

Liquor Morphinae Sulphatis, Solution of Morphine Sulphate [Magendie's Solu- 
tion), — has gr. xvj of Morphine Sulphate in each fl^ or gr.j in n\xxx, or gr. Y m 
y\ vijss. If made with Benzoic Acid, the solution will not spoil, and is not irritant hypo- 
dermically. The same result is attained by adding of Carbolic Acid, nr^ iij to the "^ . 

Oleatum Morphinae, Oleate of Morphine, — Morphine-strength 10 per cent, with 
Oleic Acid 90. For local use. 

Liquor Opii Sedativus, Sedative Solution of Ophmi (Battley's Sedative), — is about 
50 per cent, stronger than the tincture of opium. It was formerly a favorite prepara- 
tion. 



362 OPIUM.. 

Dalby's Carminative, — contains Opium, about gr.i to the ounce, also Oil of Pep- 
permint, Nutmeg, Anise, and Magnesium Carbonate. 

Godfrey's Cordial, — contains Laudanum, Sassafras and Treacle, its opium strength 
being gr.i to the ounce. 

Nepenthe, — is a purified alcoholic solution of Morphine Meconate in sherry wine. 

Chlorodyne, — (see ante, page 227, and Appendix), — contains Morphine in varying 
proportion, that of J. Collis Browne having gr.vj to the ounce. 

Mrs Winslow's Soothing Syrup, — contains Morphine, with Essence of Anise and 
Syrup of Tolu. After years of persistent denial, its proprietors have recently admit- 
ted that it contains \ grain of Morphine in each fluid-ounce (Squibb). 

Official Derivative of Morphine. 

Apomorphinae Hydrochloras, Apomorphine Hydrochlorate, C n H lv N0 2 HCl, — is 
the hydrochlorate of an artificial alkaloid (Apomorphine) which is prepared from mor- 
phine or codeine by the action of strong acids or zinc chloride, the morphine losing 
in the process a molecule of water. The Hydrochlorate occurs in minute, colorless 
crystals, odorless, of bitter taste, and neutral or faintly acid reaction ; soluble in about 45 
of water and in the same quantity of alcohol at 59 F., almost insoluble in ether or chlo- 
roform ; decomposed by boiling water or boiling alcohol. Dose, gr. ^ to J^ hypoder- 
mically, gr. ^ to \ by the mouth. For young children, gr. ^ to i should not be 
exceeded. Solutions should be fresh when used, and as they alter rapidly by keeping, 
should have a few drops of hydrochloric acid added to them, to prevent decomposition. 

Preparations of Other Alkaloids. 

Codeina, Codeine, C ]8 H 21 N0 3 -f- H 2 0, — white or yellowish- white, rhombic prisms, 
efflorescent in warm air, of bitter taste and alkaline reaction, soluble in 80 of water at 
59° F. and in 17 of boiling water, very soluble in alcohol, chloroform and ether. This 
alkaloid is official. Dose, gr. ss-ij,but gr. \ has caused alarming symptoms in children. 

The Phosphate is sufficiently soluble for hypodermic use, and comparatively unirritant. 
One part in twenty of water forms the usual solution for hypodermic employment. 

Narcotinse Hydrochloras, Narcotine Plydrochlorate (Unofficial), — Dose, gr.ij-x, as 
an antiperiodic. 

Children bear Opium badly, and for them its proportionate dosage 
should be much below that for other agents. Morphine should not be 
given to children below 10 years of age, and never hypodermically to 
those beneath the age of 15. Opium given to a nursing mother will affect 
the child, being partly excreted in the milk. 

Reactions and Incompatibles. 

An aqueous or alcoholic preparation of Opium reddens litmus paper (free meconic 
acid) ; gives a deep red color with Ferric Chloride (meconic acid) ; forms precipitates 
with Lead Acetate and Subacetate, Silver Nitrate, Zinc. Copper, and Arsenic (meconates, 
sulphates, and coloring matter) ; forms a precipitate with tincture of Galls or astringent 
preparations (tannates of morphine and codeine) ; and becomes turbid with the fixed 
Alkalies, Carbonates, Alkaline Earths, and Ammonia (precipitated morphine and nar- 
cotine). 

Tests fo r Mo rp h in e . 

Nitric Acid produces a blood-red, turning orange, then yellow, then disappearing. 
Test-solution of Ferric Chloride gives a blue color changing to green with excess of the 
reagent, and destroyed by free acids or alcohol, but not by alkalies. Iodic Acid liberates 
Iodine which maybe tested by starch. Vaughn has shown that certain intestinal ptomaines 
will give the same reactions with these reagents. 



OPIUM. 363 

Physiological Action. 

Opium is analgesic, hypnotic, antispasmodic, diaphoretic and narcotic. 
It first stimulates and afterwards depresses the cerebrum, heart and respir- 
atory apparatus, and is classed among the cerebral depressants. 

In medium dose (gr. j) it arrests all the secretions except the milk and 
sweat, the latter being increased ; producing dryness of the mouth and 
throat, retarded digestion from stoppage of the gastric juice, and decided 
loss of appetite. The action of the heart is increased, arterial tension 
raised and the pupils slightly contracted. The cerebral faculties are 
stimulated by increased blood-supply to a pleasant activity, ideas follow 
each other rapidly through the mind, and an exhilaration bordering on 
mild intoxication is experienced, succeeded by a calm of variable length. 
Sleep generally follows, disturbed, however, by dreams, and after waking, 
headache, malaise, constipation, digestive disturbance and some depression 
result. The conductivity of the nerves is not affected. Frequently the 
stage of mental activity is absent, but in persons habituated to the use of 
Opium it is usually well marked. In some subjects a lengthened period 
of calm repose takes the place of sleep, in others neither calm nor sleep 
occurs, but the stimulant action of the drug prevails, the spinal functions 
as well as the cerebral are exalted, and great restlessness is the result. 

I11 full dose (gr. iij-v) the same symptoms are produced but in greater 
intensity ; the stage of stimulation is much shorter, digestion is arrested, 
nausea and vomiting produced, also profuse diaphoresis. The conduc- 
tivity of the nerves is more or less impaired, the heart and circulation 
depressed, oxidation being interfered with and the body-temperature 
lowered. The pupils are contracted by stimulation of the motor oculi 
through the basal ganglia, intense pruritus is produced, especially at the 
nose, and often spasmodic retention of the urine. Profound sopor soon 
comes on, with irregular and slow respiration, but in some subjects this is 
replaced by coma-vigil and delirium. After-effects are nausea, depression, 
constipation, racking headache, vertigo, anorexia, nasal pruritus, and fetid 
pathological secretions. 

A toxic dose produces cold and clammy sweat, very slow pulse, slow and 
stertorous respiration gradually becoming feeble and irregular, cyanosed 
face, abolished reflexes, coma gradually deepening, the pupils minutely 
contracted but dilating as the end approaches, and finally death by paraly- 
sis of the respiratory centre due to direct action on the medulla. Post- 
mortem shows only a wet brain, congested lungs, and engorgement of the 
venous trunks and of the right heart. 

The coma produced by opium-narcosis, when deep and when a history of the case 
cannot be obtained, is almost impossible of differential diagnosis from that due to alcohol, 
apoplexy, unemia, epilepsy, etc. [See under Alcohol, ante, page 1 14.] The odor of 
the breath may point to laudanum or some other preparation of opium. The pupils are 
very much contracted in opium poisoning (also from physostigma and chloroform), but 



364 OPIUM. 

they may dilate just before death (as with chloroform), due to the irritation of the centres 
by the excessive venous condition of the blood. In alcoholic coma they may be either 
contracted or dilated ; and in apoplexy generally they are unequally contracted, though 
in apoplexy of the pons varolii they may be equally and minutely contracted. The rectal 
temperature may be an important sign, for in most cases of apoplexy there is an initial 
fall of temperature with a subsequent rise. A previous history of convulsions points to 
epilepsy, and the presence of albu?)ie?i in the urine, with sometimes oedema of the legs, 
indicates uraemia as the cause of the coma. 

The principal action of Opium is exerted upon the nervous system, first 
affecting the cerebral convolutions, which are briefly stimulated and soon 
depressed, — next the perceptive and sensory centres in the higher brain 
are more or less blunted, and the conductivity of the afferent nerves im- 
paired, — soon the ganglia at the base of the brain are involved, evinced 
by the contraction of the pupils, vomiting, and slowing of respiration, — 
the cardiac, vascular and other centres are depressed, but to a less degree 
than the respiratory and perceptive, — the gray matter of the cord, at first 
stimulated, as shown by the increase of reflex excitability, is also depressed, 
and locomotion becomes difficult, the motor nerves becoming paralyzed 
from the centre outwards, but muscular irritability is never lost. Death 
generally occurs by paralysis of the respiratory centre, rarely by sudden 
cardiac failure. 

Metabolism is greatly reduced in activity by Opium, the quantity of 
urea excreted being markedly lessened, and the biliary and glycogenic 
functions of the liver being affected, resulting in whitish stools, perhaps 
jaundice, and certainly decided decrease of the sugar excreted by diabe- 
tics, when the drug is given by the stomach. 

The vaso-motor centre is slightly, if at all, affected by small doses of 
Opium, but large doses paralyze it. On the vessels of the skin the first 
effect of the drug is to cause their dilatation, shown by turgescenceof the 
vessels of the external ear and a sense of heat therein, and often giving 
rise to a roseolous cutaneous eruption accompanied by itching. The 
long-continued use of opium causes a marked contraction of the capillaries 
and arterioles throughout the body, the skin is excessively pale and the 
subject always feels cold at the ordinary temperature of the atmosphere. 

On the uterine and generative functions Opium exerts a marked influ- 
ence, stopping menstruation if its use be continued, and in men causing 
impotence. Both male and female functions, however, return as soon as 
the drug is discontinued, but the female organs of generation suffer atro- 
phy from its long continued use. In one case, intra-uterine measurements, 
taken during a period of two years, showed a diminution in the size of 
the cavity from 5.1 to 1.9 inches. 

The hypnotic action of Opium is now believed to be produced by a 
double influence, (1) on the vascular system, causing anaemia of the brain, 
(2) on the cerebral cells, diminishing their activity, and consequently les- 
sening their demand for blood. Its constipating action is shown experi- 



OPIUM. 365 

mentally to be produced by stimulation of the inhibitory nerves of the 
intestines through the splanchnics. 

Morphine was discovered bySertiirner in 181 7. Its action is generally 
similar to that of Opium, it being the principal alkaloid therein, but when 
used by itself its influence is not complicated with the effects of the con- 
vulsive alkaloids (thebaine, codeine and narcotine) which must influence 
the action of opium to a considerable degree. As compared with the 
latter, Morphine acts more quickly, and for a shorter time, has less influ- 
ence on the intestines and skin, is less constipating, less stimulating, less 
convulsant and less diaphoretic, but more sedative, more anodyne and 
hypnotic and produces more intense pruritus. Its elimination commences 
quickly but may not be completed for as much as 48 hours, and is effected 
by the intestines, the urine, and the salivary glands. It is also eliminated 
by the gastric mucous membrane, and constantly reappears in the stomach 
until finally excreted. When injected hypodermically more than one-half 
the amount administered may be recovered by repeatedly washing out 
the stomach. It is probably retained in the organism to a great extent 
when the action of the kidneys is defective, and when given continuously 
in renal disease may accumulate with fatal result. 

Apomorphine in dose of gr. -^ given hypodermically is a systemic 
emetic, acting directly on the vomiting centre, and is the quickest, most 
certain and least irritating of all emetics, acting in from five to twenty 
minutes with but moderate nausea. In large dose it is very depressant to 
the heart (gr. -J3- having caused death in a weak adult by cardiac failure), 
and produces paralysis of the motor and sensory nerves, delirium, convul- 
sions, and depression of respiratory power. Small doses (gr. -j-^) given 
by the mouth are expectorant. Morphine in solution kept for a long time 
may become changed into Apomorphine. 

Codeine differs chemically from Morphine in having the radical methyl 
(CH 3 ) replacing an atom of hydrogen, and may be considered a methyl- 
morphine. Like all methyl compounds it possesses motor-paralyzant 
power, like that of Curare. On man it has some hypnotic action, but 
far less than that of morphine. It exalts the spinal cord more than mor- 
phine does, producing muscular tremor in excess of its sedative action. 
It has a special sedative influence on the pneumogastric nerve, contracts 
the pupils, and is remarkably analgesic to the nerves of the abdominal 
and pelvic viscera. When administered for several consecutive days it 
lessens the irritability of the digestive tract to such an extent that arsenic 
produces neither vomiting nor purging (Murrell). It markedly reduces 
the amount of sugar excreted by diabetes, but has no advantage over mor- 
phine in that respect. 

Narcotine should be named Anarcotine, as it has little or no narcotic 
power. It is a convulsant in animals and an antiperiodic in man. 



366 OPIUM. 

Narceine is said by some observers to be remarkably hypnotic, and 
free from convulsant action — by others equally deserving of credit it is 
considered almost inert. This alkaloid is difficult to obtain pure ; hence 
the samples heretofore used have probably been contaminated with other 
alkaloids. It is said to possess laxative properties. 

Thebaine is a powerful convulsant, exalting the spinal cord almost like 
Strychnine and Brucine. It is not used medicinally. 

Cryptopine is said to dilate the pupils, a remarkable property, if true. 

Fatal Doses. 

In a child one day old n\J of Laudanum caused death. A medicinal dose given to a 
nursing mother proved fatal to the infant. A few drops of Paregoric have killed a child 
of nine months. In the adult gr. y^ of Morphine in one case, and gr. iv of crude Opium 
in another, have proved fatal. 

Antidotes, Antagonists and Treatment of Poisoning. 

Potassium Permanganate is the best antidote to Opium or Morphine in the stomach, 
given in dose about one-half greater than the quantity of morphine present, and repeated 
in less quantity from time to time in cases where the poison has been administered hypo- 
dermically so as to neutralize the morphine excreted by the gastric mucous membrane. 
If an Opium preparation has been taken, or the alkaloid Morphine itself, Vinegar should 
be added to the permanganate solution in order to convert the alkaloid into a soluble salt. 
[For other antidotes see the Appendix.] Atropine antagonizes the cerebral action of 
Morphine, also its action on the pupils, respiration, heart and arterial tension, but if given 
too freely will endanger the case by substituting Belladonna-narcosis for Opium-narcosis ; 
gr. jig hypodermically every 15 minutes for three doses, is generally sufficient. It is 
unsafe to be guided in this respect by the pupils. Caffeine is also physiologically antago- 
nistic, and is generally used in the form of strong black coffee frequently administered. 

The Chief Indications in opium or morphine poisoning are — to antidote any of the 
poison in the stomach, and to wash out that viscus repeatedly at short intervals, to main- 
tain respiration and keep up the circulation. [See the Appendix for minute directions.] 
Strychnine 'is an efficient antagonist to the respiratory paralysis, and may be used in lieu 
of Atropine, or in connection therewith. Amy/ Nitrite should also be used when the 
heart shows signs of failure. Capsicum, the tincture, % ss-j by injection into the rectum, 
is said to give almost instantaneous results in antagonizing the stupor of opium poisoning. 

Therapeutics. 
The chief indications for the use of Opium are (1) to relieve pain from 
any cause except acute inflammation of the brain, — (2) to produce sleep, 
particularly in the insomnia of low fevers with delirium, in which the 
combination of Morphine and Chloral is very efficient, — (3) to allay irri- 
tation in the various forms of acute nervous erethism, — (4) to check ex- 
cessive secretion, as in diarrhoeas, dysentery, diabetes, ptyalism, etc., — 
(5) to support the system in low fevers and other adynamic conditions, 
when sufficient food cannot be retained, — (6) as a sudorific, to produce 
sweating in coryza, etc. It is considered of especial value in any irrita- 
tion of the stomach, bladder or bronchi, in severe vomiting, both forms 
of diabetes, gastralgia, colic and muscular spasm. In diabetes mellitus 
Morphine per orem reduces the sugar promptly, but when used hypodermi- 
cally it has little or no effect thereon, even in the same case. In perito- 



OPIUM. 367 

nitis and inflammations of other serous membranes, used freely even to 
narcotism it has often saved life. In cerebro-spinal meningitis it is the 
one remedy if given early, before exudation has set in. Cholera morbus 
and dysentery are efficiently treated by Morphine and Atropine hypoder- 
mically (gr. -J- with gr. -g-j^) after the ingesta have been removed by purg- 
ing. In acute uraemia its use in large doses is recommended by Loomis 
to control convulsions and promote diuresis, but here it is a dangerous 
agent. In muscular rheumatism and acute colds Dover's powder as a 
diaphoretic, conjoined with hot drinks and foot-baths, is old but excel- 
lent treatment. In chronic mania and melancholia, nervous prostration 
and the delirium of fevers, Opium is probably one of the best hypnotics. 
In acute mania it does not act nearly so well as Hyoscine, and in delirium 
tremens it should only be used in cases which show great prostration, and 
then for temporary effects alone, as a stimulant. In chronic melancholia 
small doses of Opium three times a day give better results than any other 
treatment. Severe pain from any cause (except cerebritis) is relieved by 
Opium with an efficiency possessed by no other drug, as the pain of sci- 
atica, neuralgia-, lumbago, cancer, renal and hepatic colic from calculi, 
etc. Cough of harassing and frequent character with but little secretion 
is best treated by Opium, but when there is profuse expectoration it 
should not be used, as the lowering of excitability of the respiratory cen- 
tre which it produces would in such a case be dangerous. In nearly all 
acute inflammations it is valuable, especially where it becomes advisable 
to lock up the bowels. Its tranquillizing power over the circulation 
makes it invaluable in the various forms of hemorrhage, while in that 
from uterine fibroids and cancer the implanting of the Opium-habit is 
deserving of serious consideration as a most beneficial measure, as it 
checks and even stops the bleeding, as soon as established. Dyspnoea 
from any cause is relieved by Morphine, especially that of cardiac disease. 
" It gives the power to breathe ' ' (Huchard). In cardiac disease, especially 
aortic stenosis or insufficiency, with dyspnoea, paroxysms of angina pec- 
toris, or signs of cerebral anaemia, — Morphine hypodermically presents 
the greatest advantages. 

Apomorphine, though a derivative of Morphine, is neither hypnotic 
nor narcotic in any degree. Administered by the mouth in small doses 
(gr. 3 1 - 2 1 -o) i* * s a valuable expectorant and given hypodermically in 
doses of gr. -J^- it is a powerful emetic. Its therapeutic value depends on 
these two properties and has many applications in practice. As an emetic 
it is of much service in poisoning, especially when swallowing is difficult, 
and it may be used with advantage in narcotic poisoning before narcosis 
has blunted the vagus centre. It is a very valuable agent in any case of 
poisoning where time is of great importance. As an expectorant it is 
one of the most efficient and useful agents at our command. In catarrh 



368 OPIUM. 

of the bronchi gr. -fa by the mouth every three or four hours is very 
beneficial, but the drug must be used in all cases with caution, especially 
in young children, who bear it very badly. In hacking coughs without 
expectoration it will prove very serviceable, if given in very minute doses, 
not exceeding gr. -^ in the entire 24 hours. In phthisis it may be given 
in combination with morphine with great advantage, especially in cases 
where there is dyspnoea, continual and harassing cough, and thick, tena- 
cious expectoration. The two agents do not destroy each other's action, 
but from the combination we get increased secretion from the mucous 
membrane, with diminished irritability of the respiratory centre and con- 
sequently lessened cough (Brunton). Apomorphine has been used success- 
fully, by hypodermic injection, as an antidote to strychnine in dogs; 
and in one case, in which it was given in mistake for morphine, it entirely 
dissipated an acute and severe attack of sciatica. 

Codeine is much employed as a palliative for cough, especially the 
irritable, hacking cough of phthisis unaccompanied by much expectora- 
tion. It seems to have a special influence on the nerves of the larynx, 
and will relieve a tickling cough better than any other form of opium, if 
given in one dose of gr. j4 an hour before bed-time. In vomiting from 
almost any cause, doses of gr. j^, repeated two or three times at hourly 
intervals, are usually very efficient. In the milder forms of diarrhoea, 
gr. y 2 to gr. j will generally check the disorder without inducing any un- 
pleasant after-effects. In diabetes Codeine lessens the amount of sugar 
in the urine and often removes it entirely therefrom, but it must be given 
in large doses, beginning with gr. ij-iv, and rapidly increasing to gr. xv 
or xx. It is highly efficient in abdominal and pelvic pain, especially 
when ovarian in origin. 

Applications of the Various Preparations. 

Superficial pain is often alleviated by the Plaster or by extemporaneous 
liniments containing Laudanum or some other fluid preparation. It is, 
however, very doubtful whether such applications are of direct value, as 
Morphine is not absorbed by the unbroken integument ; but the Oleate 
of Morphine is said to be very penetrating. Intense pain, as from the 
passage of calculi, is best met by the hypodermic injection of Morphine 
Sulphate in full doses (gr. %-%) with Atropine Sulphate (gr. yj 7 ). 
Either the solution of Morphine or the liquid preparations of Opium may 
be given by the mouth in corresponding doses for the same purpose. 
Severe pain enables the system to resist the action of opium, which in 
such cases should be repeated at short intervals for effect, regardless of 
dosage. 

Sedative action is obtained by different preparationsfor different organs. 
The stomach is best affected by the Solution of Morphine in effervescing 



OPIUM. 369 

mixtures, the Extract in a small pill, or Morphine hypodermically over 
the epigastrium. The intestines may be influenced by Laudanum in a 
starch enema, or internally by Dover's Powder, Pulvis Opii, or Pil. Opii, 
especially the latter with or without Calomel, as an astringent when the 
bowel must be paralyzed, as in peritonitis, hernia, intussusception, etc. 
The rectum and other pelvic organs are promptly affected by a suppository 
of the Extract of Opium, gr. ^ with gr. -^ of the Extract of Belladonna. 
The ovaries and the abdominal and pelvic organs generally are markedly 
susceptible to the analgesic action of Codeine in doses of gr. j to gr. ij 
for an adult in severe pain. 

To produce sleep the most efficient preparations are the Tinctures, the 
Solution of Morphine, Pil. Opii and Dover's Powder, in doses corre- 
sponding to the degree of insomnia and restlessness present. 

Cough is relieved by the two Trochisci, the Tinctures, and by the Solu- 
tion of Morphine in small doses with Syrup of Wild Cherry or Syrup of 
T<5lu ; also by Codeine in the last-named Syrup. Diaphoresis is obtained 
by the use of Dover's Powder in either of its forms. 

Administration. 

Probably no drug in the Materia Medica is so useful as Opium, or has 
so wide a range of application. At the same time no other drug requires 
such careful handling, by reason of the many influences which modify its 
action and uses. As before pointed out, children are extremely susceptible 
to its narcotic action, and women are more easily affected by it than men. 
Many persons are found with idiosyncrasies in respect to Opium, some 
being easily narcotized, others being remarkably insusceptible to its action, 
and many suffer from a decided shock after its hypodermic administra- 
tion, which may even produce alarming symptoms of collapse. In sub- 
jects of kidney disease it may accumulate and act more powerfully than 
expected, and generally it may be said to be contraindicated or to be used 
with great care in alcoholism, congestion of the brain, and advanced 
disease of the respiratory organs, heart and kidneys. 

The conjoint administration with opiates, of the Spiritus ^Etheris, 
Spiritus iEtheris Compositus, or Spiritus ^Etheris Nitrosi, an equal part 
with Tinctura Opii Deodorati, will prevent the nausea often excited by the 
latter, and correct the " drying-up " effects of opium, due to its checking 
secretion. Some of the cerebral effects of Opium, as vertigo and mental 
confusion, are removed by a full dose of Potassium Bromide, others are 
antagonized by Quinine, and the general intra-cranial effects of the drug 
are to some extent opposed by Digitalis and Tartar Emetic. 

Morphine and Atropine are sufficiently antagonistic to each other to 
make their combination extremely valuable as a therapeutic measure, and 
their use as mutual antidotes in poisoning by either a most efficient pro- 
24 



370 ORIGANUM OXYGENIUM. 

cedure if employed with due precautions. When Morphine is given as a 
hypnotic or an anodyne, Atropine should always be administered at the 
same time in the proportion of g r -T2"o - Tio" °f the latter to gr. ^ of the 
former. By this means the anodyne and hypnotic qualities of Morphine 
are increased, while the nausea and depression with the subsequent dys- 
pepsia and constipation due to it are avoided. Moreover, as in the doses 
above mentioned Atropine is a cardiac and respiratory stimulant, it will 
counteract the depressing tendency of Morphine on the heart and respi- 
ration in subjects who have undue susceptibility to its action. 

ORIGANUM, Wild Marjoram (Unofficial), — is the plant Origanum vulgare, a 
perennial herb of the nat. ord. Labiatae, native of Europe and America. It contains 
a Volatile Oil, some tannin, resin, and a bitter principle. The oil was formerly much 
used and was official, but it is now superseded by the Oil of Thyme. Origanum is an 
ingredient of Vinum Aromaticum. Dose, 7, j-ij, in infusion. 

Origanum is gently tonic, also carminative, stimulant, and emmenagogue. It was 
formerly much employed as a diaphoretic, etc. , but is now rarely administered. 

OXYGENIUM, Oxygen, O. This element is not official though 
it is extensively used in medicine. Its two combinations with Hydrogen, 
Water, H 2 0, and Hydrogen Dioxide, H 2 2 , are official, as are also nine 
other Oxides, namely — those of Antimony, Barium, Ethyl, Iron, Lead, 
Manganese, Mercury, Silver and Zinc. It enters into the composition of 
most of the acids and their salts, many of the organic bases, and all the 
alkaloids except a few. 

Oxygen is the most universally diffused element in nature, forming about one-fifth of 
the atmosphere, one-third of water, and a great part of the earth and of the tissues of 
plants and animals. It is a colorless, odorless, and tasteless gas, of sp. gr. 1. 1057, and 
can be liquefied by subjection to extreme cold and pressure combined. It was discovered 
by Priestly in 1774, and given its name, Oxygen (acid producer) by Lavoisier in 1 778. 
It may be obtained pure from many of its combinations, but is usually prepared by heat- 
ing Manganese Dioxide or Potassium Chlorate, or preferably both together. It is 
furnished by manufacturing chemists in all large cities, compressed in iron cylinders 
furnished with a rubber bag and mouth -piece by which to administer it. 

Ozone, 3 (Unofficial), — is an allotropic form or condensed condition 
of Oxygen, three atoms of which are contained in a molecule of the 
former, instead of two as in the molecule of oxygen. Ozone exists in 
the atmosphere in the general proportion of 1 part in 10,000, but it is 
more abundant in the open country and on the ocean than in the air of 
cities. It is formed when an electric spark is passed through air, being 
then manifested by its peculiar smell. In the sick-room it may be pro- 
duced by dissolving in water a mixture of Manganese Dioxide, Potassium 
Permanganate and Oxalic Acid. 

Official Preparations. 

Aqua Hydrogenii Dioxidi, Solution of Hydrogen Dioxide {Solution of Hydrogen 
Peroxide), commercially known as " Peroxide of Hydrogen," — consists of water to which 
nascent oxygen has been presented, whereby an additional atom thereof has entered into 



OXYGENIUM. 371 

combination with the hydrogen, producing H 2 2 . It is officially described as a slightly 
acid, aqueous solution of Hydrogen Dioxide, containing when freshly prepared about 3 
per cent, of the pure dioxide, corresponding to about 10 volumes of available oxygen ; 
and is directed to be prepared by agitating Barium Dioxide in cold distilled water, add- 
ing Phosphoric and Dilute Sulphuric Acids, filtering and diluting to the required strength. 
The commercial article is said to contain about 15 volumes of available oxygen, and to be 
permanent at ordinary temperatures ; but it undergoes decomposition in time, especially 
if agitated. It occurs as a colorless liquid, without odor, slightly acidulous, producing a » 
peculiar sensation and soapy froth in the mouth, of sp. gr. 1. 006 to 1. 012 at 59 F., and 
liable to deteriorate by age, heat or protracted agitation. Dose, ^j-iij, diluted with 3 to 
4 parts of water. 

Aqua, Water, H, 2 0, — is described under its own title. 

Oxides of Antimony, Ethyl, Iron, Lead, Mercury, Silver and Zinc, and the Dioxides 
of Barium and Manganese, are described under the titles of their respective metallic 
bases. 

Unofficial Preparations. 

Glycozone is claimed to be a stable compound resulting from the reaction between 
chemically pure glycerin and 15 times its volume of ozone ; and not a mixture of hydro- 
gen dioxide with glycerin. It is very hydroscopic, and must be kept tightly corked, to 
prevent deterioration. It is said to act upon diseased tissue in the same manner as 
Hydrogen Dioxide (which see), but more slowly; and may be used in full strength as 
an application to wounds and suppurating surfaces, to stimulate healthy granulations, and 
generally as an antiseptic surgical dressing. It is mixed with water (1 to 10) as a rectal 
injection; and maybe administered internally, in doses of ^j-ij in a wineglassful of 
water, in gastric affections, — as dyspepsia, pyrosis, ulcer and catarrh of the stomach. 

Pyrozone is the name given by a well-known manufacturer to a concentrated solution 
of Hydrogen Dioxide in Ether. It professes to contain about 50 per cent, of the dioxide, 
and is a very potent and efficient oxidizer, intended for external use only. It has abund- 
ant applications in the practice of surgeons. (Squibb.) 

Sanitas is a proprietary solution for disinfecting purposes, containing Hydrogen Diox- 
ide, and described under Terebinthina. 



Physiological Action. 

Oxygen is essential to respiration, blood-formation, nutrition and tis- 
sue-change, in fact, to life itself, and to fully describe its physiological ac- 
tion would involve a complete description of these processes, which would 
be a treatise on physiology. Applied to the unbroken skin it has no ap- 
parent effect, but when applied to a wounded tissue it increases the circu- 
lation therein and acts as a stimulant. Inhaled in the pure state (not as 
air) it causes very little constitutional disturbance. A slight sense of heat 
is felt in the mouth and may extend downward along the larynx, trachea 
and bronchi. The pulse is usually quickened, but it may be lessened in 
frequency, the appetite is increased, the temperature is slightly raised and 
the cardiac action is stimulated, and a sense of mental exhilaration and a 
disposition to greater bodily activity are produced, but no constant in- 
fluence on the excretions has been noticed. In some persons it seems to 
cause nervous symptoms similar to those produced by nitrous oxide gas 
(Brunton). 

Ozone is a powerful oxidizing and destructive agent. It attacks metals, 
destroys organic substances and the coagulability of albumen and decom- 
poses blood. It is highly irritant to the tissues, and sets up an acute ca- 



372 OXYGENIUM. 

tarrh of the respiratory mucous membrane if inhaled in quantity. When 
present in small quantity in the air it is breathed without any unpleasant 
effects and is decidedly soporific (Binz). It is exceedingly poisonous to 
low organisms, and is therefore an energetic antiseptic and disinfectant. 
In animals it sometimes quickens and often slows respiration, and pro- 
duces excitement followed by exhaustion, sometimes by convulsions, and 
death. 

Hydrogen Dioxide, in fresh solution, is one of the most powerful oxi- 
dizing agents known, by reason of the facility with which it parts with 
oxygen to oxidizable substances brought in contact with it. It is, con- 
sequently, a powerful, yet non-toxic antiseptic, destroying morbid pro- 
ducts and organized ferments to which it is applied. In contact with a 
suppurating surface, it generates a white foam, as the result of its action 
on the pus. This soon subsides, leaving the subjacent tissue cleansed of 
all morbid secretions. One part added to iooo of water containing sew- 
age or infectious microbes, is sufficient to destroy the various organisms 
therein, if allowed to act thereon for 24 hours. 

Therapeutics. 

Oxygen is efficient as an application to the surface in atonic, scrofulous, 
and syphilitic ulcers, also in cases of senile and other forms of gangrene. 
Its application to the scalp, by means of a rubber cap fitted to the head, 
has restored the hair in a case in which it was lost by reason of alopecia 
areata. Its principal use has been in cases of disease of the respiratory 
apparatus characterized by dyspnoea, as emphysema, bronchial dilatation, 
phthisis and gangrene of the lungs, also spasmodic asthma, and asphyxia 
from the inhalation of toxic gases or due to opium and chloroform nar- 
cosis. It has been employed with benefit in uraemic coma, and in the 
dyspnoea of cardiac disease and that of anaemia from loss of blood or 
from protracted suppuration. It has given good results in diseases char- 
acterized by defective oxidation, as gout and diabetes; in the latter af- 
fection the sugar sometimes disappears entirely from the urine during its 
inhalation. It has been used in the treatment of epilepsy and spasm, and 
is recommended in cholera. 

Ozone has been recommended in cases similar to those for which oxy- 
gen is used ; also in infectious diseases, as diphtheria, in which it is ex- 
pected to destroy the pathogenic microbes exposed to its influence. 

Hydrogen Dioxide in solution has long been employed as a bleaching 
agent for delicate fabrics, and on the human hair for the production of 
the " bleached-blonde " hue so fashionable lately in certain circles of 
society. As a cleansing agent for foul wounds, ulcers, sores, and the like, 
it is highly efficient; and has been used with great benefit as a gargle or 
spray to the throat and nasal passages, in quinzy, croup, diphtheria, scar- 



PARALDEHYDUM. 373 

let fever, ozaena, and other morbid conditions of these parts. As a diag- 
nostic agent in determining the presence of pus, it is injected into the 
part in which suppuration is suspected, and indicates its contact with pus 
by causing an almost immediate swelling up of the part. If such a spot 
is cut into at once, pain is not felt. In this manner a number of suppu- 
rating buboes have been treated with great success. As a disinfectant of 
drinking water suspected of pollution it is highly recommended, as it does 
not impair the taste or other potable qualities of the water, in the small 
quantity (i to iooo parts) needed for its efficient action. Used internally, 
it imparts oxygen to the blood, improves digestion, and relieves spasm of 
the respiratory apparatus, — aborting the paroxysms of whooping-cough. 
It gives great relief in chronic bronchitis with dyspnoea, and operates well 
in phthisis by promoting digestion, palliating cough, and giving increased 
activity to chalybeate remedies. 



PARALDEHYDUM, Paraldehyde, C 6 H 12 3 , — a polymeric 
modification of Ethylic Aldehyde, (C 2 H 4 0), — is a colorless liquid (at 
ordinary temperatures), obtained by treating Aldehyde with dilute sul- 
phuric or nitric acid ; aldehyde being the oxidation product of alcohol 
just preceding the formation of acetic acid. When cooled to 32 F. 
Paraldehyde solidifies to a crystalline mass, which becomes liquid again at 
51 F. It is soluble in 8^ of water, and miscible, in all proportions, 
with alcohol, ether, and fixed or volatile oils. 

The dose of Paraldehyde may be placed at ^ss-^ijss, but the latter quantity has fre- 
quently been exceeded without any ill effects, with no digestive or cerebral disturbances 
following, nor any unpleasant symptoms resulting, other than a disagreeable odor to the 
breath. Very few cases of poisoning therefrom, acute or chronic, are recorded. One 
case, under treatment by Dr. Mackenkie, of Douglas, in the Isle of Man, recovered from 
a dose of 3^ ounces, after 34 hours of sleep, furnishing "a striking testimony to the 
safety of Paraldehyde as a hypnotic." The average hypnotic dose for an adult is about 
>jjss, given in £] of simple elixir. 

Physiological Action and Therapeutics. 
Paraldehyde is a reliable hypnotic, almost equal in this respect to 
Chloral, though its hypnotic action is not so persistent as that of the latter 
drug, and it requires more frequent repetition to produce sustained sleep. 
It is also diuretic but not diaphoretic, and is unquestionably safer than 
chloral, strengthening and slowing the heart's action, instead of weaken- 
ing it. Its administration is followed by a well-marked stage of excite- 
ment, after which it produces a sound sleep, which is described as refresh- 
ing. It does not interfere with the appetite or digestion, but occasionally 
causes an erythematous eruption ; and may give rise to cerebral conges- 
tion and vaso-motor paralysis, if used for any long period of time. A 
toxic dose paralyzes the medulla and the respiratory centre therein. 



374 PAREIRA PEPO. 

Paraldehyde is used as a hypnotic in fevers, rheumatism, acute mania, 
hysteria and insomnia from various causes. Several cases of tetanus have 
been treated successfully with it, and it has lately been found useful as a 
diuretic and hypnotic in a case of senile arterial degeneration with double 
aortic and mitral regurgitant murmurs, mental depression and very marked 
insomnia and restlessness. 

Cases of Paraldehyde habit are occasionally seen, and exhibit a train of symptoms 
similar to those observed in delirium tremens. There is great emaciation and anaemia, 
weak and irregular action of the heart, a soft and intermittent pulse, general muscular 
weakness, tremulousness and restlessness, the gait feeble and unsteady, mental anxiety, 
agitation and confusion, temporary loss of memory and incoherent speech, also hallucina- 
tions of sight and hearing and delusions, all of an unpleasant kind. There is marked gas- 
tric derangement, but an abnormally large appetite, excessive flatulence and constipation. 
The treatment of such a case generally takes about three months, and should be con- 
ducted in an inebriate asylum. 



PAREIRA, Pareira {Pareira Brava), — is the root of Chondoden- 
dron tomentosuniy a climbing, woody vine of the nat. ord. Menispermacese, 
with very large leaves and grape-like fruit, inhabiting Peru and Brazil. 
It contains Pelosi?te or Cissampe/ine, an alkaloid identical with the Ber- 
berine of Nectandra and the Buxine of Buxus sempervirens (Boxwood). 
Several other Pareiras are on the market, that from the West Indies (Cfo- 
sampelos Pareira) being the plant formerly official in the British Pharma- 
copoeia. 

Preparations. 

Extractum Pareirae Fluidum, Fluid Extract of Pareira. — Dose, ^ss-^j. 

Infusum Pareirae, Infusion of Pareira (Unofficial), — I in 17. Dose, ^j-ij. 

Pareira is diuretic and laxative, stimulating peristalsis and the action of 
the kidneys. It is eliminated by the renal secretion, and passing over 
the mucous membrane of the genito-urinary tract, it acts thereon in a 
tonic and soothing manner, especially on the bladder. It is particularly 
useful in chronic cystitis, suppurative kidney diseases, gonorrhoea and 
gleet, but must be used internally, as when injected locally for gonor- 
rhoea and cystitis it has not proved successful. Formerly Pareira was 
considered an efficient lithontriptic, and in Brazil it is used as a cure for 
bites of poisonous serpents, being employed both internally and locally 
to the wound. 



PEPO, Pumpkin-seed, — is the seed oiCucurbita Pepo, or common Pumpkin (nat. 
ord. Cucurbitaceae) . The active principle is a resin contained in the endopleuron or en- 
velope immediately surrounding the embryo. It also contains an alkaloid Cucurbitine, a 
fixed oil, starch, sugar, etc. There are no official preparations. Dose, of the resin, gr. 
xv ; of the seeds, ^j-ij, beaten up into an emulsion with sugar and water. 

Pumpkin-seed is an efficient agent for the removal of tapeworm (a taeniafuge), and its use 
is not followed by unpleasant symptoms. The outer coat of the seed should be removed, 
and an emulsion then made by trituration with sugar and water. This, if taken on an 
empty stomach and followed by a brisk cathartic, will generally prove effective. Dr. 



pepsinum. 375 

Squibb maintains that the seeds should not be decorticated, but that husks and all should 
be swallowed. According to some observers the expressed oil is equally efficient in doses 
of ^ ss repeated twice or three times, and followed by a cathartic. 



PEPSINUM, Pepsin, — is a hypothetical name for the digestive 
principle of the gastric juice, and as a definite body is unknown, the 
various preparations, official and unofficial, being mere approximations, 
and varying much from each other. It is officially described as a proteo- 
lytic ferment or enzyme, obtained from the glandular layer of fresh 
stomachs from healthy pigs, and capable of digesting not less than 3000 
times its own weight of freshly coagulated and disintegrated egg albu- 
men, when tested by the official process. 

Pepsin is a fine, white, or yellowish-white, amorphous powder, or thin, pale-yellow, 
translucent grains or scales, free from any offensive odor ; soluble in about 100 of water, 
more soluble in water acidulated with HC1, insoluble in alcohol, ether or cbloroform. It 
usually has a slightly acid reaction, and may be neutral, but should never be alkaline. 

Commercial Pepsin is usually obtained from a solution prepared by 
digesting the mucous membrane scraped from the rennet-bags of sheep or 
the stomach of the pig in acidulated water for several days. It is then 
precipitated by Chloride of Sodium (Scheffer), Acetate of Lead (Bou- 
daidt), or by drying the peptones on glass plates (Beale). It may also 
be precipitated by alcohol. By Scheffer's process it occurs as a tough, 
gray, leathery substance, partially soluble in water, one grain dissolving 
3000 grains of albumen in a few days. Jensen's "Crystal Pepsin," 
probably prepared after Beale's method, is in yellowish, translucent scales, 
soluble in water, and reputed to be many times stronger than any other 
preparation yet obtained. 

Prepai'ations. 

Pepsinum Saccharatum, Saccharated Pepsin, — is Pepsin I, triturated with 9 of 
Sugar of Milk. One part should digest at least 300 parts of , egg-albumen, when tested 
by the official process. Dose, gr.v-^j, shortly after meals. 

Liquor Pepsini, Liquid Pepsin (Unofficial), — contains of Saccharated Pepsin 40 
parts, Hydrochloric Acid 12, Glycerin 400, Water q. s. ad 1000 parts. Dose, ^ij-iv, 
after meals. 

Every manufacturer of Pepsin has his own preparation, and his peculiar name there- 
for, such as " Liquid Pancreopepsine," " Lacto-peptine," " Gluco-pepsine," "Golden 
Scale Pepsin," " Peptogenic Milk Powder," etc. They vary considerably in their prop- 
erties, but all have the power in some degree of digesting albumen or fibrin. 

Lactopeptine (Unofficial), — is claimed to contain Pepsin, Diastase or Ptyalin, Pan- 
creatin, Lactic and Hydrochloric Acids, and that %] will digest 3 viij-x of albumen, 
fibrin, casein, or gelatin, will emulsionize ^ xyj of cod-liver oil, and convert ^iv of 
starch into glucose. A proprietary preparation. Dose, gr.v-xv. 

Peptenzyme (Unofficial), — is prepared from the peptic, pancreatic, salivary, Lieber- 
kuhn's and Brunner's glands and the ferment extract of the spleen and liver, slightly 
benzoated and mixed with sugar of milk and citric acid. It is claimed for it that it con- 
tains the active ferments and undeveloped ("mother") enzymes of all the digestive 
organs or glands, in the same physiological condition as they exist in nature ; that it digests 
food in an acid, an alkaline or a neutral menstruum ; and that it will digest all kinds of 
food. It is best administered before meals. 



37^ PEPSINUM. 

Analogous Products. 
Pancreatinum, Pancreatin, — is officially described as a mixture of 
the enzymes naturally existing in the pancreas of warm-blooded animals,. 
usually obtained from the fresh pancreas of the hog (Sus scrofd). It 
occurs as a yellowish-white or grayish, amorphous powder, of faint odor, 
and meat-like taste ; slowly soluble in water, insoluble in alcohol. It 
consists of four ferments, viz. : (1) Trypsin, the proteolytic ferment, (2) 
Pancreatic Diastase, the amylolytic ferment, (3) a fat-emulsifying, and 
(4) a milk-curdling ferment. Besides the above-described official form it 
is marketed in various preparations, as Pancreatic Emulsion, and the fol- 
lowing — 

Liquor Pancreaticus, Pancreatic Solution (Unofficial), — prepared by digesting a 
finely-chopped pig's pancreas with 4 times its weight of dilute alcohol. It is a nearly 
clear alcoholic solution, with little taste or smell. Dose, gj-^ss. 

Ingluvinum, Ingluvin (Unofficial), — is obtained from the gizzard of 
the domestic fowl, and owes its activity to a peculiar, bitter principle, 
and not to any ferment corresponding with pepsin. Dose, gr. x-xxx. 

Unofficial Vegetable Digestives. 

Papain, Papaiva, — is a vegetable ferment obtained from the milky juice of Carica 
Papaya, a S. American fruit-tree of the nat. ord. Papayacere. It is soluble in water but 
not in alcohol, and has active digestive powers. It is composed essentially of a mixture 
of vegetable globulin, albumoses and peptone, with which are associated the ferments 
characteristic of the preparation. It is marketed under the name Papoid. Dose, gr. j-iij. 
Papazv Milk is the milky juice of the fruit, coagulating into two parts, a pulpy mass and 
a liquid serum. When mixed with alcohol an amorphous powder is precipitated, which 
when dried forms Papain. 

Bromelin, — is an active digestive ferment contained in the fresh juice of Ananassa 
Saliva, the Pineapple. It is more nearly related to trypsin than to pepsin, and is de- 
cidedly active in the presence of either acids or alkaline carbonates, but is most energetic 
in neutral solutions, and is a very constant and powerful digestant of vegetable and 
animal proteids. Dose of the fresh juice, 5SS-J. 

Physiological Action and Therapeutics. 

Pepsin is not a solvent, but a ferment, and is a normal constituent of 
the gastric juice, converting albuminoids (casein, albumen, fibrin, etc.) 
into peptones for assimilation, with the aid of the lactic and hydro- 
chloric acids associated with it. This it will do out of the body or in 
cavities, as the rectum, if warmth, acidity and moisture are present. Pan- 
creatin, on the other hand, is destroyed by acids and requires an alkaline 
medium in which to exercise its powers. As the food passes out of the 
stomach in 2 or 3 hours, Pepsin should be administered within, and 
Pancreatin after that period, to be effective. Alcohol destroys the activity 
of pepsin, Alkalies and many mineral salts precipitate it. 

Dyspepsia in its various forms is the malady for which Pepsin is chiefly 
employed, but it is also extremely useful in the apepsia of infants, gas- 
tralgia, anaemia, chlorosis, gastric ulcer and cancer, the diarrhoea of 
infants and the vomiting of pregnancy. It is added to nutritive enemata, 



PETROLATUM. 7)77 

the rectum not being a digestive organ, and is injected into the substance 
of morbid growths which are homologous to the tissues, particularly fatty 
tumors, for the purpose of arresting their growth and promoting their 
absorption. It has been injected into the bladder to break down a blood- 
clot, and has been suggested as an atomized inhalation in diphtheria and 
croup to digest the membrane without injuring the living tissues. 

Pancreatin digests albuminoids and converts starch into sugar and 
proteids into peptones, also emulsifies fats in the presence of an alkaline 
solution (Pepsin requiring an acid one). Prolonged contact with mineral 
acids renders it inert. It is digested by pepsin, and hence probably 
never passes into the duodenum in its own character. Pancreatin is used 
to partially digest (peptonize) milk, gruel, soups, and other foods, before 
their administration in cases of great digestive debility. These peptonized 
foods may be administered by the stomach or the rectum, and are valua- 
ble in intestinal dyspepsia, wasting diseases, and convalescence from acute 
affections. A teaspoonful of Pancreatin solution taken after the adminis- 
tration of Cod-liver Oil will prevent the disagreeable eructations which 
are so offensive to some patients, and will aid in the digestion of the oil. 

Trypsin, unlike Pepsin, will dissolve mucin, and like pepsin it is inert towards nuclein, 
horny tissues, and amyloid matter. Used as a spray on diphtheritic membrane it has 
proved a very efficient solvent. It affects albuminoids even in a slightly acid solution. 

Ingluvin is particularly useful against vomiting and has been found exceptionally 
efficient in the vomiting of pregnancy, given in 20-grain doses before meals. 

Papain, [Papoid), has the power of digesting to a greater or less extent all forms of 
proteid or albuminous matter, both coagulated and uncoagulated. It is peculiar in that 
its digestive power is exercised in either acid, alkaline or neutral media, in which respect 
it differs greatly from the other digestive ferments. It acts more rapidly than Pepsin and 
at higher temperatures. It is a rapid solvent of false membranes and intestinal worms ; 
and has been injected into neoplasmic tumors, dissolving their tissues in its immediate 
vicinity, but with much pain and considerable febrile reaction. Papoid has been used as 
a paste locally in diphtheria, to destroy and remove the false membrane ; internally, in 
gastric and gastro-intestinal catarrh, the diarrhoea of infancy, and various dyspeptic con- 
ditions, with very great success. Its power over both gastric and intestinal indigestion 
renders it much more useful than either pepsin or pancreatin in cases of doubtful diag- 
nosis, in which it is difficult to decide as to the location of the trouble. 

Papoid may be obtained in powder or tablets, either alone or in combination with 
Sodium Bicarbonate, Boracic Acid, and Nux Vomica ; also as a glycerole, which is said 
to be a permanent liquid preparation. The dose of Papoid is from I to 3 grains, but 5 
grains or more may be given in special cases. 

Pineapple Juice is one of the most efficient digestive aids at our command, and has 
the advantage of being pleasant to the patient. The author directs the fruit to be cut 
into slices as required, and the juice to be squeezed out immediately before administra- 
tion. It has long been used by the natives of South Africa as a remedy for diphtheria 
and diphtheritic sore throats with unusual success, according to the testimony of competent 
observers ; and has been employed by Dr. Chambers, the Coroner of Calcutta, in this 
disease with marked benefit. He has the patient sip the juice all day at short intervals, 
or else masticate slices of the fruit and swallow the juice ; but as he employed Papaya 
fruit in the same cases, it is impossible to give all the credit of his success to the pine- 
apple. 

PETROLATUM,— is a mixture of hydrocarbons, chiefly of the 
marsh-gas series, obtained from Petroleum, by distilling off the lighter 



3/8 PHENACETINUM. 

portions and purifying the residue. It is colorless or yellowish in color, 
and in the latter case is more or less fluorescent ; amorphous, odorless 
and tasteless, of neutral reaction, insoluble in water or alcohol, soluble in 
ether, chloroform, benzin, fixed and volatile oils, etc. Commercially it 
is known as Cosmoline, Vaselin, Petroleum Oi?itme?it, etc., and is largely 
prepared from residuums or sediments deposited in tanks containing crude 
petroleum. It is official in the following three forms, all of which, when 
heated, give off a faint odor of petroleum, viz. : — 

Petrolatum Liquidum, Liquid Petrolatum, — an oily, transparent fluid, of sp. gr. 
0.875 t0 °-945- 

Petrolatum Molle, Soft Petrolatiwi, — a fat-like mass, of the consistence of an oint- 
ment, sp. gr. about 0.820 to 0.840, melting-point between 104 and 113 F. 

Petrolatum Spissum, Hard Petrolatum, — a fat-like mass, of about the consistence 
of a cerate, sp. gr. 0.820 to 0.850, melting-point between 113 and 125 F. 

Petrolatum is a valuable protective dressing, and an excellent basis for 
ointments, having no acridity and no liability to become rancid. It is 
readily miscible with many active agents, as the alkaloids, phenol com- 
pounds, etc., but it does not penetrate "the skin as readily as animal fats 
and fixed oils. Uncombined, it forms an excellent bland application in 
all irritated conditions and injuries of the skin. 



PHENACETINUM, Phenacetin, Oxy-ethyl-acetanilid, (Para- 
acet-phenetidin) C 10 H 13 NO 2 , (Unofficial), — isacrystalline substance, closely 
allied in chemical composition to Acetanilid, and produced by the 
action of glacial acetic acid on para-phenetidin, a body obtained from 
phenol. 

Phenacetin occurs in colorless, tasteless, inodorous, glistening, scaly crystals, sparingly 
soluble in cold water, more freely in boiling water, also in about 16 fluid parts of alcohol. 
Dose, gr. ij-xx ; — as an antipyretic, gr. viij-x hourly or every two hours, in powder or 
tablets ; against neuralgia and rheumatism, gr. xv, repeated if necessary up to gjss in 
24 hours. 

Physiological Action and Therapeutics. 

The physiological action of Phenacetin is analogous to that of Acet- 
anilid. It is probably the safest of the new synthetical antipyretics, yet 
in sufficiently large doses it is undoubtedly as poisonous as any of its 
analogues. Dr. Cerna reports a case in which a baby, five days old, re- 
ceived seven 2-grain doses of phenacetin in three days, by mistake for 
bismuth, and was deeply cyanosed for three days, and less so for nearly a 
month, notwithstanding the repeated employment of oxygen inhalations. 
There was also marked jaundice, grave ansemia, and pronounced loss of 
weight. 

Phenacetin reduces pyrexia gradually and causes perspiration without 
producing collapse. It is also analgesic and hypnotic inaction, soothing 
pain and inducing sleep. It has been administered with benefit, in 2- 



PHENACETINUM. 379 

grain doses with x / 2 grain of citrated caffeine at short intervals, for mi- 
graine; and also in epidemic influenza, both as a prophylactic and as a 
remedy. As an antipyretic it is extensively employed in phthisis, peri- 
tonitis, polyarthritis, etc., also in endocarditis, typhus and typhoid fevers; 
and as an analgesic in vaso- motor neuroses, for the lancinating pains 
of locomotor ataxia, and in neuralgia and hemicrania. It is highly 
praised in whooping-cough, rheumatic and other fevers, and, though 
slower in action than Antipyrin or Acetanilid, is deemed fully as efficient 
in reducing pyrexia, while usually free from the depressant after-effects of 
these latter agents. 

Lactophenin, Lactyl-para-phenetidin (Unofficial), — is another phenetidin derivative, 
containing a lactic acid constituent instead of the acetic acid one of phenacetin. Its 
action is antipyretic, analgesic and hypnotic ; and it has been recommended as a substi- 
tute for phenacetin on account of its greater solubility. It has been used with especial 
benefit in abdominal typhus (Jaksch) ; also in acute rheumatism, chorea and locomotor 
ataxia (Von Roth). Dose, gr.viij-xv or more, up to ^jss daily, in wafers. 

Methacetin, Oxy-methyl-acetanilid (Unofficial), — derives its name from its analogy 
to Phenacetin, from which it differs only in containing a methyl group in place of an 
ethyl one. From Acetanilid it differs in the substitution of the oxy-methyl group for a 
hydrogen atom. It occurs as lustrous, scaly, colorless, odorless crystals ; soluble in 12 of 
hot water, in alcohol, chloroform, glycerin and fatty oils ; scarcely soluble in cold water. 
Dose, gr.iij-v, or more. 

Methacetin was introduced as an antipyretic for children and feeble persons, and 
promised at one time to supersede phenacetin. It is well borne, and no malaise, tinnitus, 
cardiac weakness or exanthem follow its ingestion ; but it often gives rise to a violent and 
exhausting perspiration. It has been used successfully in typhoid fever, all forms of 
rheumatism, neuralgias, pneumonia, and in most forms of pyrexia, but has not as yet equaled 
the results obtained by either phenacetin or antipyrin. Its employment in phthisis was 
not favorable, chiefly by reason of the profuse sweating induced by it. Its advantages, 
over all the other antipyretics of its class, are its lack of toxic properties, and its com- 
paratively ready solubility in water, being five times more soluble than its rival, phenacetin. 

Malakin, Salicyl-para-phenetidin, — is described under SALICINUM. 

Phenocoll Hydrochloride (Unofficial), — is another synthetical antipyretic, closely 
allied to Phenacetin, both chemically and medicinally, and distinguished by its com- 
paratively free solubility. It is produced by the interaction of Phenetidin and Glycocoll 
(amido-acetic acid), and occurs as a white, micro-crystalline powder, soluble in about 1 6 
of water, therein forming a neutral solution. The pure base, Phenocoll, is precipitated 
from the solution by ammonia, the fixed alkalies and their carbonates. 

Phenocoll Hydrochloride may be looked upon as a soluble Phenacetin, 15 grains dis- 
solving readily in Jj of water. With decided antipyretic, antirheumatic and analgesic 
powers, it possesses a marked advantage over the other members of its class, in that it 
has no injurious effect upon the blood corpuscles, even when in direct contact with them. 
It is promptly absorbed, readily excreted, and reduces the hyperpyrexia of fever without 
producing very profuse sweating, or other unpleasant by-effects. The fall in temperature 
is very decided, and occurs within an hour after the administration of the drug ; being 
due to great diminution of heat-production, without any alteration of heat-dissipation. In 
ordinary doses it has no effect on the circulation, but large doses diminish the blood- 
pressure and reduce the pulse-rate, by stimulating the cardio-inhibitory centres. This 
drug has been employed, with marked success, as an antipyretic in hectic, malarial, 
typhoid, and other fevers : also in acute rheumatism, neuralgia, epidemic influenza, and 
for the neuralgic pains of the latter affection. In combination with Piperazin, 15 grains 
of each daily, in a pint or more of carbonated water, it has rendered excellent service in 
gouty and rheumatic affections, especially when accompanied with pain and fever. The 
same combination has proven of service in a case of obstinate gastric irritability with 
uncontrollable vomiting, which had resisted every known remedy. The doseis gr.v— xxx, 
an average dose being about 12 grains, thrice or four times a day. 



380 PHOSPHORUS. 

PHOSPHORUS, PHOSPHITES and PHOSPHATES — 

are best studied together, as the supplying of the element Phosphorus to 
the body is the aim of the administration of these agents. 

Phosphorus, P, — is a non-metallic element obtained from bones, and 
occurs as a translucent, nearly colorless solid, of waxy lustre, and usually 
the consistence of beeswax, insoluble in water, soluble in 50 parts of any 
fatty oil, in 80 of absolute ether, 350 of absolute alcohol, and freely in 
carbon disulphide. It has a disagreeable odor and taste, melts at 111 
F., is luminous in the dark, ignites in the air, and should be kept under 
water in a cool place, protected from light. It usually contains Arsenic 
and sometimes Sulphur, the limits of which are fixed by the pharma- 
copceial tests. Dose, gr. y-J-o - TV thrice daily. 

Preparations of Phosphorus. 

Pilulse Phosphori, Pills of Phosphorus, — each contains gr. T ^ of Phosphorus, dis- 
solved in Chloroform, mixed with Althaea and Acacia in Glycerin and Water, and coated 
by shaking with a solution of Balsam of Tolu in Ether. Dose, j-v. 

Oleum Phosphoratum, Phosphorated Oil, — has of Phosphorus I part, Ether and 
Expressed Oil of Almond to 100. Dose, fuj-v thrice daily. 

Acidum Phosphoricum, Phosphoric Acid, and Acidum Phosphoricum Dilutum, 
are described on pages 91, 92, ante. 

Acidum Hypophosphorosum Dilutum, Diluted Hypophosphorous Acid, — a liquid 
composed of about 10 per cent, of the absolute acid (HPH 2 2 ), and about 90 per cent, 
of water. Used in the preparation of Syrujms Hypophosphitum. 

Spiritus Phosphori, Spirit of Phosphorus {Tincture of Phosphorus), — has of Phos- 
phorus 1.2, dissolved in Absolute Alcohol 1000. 

Elixir Phosphori, Elixir of Phosphorus, — has of the preceding 210, Oil of Anise 2, 
Glycerin 550, Aromatic Elixir to 1000. Each cubic cm. represents about l /± milligramme 
of Phosphorus (each 3 contains about gr. J^). Dose, ^ss-^ss. 

Tinctura Phosphori [Thompson 's), Unofficial, — Phosphorus gr. j, Absolute Alcohol 
%v, Glycerin ^jss, Alcohol gij, Spt. Mentha Piperita n\xl. Of this ^j contains gr. 
y^ of Phosphorus. Dose, ^ss-^jss. 

Tinctura Phosphori (Bellevue Hospital), Unofficial, — Phosphorus gr. xxxij, Absolute 
Alcohol ,^xlvj, Essence of Vanilla t ^j, Oil of Orange giij, Alcohol q. s. ad ^xlviij. Of 
this 3J contains gr. yV of Phosphorus. Dose, ^ss-j. 

Zinci Phosphidum, Zinc Phosphide, Zn 3 P 2 , — crystalline fragments or a gray-black 
powder, insoluble in water or alcohol, but completely soluble in hydrochloric or sulphuric 
acids with evolution of hydrogen phosphide. Is very irritant. Dose, gr. yfr-sV 

Preparations of Ph osph ites . 

Calcii Hypophosphis, Calcium Hypophosphite, Ca (PH 2 2 ) 2 , — colorless prisms, or 
thin, pearly scales, of nauseous taste, soluble in 6.8 of water, insoluble in alcohol. Is an 
ingredient of the Syrupus Hypophosphitum. Dose, gr. x-xxx. 

Ferri Hypophosphis, Ferric Hypophosphite, Fe 2 (H 2 P0 2 ) 6 , — a white or grayish-white 
powder, odorless and tasteless, slightly soluble in water, freely so in hydrochloric acid or 
a solution of sodium nitrate. Dose, gr. v-x. A ferruginous tonic. 

Potassii Hypophosphis, Potassium Hypophosphite, KH 2 P0 2 , — white masses, or a 
white, granular powder, deliquescent, odorless, of saline taste and neutral reaction. Sol- 
uble in 0.6 of water and in 7.3 of alcohol at 59 F. Dose, gr. v-x. 

Sodii Hypophosphis, Sodium Hypophosphite, NaPH 2 2 + H 2 0, — small plates, or a 
white, granular powder, deliquescent, odorless, of sweetish, saline taste, and neutral reac- 
tion. Soluble in I of water and 30 of alcohol at 59 F. Dose, gr. v-x. 






PHOSPHORUS. 381 

Syrupus Hypophosphitum, Syrup of Hypophosphites, — has of Calcium Hypophos- 
phite 4j^,of Potassium and Sodium Hypophosphites I l / z each, percent. Dose, 3 j-^ss. 

Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron, — has 
of Ferrous Lactate I, Potassium Citrate I, in Syrup of Hypophosphites to 100 parts. 
Dose, 3J-^ss. 

Preparations of Phosphates. 

Calcii Phosphas Praecipitatus, Precipitated Calcium Phosphate, Ca 3 (P0 4 ) 2 , — a 
light, white, amorphous powder, odorless and tasteless, insoluble in water or in alcohol. 
Dose, gr. ij-x. 

Syrupus Calcii Lactophosphatis, Syrup of Calcium Lactophosphate, — has of the 
preceding 2 *4 per cent. The Calcium Phosphate is dissolved by Lactic and Phosphoric 
Acids, but does not form the chemical combination suggested by the title. Dose, 3 j- ^ ss. 

Sodii Phosphas, Sodium Phosphate, Xa 2 HP0 4 + I2H 2 0, — large, colorless, mono- 
clinic prisms, efflorescent, of saline taste and alkaline reaction; soluble in 6 of water, 
insoluble in alcohol. Dose, 3 j-^j- 

Sodii Pyrophosphas, Sodium Pyrophosphate, Na 4 P 2 7 + loH 2 0, — colorless, mono- 
clinic prisms, of saline taste and alkaline reaction; soluble in 12 of water, insoluble in 
alcohol. Dose, £ss— ^ss. 

Syrupus Ferri, Quininse et Strychninae Phosphatum, Syrup of the Phosphates 
of Iron, Quinine and Strychnine, — has of Soluble Feme Phosphate 2, Quinine Sulphate 
3, Strychnine -yL, Phosphoric Acid 4.8, Glycerin io ; Water 5, Syrup to 100. A power- 
ful tonic. Dose, 3J-iij- 

Syrupus Phosphatum Compositus, Compound Syrup of Phosphates, Parrish's 
Chemical Food, (Unofficial), — has in each 3 , of P'erric Phosphate gr. 2^, Calcium 
Phosphate gr. j. Dose, gj-iij. 

Melachol (Unofficial), — is a proprietary preparation, advertised to contain in each f 3 
eighty-five grains of Sodium Phosphate, with Citric Acid and Sodium Xitrate. Dose, 
3 S5- 3J> m water - 

Ferri Phosphas Solubilis, Soluble Ferric Phosphate, and Ferri Pyrophosphas 
Solubilis, — are described under Ferrum, ante, page 282. 

Physiological Action. 
Phosphorus in small doses stimulates the brain and circulation, the 
functions of the stomach and the genital organs, and the growth of bones. 
It aids digestion by irritating the end-organs of the gastric nerves, but 
produces eructations of Hydrogen Phosphide. Its fumes cause necrosis 
of the upper or lower maxillae, especially in those whose teeth are decayed ; 
but this may be prevented by the inhalation of the fumes from old acid 
turpentine. In poisonous doses it is a powerful irritant of the gastroin- 
testinal tract, causing vomiting and purging, with great depression of the 
vital forces. Reaching the blood as Phosphorus, it is partly oxidized at 
the expense of the oxygen of the red corpuscles, causes acute hemorrhages 
by producing fatty degeneration of the arterial walls, also rapid steatosis 
of the stomach, liver and heart, accompanied by deep jaundice, —then 
delirium, convulsions, coma and death usually from gradual failure of the 
respiration and circulation. Acute yellow atrophy of the liver resembles 
acute phosphorus poisoning so much that it is generally impossible to dis- 
tinguish between them. Its effect on metabolism is to increase the nitrog- 
enous products, to diminish the excretion of carbonic acid, to reduce 
the glycogen of the liver to almost nothing, and to raise the temperature. 



382 PHOSPHORUS. 

While generally increasing metabolism it so influences that process as to 
arrest it at the stage of the conversion of proteids into urea and oil, in- 
stead of allowing it to proceed to the final oxidation of oil into carbonic 
acid and water, hence leading to fatty degeneration of epithelial, gland- 
ular and muscular protoplasm throughout the body. 

Calcium Phosphate is an essential ingredient of all the tissues and 
fluids of the body, and forms more than 50 percent, of the bones. Lactic 
and Hydrochloric acids dissolve it in small quantities. It increases the 
alkalinity of the blood as well as its power of holding carbonic acid, and 
diminishes the excretion of urea. 

Sodium Phosphate acts on the blood and on the excretion of urea 
similarly to the calcium salt. It increases secretion generally, especially 
that of the bile, being an excellent cholagogue and thereby aiding in the 
digestion of fats. In half-ounce doses it is laxative. It is a normal con- 
stituent of the blood, and possesses the property of increasing the capa- 
city of any fluid to hold carbonic acid in solution. 

The Hypophosphites are generally tonic in action, and are supposed 
to constitute a safer form in which to administer Phosphorus than in the 
unoxidized state. They are probably converted into phosphates in the 
stomach. 

Antidotes and Antagonists to Phosphorus. 

Antidotes are Hydrated Jl/agnesia, Lime-water, powdered Charcoal, Copper Sulphate 
and old acid Turpentine. Hydrated Magnesia as a . quickly-acting purgative, Lime- 
water or Charcoal to prevent the action of the poison on the tissues. Potassium Perman- 
ganate may have antidotal action. No Oils or Fats should be used, as they dissolve 
phosphorus and promote its absorption. Opium to antagonize the depression of the heart 
and system. Transfusion has proved efficient when the blood is seriously affected as a 
result of phosphorus poisoning. 

Copper Sulphate, as an emetic and to form the comparatively insoluble phosphide of cop- 
per, also Crude French Acid Turpentine, given rapidly in an emulsion of gum, are gener- 
ally placed among the antidotes, but are both practically useless. The first has caused 
death more rapidly than the phosphorus, and the second is generally unobtainable, and 
has proved useless when employed. 

Therapeutics. 
Phosphorus is chiefly used to promote the nutrition of osseous and 
nervous tissue. It is useful in chronic nervous exhaustion when the nerve 
centres are implicated, in osteomalacia, rachitis and progressive locomotor 
ataxia. In threatened cerebral softening it affects the nerve centres as no 
other drug does, and in paraplegia of myelitic origin from excessive 
venery it is often very efficient. Progressive pernicious anaemia has some- 
times been arrested by Phosphorus in very small doses, while in impotence 
of functional character there is no remedy so effective. In wakefulness 
of the aged and that due to cerebral anaemia small doses of the pill or 
tincture are sometimes remarkably beneficial. In certain skin diseases 
(acne, psoriasis, lupus), it is an excellent substitute for Arsenic. Neural- 
gia is often cured by Phosphorus, but large doses are necessary, at least 



PHYSOSTIGMA. 383 

gr. y 1 ^ every four hours. The solution of Phosphorus in Retinol is very 
stable, and is strongly recommended for the external and internal use of 
that substance. 

Calcium Phosphate and the Hypophosphites* are used with benefit 
in all diseases of mal-nutrition, and where the repair or development of 
the bones is required. They are particularly useful in protracted suppu- 
ration, osteomalacia, rachitis, caries, scrofulosis, chronic phthisis, and in 
the anaemia and bone-softening of lactation. The Hypophosphites are 
much employed in nervous and general debility and in chronic lung dis- 
eases, and are supposed to act in the same manner as free Phosphorus, but 
without irritation. They are probably converted into Phosphates in the 
stomach, and hence may be expected to promote the growth and healing 
of bones, to stimulate the hepatic and intestinal secretions, and to affect 
the lymphatic glands and adenoid tissue. The Compound Syrup of the 
Hypophosphites is an excellent remedy in acne indurata. 

Sodium Phosphate in doses of gj-ij thrice daily for adults (gr. x-xxx 
for children) is extremely useful as a laxative in conditions depending 
on catarrh of the bile-ducts and duodenum, as headache, jaundice, chalky 
stools, etc. Gall-stones may be prevented from forming by scruple or 
drachm doses before meals for months at a time. It is also an efficient 
agent in obesity, hepatic diabetes, incipient hepatic sclerosis, chronic in- 
fantile diarrhoea, cerebral debility, bilious sick-headache, and the pasty, 
white stools of ill-conditioned children. Vichy-water contains this salt 
in the proportion of gr. ^ to the pint, and is considered a valuable water 
in hepatic colic and kindred conditions. Hypodermic injections of So- 
dium Phosphate have been used with highly beneficial results in syringo- 
myelitis and in unilateral astasia-abasia. Drs. Crocq and Luton of 
Rheims advocate the hypodermic use of this salt as a substitute for the 
organic extracts, and maintain that it is equally efficient in all cases in 
which these extracts have proved to be of value. [Compare the article 
on Animal Extracts, page 129.] 

Crocq's solution contains Sodium Phosphate I part, Alcohol 5, Glycerin 20, Distilled 
"Water 25 ; the dose of which is 3 cc. (about 45 minims) hypodermically, with aseptic 
precautions, once daily or on alternate days. Luton uses a solution of the crystallized 
Sodium Phosphate and Sodium Sulphate. 



PHYSOSTIGMA, Calabar Bean,— is the seed of Physostigma 
venenosum (nat. ord. Leguminosse), a woody creeper of Calabar, West 
Africa, where it is used by the natives as an ordeal for witches, etc., vom- 
iting after its ingestion being held to establish the innocence of the 
accused. It contains two alkaloids, Physostigmine (or Eserine), C 15 H 21 
N 3 2 , and Calabarine, which is antagonistic to the former and is allied 
to strychnine in its action, while Physostigmine resembles gelsemium. 



384 PHYSOSTIGMA. 

Preparations. 

Extractum Physostigmatis, Extract of Physostigma, — an alcoholic extract, of which 
the usual dose is from gr. ^ to 1, but gr. j-iv are used in tetanus. 

Tinctura Physostigmatis, Tincture of Physostigma , — 15 per cent. Dose, rr\v-xx. 

Physostigminae Salicylas, Physostigmine Salicylate (Eserine Salicylate'), — color- 
less, columnar crystals, of bitter taste and neutral reaction, soluble in 150 of water and 
in 12 of alcohol. Dose, gr. T 7o~6V 

Physostigminae Sulphas, Physostigmine Sulphate {Eserine Sulphate), — a white, 
micro-crystalline powder, of bitter taste, very deliquescent in moist air, very soluble in 
water and in alcohol. Dose, gr. j^q-^q- 

Physiological Action. 

Physostigma is a direct spinal paralyzer, producing complete general 
paralysis, and abolished reflexes, but not affecting muscular irritability or 
the cerebral functions. It stimulates secretion, excites nausea and vomit- 
ing, salivation and diaphoresis, and is laxative by stimulating the muscular 
coat of the intestines to increased peristalsis as well as by increasing the 
intestinal secretions. It first lowers then raises arterial tension, increases 
the frequency of the heart-beat, but depresses the power of the cardiac 
muscle though not destroying it. It produces dyspnoea by a tetanic ac- 
tion on the respiratory muscles, causing carbonic acid narcosis and death 
by paralysis of respiration. It contracts the pupil (how, is disputed), and 
the ciliary muscle, producing marked myosis. It is eliminated chiefly by 
the kidneys, the urine of the animal affected poisoning another. 

The alkaloids of Phyostigma have opposite actions, and different or even 
contradictory results may be obtained from the drug according to the 
proportion of each in the preparation employed. Physostigmine repre- 
sents the action of the bean, paralyzing the nervous centres and stimulat- 
ing muscular fibre, while Calabarine causes convulsions like strychnine 
(Brunton). Physostigmine, in its action on the cord is allied to gelse- 
mium and antagonistic to strychnine and to picrotoxin, but Calabarine 
is allied to both (Murrell). 

Antagonists and Incompatibles.. 

Atropine is antagonistic as to the effects on the respiration, heart and pupils. Chloral 
is also antagonistic, and over a greater field of action, but to be effective must be admin- 
istered before the ingestion of the Physostigma. The vegetable astringents, Tannic Acid 
and the caustic alkalies are chemically incompatible. 

Therapeutics. 
The applications of Physostigma are not many. It is efficient in con- 
stipation due to torpor of the bowels, in which condition it is usually 
combined with belladonna and nux vomica. In tetanus it has been used 
with advantage to diminish reflex excitability, but large doses (2 to 4 
grains) must be given, and its effects must be carefully watched. In small 
doses it is a useful remedy in manv nervous affections, such as locomotor 



PHYTOLACCA. 385 

ataxia, writers' cramp and the paraplegia due to myelitis, also in progres- 
sive paralysis of the insane which is apparently retarded by it. The ex- 
tract should be given in these diseases, in doses of gr. -^ in pill every 
three hours ; and if the treatment is kept up for six months or longer the 
results will prove very satisfactory, though the improvement will be slow 
(Murrell). While theoretically antagonistic in poisoning by atropine or 
strychnine, practically it is not of much value therein. 

Physostigmine (Eserine) is used locally by ophthalmologists for many 
purposes in affections of the eye. In a solution of gr. ij to the § of water 
dropped into the eye, it is efficient in breaking up or preventing adhesions 
of the iris, diminishes intraocular tension, prevents suppuration after 
operations, contracts the pupil, diminishing the entrance of light in pho- 
tophobia, etc., and empties the vessels of the eye. It is very useful in 
keratitis, glaucoma, strumous ophthalmia, and neuralgia of the eye-ball. 
The salts of Physostigmine in neutral solution may be used for these pur- 
poses, as well as to counteract the effects of atropine on the pupil. Gelatin 
disks medicated therewith may be obtained in the shops, and are a con- 
venient form in which to use the drug for ophthalmic purposes. In dose 
of gr. y^j- hypodermically it has proved remarkably efficient as an occa- 
sional substitute for morphine, after the final withdrawal of that drug in 
the treatment of its habitues. 

PHYTOLACCA, Poke,— is official under two forms, the fruit and 
the root of Phytolacca decandra, a plant of the nat. ord. Phytolaccaceae, 
found in all parts of the United States. It contains a neutral principle 
Phytolaccin, and an acid Phytolaccic Acid, also tannin, starch, fixed oil, 
etc. The official titles are as follows, viz. : — 

Phytolaccse Fructus, Phytolacca Fruit {Poke Berry), — a depressed- 
globular, dark purple, compound berry, about yi inch in diameter, 
inodorous, taste sweet, slightly acrid. Dose, gr. x-xxx. 

Phytolaccse Radix, Phytolacca Root {Poke Root), — large, conical, 
branched, fracture fibrous, inodorous, sweetish and acrid. Dose, as 
emetic, gr. x-xxx, — as an alterative, gr. j-v. 

Preparations. 

Extractum Phytolaccse Radicis Fluidum, Fluid Extract of Phytolacca Root. — 
Dose, n\j-xxx. 

Tinctura Phytolacca^, Tincture of Phytolacca (Unofficial). — Dose, rr^x-^j. 

Physiological Action and Therapeutics. 
Phytolacca is an emeto-cathartic, acting slowly but persistently, with 
great nausea and considerable depression. It lowers the rate of respira- 
tion and of cardiac action, and is a motor depressant, paralyzing the 
spinal cord and the medulla, death occurring from paralysis of respiration, 
25 



PICHI PICROTOXINUM. 

preceded by tetanic convulsions. Several cases of poisoning by this 
plant have occurred. Its action is antagonized by Alcohol, Ether, Opium, 
Digitalis, etc. 

Alterative powers have been ascribed to Phytolacca, and competent 
observers have reported curative results from its use in malignant tumors, 
varicose and other ulcers, obstinate eczema, sycosis, favus and other skin 
affections, employing it both internally and externally. It is a very 
serviceable remedy in chronic rheumatism, and given internally has un- 
doubtedly cured cases of granular conjunctivitis. Mastitis is sometimes 
aborted and suppuration of the breasts prevented by the use of the fluid 
extract internally while a solid extract is locally applied to the seat of the 
impending inflammation. In tonsillitis and diphtheritic sore throat, also 
in chronic follicular pharyngitis, it has been much used with good results, 
especially when there is high fever and pains in the head, back and 
limbs. In true adynamic diphtheria it will do little good. 

Phytolacca has long been known to promote the absorption of adipose 
tissue, and was suggested as a remedy for obesity as early as 1858. A 
resinoid preparation of the berries is on the market as an "anti-fat" 
remedy, under the name Phytoline, the dose of which is n^x six times a 
day, before and after each meal. 



PICHI, Pichi (Unofficial), — is the shrub Fabiana imbricata, a member of the nat. 
ord. Solanacese and a native of S. America. Among the Chilians it has been much 
prized as a remedy in cystitis with calculi and gravel, and in chronic catarrh of the blad- 
der. It seems to have considerable power over the hematuria and pain of renal calculus. 
It is also highly praised in dyspeptic disorders. Its medicinal virtues reside in oleo- 
resinous constituents which are insoluble in water. An extract is prepared from the 
leaves, of which the dose is gr.v-x in capsules. Dose of the fluid extract, 3J, but it 
should not be added to water. 



PICROTOXINUM, Picrotoxin (Picrotoxic Acid), C 30 H 34 O 13 ,— is 
a poisonous, neutral principle obtained from the seeds contained in the 
berries ( Cocculus Indicus, Fish-berries), of Anamirta paniculata (Anamirta 
Cocculus, Menispermum Cocculus), a climbing shrub of the nat. ord. 
Menispermaceae, a native of the East Indies. The berries contain, be- 
sides Picrotoxin, a large quantity of fixed oil and other substances of 
less interest. In the shell are found Menispermin, an alkaline principle 
Paratnenispermin, which is neutral and crystalline, and Hypopicrotoxic 
Acid. There are no official preparations. 

Picrotoxin occurs in colorless, flexible crystals, of prismatic form, bitter taste and 
neutral reaction, soluble in 240 of water and in 9 of alcohol, also in acids and in alkaline 
solutions. Dose by the stomach gr. sV~zV> cautiously. For hypodermic use a solution 
in water of gr. ij in ^j may be used, in doses of gr. ■^p'TTr °^ tae principle, TT\, iv 
equalling gr. fa. 



PICROTOXINUM. j$/ 

Unofficial Preparations of Cocculns. 
Tinctura Cocculi, Tincture of Coccnlns, — I in 8. Dose, tr\jj-xv. 
Extractum Cocculi Fluidum, Fluid Extract of Cocculus. — Dose, tT\J-iij. 
Planat's Tincture of Cocculus, — I in 4. Dose, Tt\J-v. 

Physiological Action. 

Picrotoxin is a cerebro-spinal exaltant, affecting especially the centres 
in the medulla oblongata, and in its action representing the combined 
action of Belladonna and Nux Vomica. It stimulates all the secretions, 
especially the cutaneous, the salivary and intestinal ; produces nausea and 
vomiting, and slows the heart and the respiration after transiently accelera- 
ting both. It causes muscular twitching, incoordination, stupor, delirium, 
epileptiform convulsions, tonic spasms of the flexor muscles alternating 
with clonic ones, exalted reflexes and trembling, — then coma, insensibil- 
ity and death by paralysis of the heart, which is arrested in diastole. 
The action of the drug is on the spasm and vagus centres in the medulla, 
and on Setchenow's inhibitory centre, as well as on the cerebellum and 
spinal cord, paralyzing the first-named centres and stimulating the reflex 
centres in the cord. It is eliminated by all the excretory channels, 
chiefly by the kidneys. The spasms caused by Picrotoxin are choreic and 
chiefly affect the flexor muscles, — those from Strychnine are tetanic, af- 
fecting principally the extensors. The order, succession and character 
of the phenomena produced by Picrotoxin resemble in marked degree 
those of the epileptic paroxysm. 

Cocculus berries are used to stupefy fish, being thrown into ponds con- 
taining them. They are also employed to adulterate beer and porter in 
order to make these drinks more intoxicating. 

Antagonists. 

Chloralvs, antagonistic to its cerebral and spinal actions, but synergistic to its depressant 
power over the heart and the respiration. Acetic Acid gives relief in overdosing, and 
may have some antidotal power. Ancesthetics antagonize its spasm-producing action. 

Therapeutics. 
Picrotoxin is used chiefly in nervous diseases. Epilepsy is amenable to 
it, especially when the attacks are nocturnal, and in anaemic cases and 
those attributable to onanism. Paralyses of several forms have been 
greatly benefited by it, especially paralysis of the sphincters, hemiplegia 
from cold, glosso-labio-laryngeal paralysis, and paralysis agitans. Chorea 
is well treated by it but requires full doses. It is remarkably efficient in 
controlling the night sweats of phthisis, and in flatulent colic, also in dys- 
pepsia with flatulence and severe epigastric pain, and in vomiting with 
giddiness, headache and intolerance of light and sound. Dysmenorrhoea 
is often benefited by Cocculus administered for two days before the 
period ; and leucorrhcea, when the discharge is sero-purulent, with lumbar 



388 PILOCARPUS. 

pains, is frequently controlled by it. Parasitic skin diseases are well 
treated by an ointment of Picrotoxin (gr. x to the g), which will also kill 
pediculi, but it must be used cautiously and with special care to avoid 
an abraded surface. The tincture of Cocculus may be used undiluted as 
a wash to kill body-lice. 

PILOCARPUS, Jaborandi,— the leaflets of Pilocarpus Selloanus, 
and of Pilocarpus Jaborandi, Brazilian plants of the nat. ord. Rutaceae. 
The word Jaborandi is applied in Brazil to any tree or shrub which pos- 
sesses the power of inducing sweating, and a number of plants are so 
designated, but the true leaves are known by their numerous pellucid dots, 
easily recognized when the leaf is held between the eye and a light. They 
contain the four alkaloids Pilocarpine, C n H 16 N 2 2 , a syrupy fluid, slightly 
soluble in water, and forming salts ; Jaborine, isomeric with pilocarpine, 
but antagonistic thereto in action, and does not form crystallizable salts; 
Pilocarpidine, which acts like pilocarpine; and Jaboridine, which is anal- 
ogous in action to jaborine. 

Preparations. 
Extractum Pilocarpi Fluidum, Fluid Extract of Pilocarpus. — Dose, ffbv-oJ- 
Pilocarpine Hydrochloras, Pilocarpine Hydrochlorate, C n H ]6 N 2 2 HCl, — small, 
white, deliquescent crystals, odorless, of faintly bitter taste ; very soluble in water and in 
alcohol, almost insoluble in ether or chloroform. Dose, gr.^-J^.' 

Physiological Action. 
Pilocarpus is a paralyzer of the vaso-motor system, and a stimulant of 
the peripheral terminations of nerves supplying glands and involuntary 
muscular fibre, subsequently paralyzing the latter. It is therefore a power- 
ful diaphoretic and sialogogue, a cardiac depressant by stimulation of the 
vagus ends, — also myotic, emetic, and under some circumstances aborti- 
facient. Its taste is hot and pungent. It causes prompt and profuse per- 
spiration (§ix-xv in quantity) and salivation (gx-xxvij), after a prelim- 
inary flushing of the skin. The nasal, bronchial and lachrymal secretions 
are much increased ; sometimes watery diarrhoea occurs ; the action of 
the heart, at first increased, is afterwards lowered, the arterial tension is 
reduced, and the temperature falls from i° to 4 . Drowsiness, pallor, 
chilliness and debility succeed, and last several hours ; the pupils are con- 
tracted and accommodation is impaired. The elimination of urea is greatly 
increased, but not the quantity of urine. The respiratory power is low- 
ered, and apncea may occur, from increase of the bronchial mucus. Pilo- 
carpus is rapidly diffused, and is eliminated by the skin and the salivary 
glands. Its effects pass off usually in from three to six hours. Children 
are less affected than adults, by proportionate doses. It causes contrac- 
tions of the bladder, uterus and spleen, in the latter case whether the 
organ is enlarged or of normal size. The desire to urinate, which is 



PILOCARPUS. 389 

experienced after a full dose, is due to the drug causing contraction of 
the bladder. Pilocarpus is not a diuretic but tends rather to diminish the 
quantity of urine as a result of its powerful diaphoretic action. 

Pilocarpine is the principle to which the foregoing actions are due, but 
Jaborine, though chemically identical, is perfectly antagonistic thereto in 
its effects on the heart, pupils, lungs and salivary glands, acting precisely 
like Atropine on these organs. The difference is probably due to a dif- 
ferent molecular arrangement. 

Antagonists and Incompatibles. 

Atropine is the antagonist to Pilocarpine in dose of gr. T ^ for gr. £ of the latter. The 
antagonism between these two alkaloids extends over the whole range of their action, 
and is the most complete known to physiological experimentation. Conversely Pilocar- 
pine is exactly antagonistic to Atropine, but Jaborine acts similarly to the latter drug. 
Morphine controls the nausea and vomiting. Caustic alkalies, the persalts of Iron and 
salts of the metals generally, are chemically incompatible. 

Therapeutics. 

Pilocarpus is used with great benefit in dropsies, especially the renal 
form, also in eclampsia of renal origin, in uraemia, pleuritis, meningitis, 
and other inflammations of serous membranes, but it is contraindicated 
when from any cause there is weak heart. In diabetes insipidus it reduces 
the quantity of urine remarkably, relieving the kidneys by throwing the 
work on the skin. In the acute and chronic forms of Bright's disease it 
has been used with advantage, but being very depressant it must be em- 
ployed with great caution in this disorder. For alopecia it is the most 
efficient remedy known, stimulating the skin and improving the color and 
condition of the hair. In agalactia it stimulates the secretion of the 
milk, and it often gives prompt relief in parotitis. Ptyalism is frequently 
relieved by minute doses of Pilocarpine (gr. -fa), which, acting specifi- 
cally on the same gland, may correct the morbid action thereof; and 
similar doses used thrice daily will check profuse perspiration. The hy- 
podermic use of Pilocarpine will arrest a paroxysm of spasmodic asthma, 
and is equally efficient in hiccough. Atropine-poisoning is best combated 
by the use of Pilocarpine hypodermically. 

Diphtheria has been treated by Pilocarpine with a high degree of suc- 
cess, Guttmann having reported eighty-one cases without a single death, 
but other clinicians have not found it so efficient, and Lashkewitz and 
Jacobi condemn it absolutely. In children above the age of five years, 
in whom the condition of the heart does not contraindicate it, this drug 
often gives pronounced satisfaction in detaching the false membrane and 
preventing its reformation ; but care must be taken to give full support 
by food and alcohol throughout its use, and to avoid it altogether in 
cases which manifest cardiac weakness or great depression. In erysipelas 
it is often highly efficient, and for the purpose of breaking up a common 



390 PIMENTA PIPER. 

cold it is one of the best agents at our command. For the latter purpose 
the fluid extract may be used in doses of n^x-gj, according to age, given 
at bed-time and repeated once or twice during the night if necessary. 
Children bear it well in respect of all its physiological actions. 

Ophthalmologists employ Pilocarpine with most excellent results in the 
amblyopia of alcoholism and that from the abuse of tobacco, in detach- 
ment of the retina, chronic iritis, keratitis, glaucoma, hemorrhage into 
the vitreous, atrophic choroiditis, white atrophy, to promote resolution 
and absorption in inflammatory conditions with exudation, and instead 
of Physostigmine as a myotic. 

Pilocarpine is highly efficient as an aid to sorbifacient remedies in re- 
moving inflammatory exudations and promoting the absorption of effu- 
sions. When iodides and mercurials are being used for these purposes 
their action is greatly aided by this drug administered occasionally for a 
few days at a time. It has lately been suggested by Dr. Waldstein as a 
remedy in phthisis, for the purpose of inducing leucocytosis and stimu- 
lating glandular activity, and is one of the ingredients in a new " cure " 
for consumption named Aseptolin. (See ante, page 78.) » 



PIMENTA, Allspice, — is the nearly ripe food of Pimento, officinalis , a West Indian 
tree of the nat. ord. Myrtacese. The berries contain a Volatile Oil which is official, a 
green fixed oil, fat, tannin, gum, resin, etc. Dose, gr. x-xl. 

Oleum Pimentae, Oil of Pimento, — the volatile oil, colorless or pale yellow, of aro- 
matic odor, pungent taste and slightly acid reaction. Is a constituent of Bay Rum (Spt. 
Myrcise). Dose, rr\jj-vj. 

Allspice is a warm, aromatic stimulant, very useful as a condiment, improving digestion 
by increasing the vascularity of the gastric mucous membrane, and by stimulating the 
salivary secretion. The oil is an agreeable remedy for flatulence, nausea, and intestinal 
colic, and is used to prevent the griping of purgatives and to cover the taste of nauseous 
medicines. 

PIPER, Pepper [Block Pepper}, — is the unripe fruit of Piper nigrum, or Pepper- 
vine, a perennial plant of the nat. ord. Piperaceae, growing in India, Siam, Java, Borneo, 
etc. It contains a principle, Piperin, which is official, also a green, acrid, concrete oil, a 
balsamic volatile oil, starch, lignin, gum, extractive, etc. Dose, gr.v-xx. 

Oleoresina Piperis, Oleoresin of Pepper, — contains almost all the volatile oil and acrid 
resin extracted by ether, with little of the Piperine. Dose, TT^X - ]- 

Piperinum, Piperin, C n H ]9 N0 3 , — a neutral principle prepared from Pepper, and 
occurring also in other plants of the natural order Piperaceae. Occurs in colorless or 
pale-yellowish prisms, of neutral reaction, almost insoluble in water, slightly so in ether, 
but soluble in 30 of alcohol. Dose, gr. j-x. 

Pepper when applied to the skin acts as an irritant ; internally its effects are similar to 
those of other aromatics, being a warm carminative and stimulant, increasing slightly the 
action of the heart, stimulating the kidneys somewhat, and toning up the mucous mem- 
brane of the urinary and intestinal passages, by which channels it is eliminated. It has 
been thought to possess antiperiodic powers, and was formerly much employed in inter- 
mittents. Its chief medicinal use is to correct flatulence, and to excite action of the 
stomach, being very commonly taken as a condiment with food. It is occasionally em- 
ployed in gleet, but more extensively in hemorrhoids and other diseases of the rectum. 
Its active constituents are the concrete oil or resin and the volatile oil, Piperin having very 
slight action on the system, except as an antiperiodic and antipyretic, qualities which it 
certainly possesses. 



PIPERAZINUM. 39I 

PIPERAZINUM, Piperazin, QH 10 N 2 (Unofficial),— is a syntheti- 
cal basic compound which is formed by the action of Ammonia upon 
Ethylene Bromide or Chloride; and occurs as a white, crystalline powder, 
readily soluble in water, and liquefying when exposed to the air, from 
which it greedily absorbs water and carbon dioxide. Dose of the base or 
its hydrochloride, gr.v-x. It may be injected hypodermically in 3 to 5 
per cent, solution. 

Piperazin possesses the valuable property of forming with uric acid a 
very soluble compound, piperazin urate being seven times more soluble in 
water than is lithium urate, the former requiring but 50 parts and the 
latter 368 parts of water for solution. It is non-toxic, and devoid of 
powerful physiological effects, being well borne without ill results, even 
when administered for prolonged periods. It is non-irritant to mucous 
membranes, is readily absorbed from the stomach, and circulates in the 
blood unchanged, reaching the parts affected by gouty deposits in a con- 
dition in which it readily neutralizes and dissolves the latter, thus facilitat- 
ing their removal from the body. 

The administration of Piperazin in gout promptly reduces the redness 
and swelling of the affected joints, and is frequently followed by a dis- 
charge of gravel. The minimum daily dosage for this purpose is about 
15 grains, which should be dissolved in half a pint of water, and the solu- 
tion should be added to a pint or more of any convenient carbonated 
water, and be taken in divided doses through the day. When there is 
much pain and fever present, an equal quantity of Phenocoll Hydro- 
chloride may be added, — but in preparing them, each agent should be 
dissolved separately and then mixed together, otherwise a precipitate will 
form in the solution. It gives marked relief in the pruritus of the uric 
acid diathesis due to the irritation of imperfect nitrogenous elimination. 
In solution it may be introduced into the bladder in order to dissolve 
vesical calculi of the uric character, and in gout it may be locally em- 
ployed by hypodermic injection. A one per cent, solution, applied locally 
to open gouty sores, relieves the pain and reduces the inflammation. It 
should be tried in rheumatic arthritis of difficult diagnostic differentia- 
tion. As a solvent for uric acid and urate concretions Piperazin is prob- 
ably superior to all other agents. It is patented, which fact, together with 
its extremely high price, prevents its general use. It is supplied by the 
manufacturers in vials containing 10 grammes (150 grains), which is suffi- 
cient for ten days' dosage, and may be prescribed in gviij of water, of 
which solution the daily dose would be gj (equal to 18^ grains), taken 
in a quart or more of any carbonated water during the day in broken 
doses. 

Lysidin (Unofficial), — is a new base obtained by the action of Sodium Acetate upon 
Ethylene-diamine Hydrochlorate, and is said to possess a solvent power on uric acid five 
times greater than that of Piperazin. It has been tried in cases of chronic gout with ex- 



392 PISCIDIA — PIX. 

cellent results. The stiffness of the joints was lessened, and there was a conspicuous 
reduction in the bulk of the tophi around the joints, and on the epiglottis in one case. 
The dose is ^ss-spjss of the 50 per cent, alkaline solution in a glassful of carbonated 
water. 

Lycetol, Dimethyl-piperazin Tartrate (Unofficial), — is a new uric acid solvent, which 
is said to combine the solvent properties of Piperazin with the alkaline and diuretic effects 
of Tartaric Acid. The dose is gr. xv-xxx daily, administered in carbonated water or in 
the form of a lemonade. 



PISCIDIA, Jamaica Dogwood (Unofficial), — is the bark of the root of Piscidia 
erythrina, a tree of the nat. ord. Leguminosae, growing in the West Indies. It occurs as 
a tough, fibrous bark, of a heavy, narcotic odor, and contains a yellowish, resinoid sub- 
stance named Piscidin. Its active principle has not yet been isolated. A fluid extract 
is on the market, of which the dose is 3 ss-j, carefully increased. 

Piscidia has a narcotic effect on many animals, and has been used in Jamaica for many 
years to stupefy fish, that they may be easily taken. It produces muscular relaxation, 
incoordination of movement, lowered sensibility, increased action of the heart and increase 
of the arterial tension by stimulation of the vaso-motor centre. Soon, however, the 
heart is weakened, vascular tension falls, and a tetanoid state results from stimulation of 
the spinal cord, with reduced reflex action. On the brain its effects resemble those of 
Opium, causing deep sleep without any unpleasant after-results. It relieves pain in less 
degree, however, than Opium does, but its hypnotic action is greater. It also relieves 
cough and spasm, produces diaphoresis and salivation, and dilates the pupil. From toxic 
doses death occurs by asphyxia in animals. In man its action is probably the same, but 
in decidedly less marked degree. 

Piscidia is used chiefly as a general nervous sedative. Its hypnotic and anodyne 
powers are somewhat uncertain, but have in many cases been very decided. It is useful 
in whooping-cough and spasm, and has proved almost specific in many cases of neuralgia, 
while in others it has caused great gastric distress without the least anodyne effect. 



PIX, Pitch, — is a resinous exudation from the stem of certain trees 
of the genera Pinus (Pines) and Abies (Firs and Spruces) ; and may also 
be obtained by the evaporation of wood-tar. [See Pix Liquida below.] 
The first two of the following varieties are official. 

Pix Burgundica, Burgundy Pitch, — the prepared resinous exudation 
of Abies excelsa or Norway Spruce (nat. ord. Coniferae), a native of 
Europe and Northern Asia. It occurs in bard, brittle, opaque or translu- 
cent mass, with a shining, conchoidal fracture, almost entirely soluble in 
glacial acetic acid. It is very fusible, and at the body-heat it softens 
and becomes adhesive. Used for plasters. 

Pix Liquida, Tar, — is an empyreumatic oleo-resin obtained by the 
destructive distillation of the wood of Pinus palustris and other species 
of Pinus, (nat. order Coniferae). Is thick, viscid, semi-fluid, blackish- 
brown, of acid reaction, terebinthinate odor, and sharp, empyreumatic 
taste, slightly soluble in water, soluble in alcohol, oils, and in solution of 
potassa or of soda. 

By distillation Tar yields an acid liquor named Pyroligneons Acid and an empyreu- 
matic oil called Oil of Tar, (see Oleum Picis Liquidae, below), the residue being pitch. 
Its granular appearance is due to crystals of Pyrocatechin, C 6 H 4 (OH) 2 , which occur 
either in the Pyroligneous Acid or in the tarry mixture. Dose, 3J-ij daily, in ten-grain 
doses. 



pix. 393 

Pix Canadensis, Canada or Hemlock Pitch (Unofficial), — is the pre- 
pared resinous exudation of Abies canadensis (nat. ord. Coniferse), the 
Hemlock Spruce of the U. S. and Canada. Its properties are much the 
same as those of Burgundy Pitch. 

Preparations. 

Emplastrum Picis Burgundicae, Burgundy Pitch Plaster, — has of Burgundy Pitch 
80, Olive Oil 5, Yellow Wax 15. 

Emplastrum Picis Cantharidatum, Cantharidal Pitch Plaster, Warming Plaster, 
has of Cerate of Cantharides 8, Burgundy Pitch to loo. 

Oleum Picis Liquidae, Oil of Tar, — a volatile oil distilled from Tar. Dark, reddish- 
brown (almost colorless when fresh), of tarry odor and taste, and acid reaction, readily 
soluble in alcohol. Contains a great variety of compounds, including Hydrocarbons, 
Phenols, Paraffin, etc., among the phenols being Creosote and Carbolic Acid. Is used 
locally and as an atomized inhalation. 

Syrupus Picis Liquidae, Syrup of Tar, — has of Tar 7j^ per cent. ; and is a sweet- 
ened Tar- water. Dose, :pj-3;ss. 

Unguentum Picis Liquidae, Tar Ointment, — contains of Tar 50 parts, Yellow Wax 
12 l / z , Lard 37^. Is irritating unless mixed with finely levigated chalk. 

Infusum Picis Liquidae, Tar Water (Unofficial), — made by shaking Tar I with 
Water 4 frequently during 24 hours, decanting and filtering. Is stimulant and diuretic. 
Dose, Oj-ij daily. 

Vinum Picis Liquidae, Wine of Tar (Unofficial), — Tar % xvj, Glycerin, White Wine, 
Honey, aa^viij, Acetic Acid 3 j, Boiling Water Ovj, shaken together and digested in a 
close vessel for two hours at 150 to 160 , then macerated for a few days, frequently 
shaken, strained and filtered. 

Oleum Pini Sylvestris, Oil of Scotch Fir (Unofficial), — a colorless, fragrant oil, dis- 
tilled from the leaves of Pinus Sylvestris, resembling Turpentine in action. Used by in- 
halation (^ss to Oj of boiling water), or locally. 

Retinol, Reshiol (Unofficial), — obtained by the distillation of Burgundy pitch, occurs 
as a yellowish, oily liquid, boiling at temperatures above 536 F. Used as a solvent for 
a number of the newer remedies, as Cocaine, Aristol, Iodol, also Carbolic Acid, Creosote, 
Phosphorus and many alkaloids. 

Concentrated Extract of Pinus Canadensis (Unofficial), — is an aqueous, non-irri- 
tant astringent, prepared from the Abies Canadensis or Hemlock Spruce. It is said to 
have a specific tonic action upon mucous membranes Two kinds are sold, one being 
called the " White " Extract, — in reality a golden yellow, — and the other the " Dark " 
Extract, — the former intended for use when it is desirable to avoid staining the linen. 
This preparation received the endorsement of Dr. J. Marion Sims, and has been exten- 
sively employed both locally and internally, as a topical application in uterine and vaginal 
catarrhs, and as a systemic remedy in catarrhal inflammation of the gastro-intestinal and 
broncho-pulmonary mucous membranes. 

Physiological Action and Therapeutics. 
Pitch is a gentle rubefacient when applied to the skin, but in some 
constitutions the Burgundy variety causes a vesicular and pustular inflam- 
mation if used extensively. It is generally employed as a basis for plas- 
ters, and is of benefit in lumbago, rheumatism, chronic pleurisy, painful 
joints, superficial neuralgias, etc., protecting the part from variations of 
temperature, and perhaps by the gentle pressure exercised stimulating the 
lymphatics and promoting absorption. It is supposed to have a special 
influence on the rectum, and in pill with Tar has been employed as a rem- 
edy for hemorrhoids. In applying adhesive plasters the hair should first 



394 PLANTAGO PLUMBUM. 

be shaved off, and when about to be removed the plaster should be warmed, 
and a little Oil of Turpentine inserted between its edge and the skin. 
Canada Pitch is too soft for plasters, but is employed for the same pur- 
poses as the preceding. A volatile oil obtained from the same tree (Oil 
of Spruce, Oil of Hemlock) has been used for abortifacient purposes, 
endangering the life of the subject. 

Tar is a complex mixture of resins and hydrocarbons, containing Creo- 
sote and Carbolic Acid, which give to it irritant qualities. Internally it 
is expectorant, and produces gastro-intestinal irritation, sometimes severe 
headache, giddiness and febrile phenomena. It is eliminated by the 
kidneys chiefly, which it stimulates, and may cause their congestion and 
increased diuresis. Externally it is a decided stimulant to the skin, often 
giving rise to considerable irritation and pain. It is also antiseptic, and 
in most of its effects it resembles the turpentines. Tar is used as a local 
application in chronic scaly skin diseases, especially psoriasis and chronic 
eczema. As an atomized inhalation it is of decided benefit in bronchi- 
tis, pharyngitis, laryngitis and winter cough. Internally it may be em- 
ployed with advantage in these affections, in hemorrhoids, bronchial ca- 
tarrh, and phthisis. The best preparation for internal administration is 
the syrup, which is a sweetened tar-water, the sugar forming with the Tar 
a soluble compound. 

PLANTAGO, Plantain (Unofficial), — is the leaf of Plantago major, and Plantago 
lanceolata (nat. ord. Plantaginacese), the common " Ribbed Grass." The pounded leaves 
applied as a paste, or the dry leaf powdered, are actively hemostatic, stopping hemor- 
rhages speedily. Among the ancients it had a good reputation as a remedy for toothache 
and earache, which still adheres to it in Switzerland and other parts of Europe. In 
many other painful affections it is extremely efficient, especially in mastitis, rhus-poison- 
ing, erysipelas, burns, scalds, wounds and bruises. A poultice of the leaves may be 
applied to the affected part, and an infusion administered internally. A fluid extract is 
sold in the shops, of which the dose is TT\v-xv. 

PLUMBUM, Lead, Pb, — is not official, but several of its salts are, 
namely — the Acetate, Carbonate, Iodide, Nitrate and Oxide; of which 
the Acetate is the only one administered internally, the solutions of the 
S?ibacetate are the only liquid preparations, the Oxide (Litharge) is used 
as Emplastrum Plumbi, the Nitrate is used as a local stimulant or escha- 
rotic, the Iodide as an ointment for absorbent purposes, and the Carbonate 
as an astringent locally to inflamed surfaces. The metal occurs in nature 
chiefly as a Sulphide named Galena, also as an Oxide rarely, and in vari- 
ous other combinations (salts). 

Official Salts of Lead. 

Plumbi Acetas, Lead Acetate, Sugar of Lead, Pb (C 2 H 3 2 ) 2 + 3H 2 0, — colorless, 
shining, prismatic crystals or scales, efflorescent, of faintly acetous odor and acid reaction, 
and a sweetish, astringent and metallic taste. Soluble in 2.3 of water and in 21 of alco- 
hol at 59 F. , in 0.5 of boiling water and in I of boiling alcohol. Dose, gr. ss-v. 



PLUMBUM. 395 

Plumbi Carbonas, Lead Carbonate, White Lead, (PbC0 3 ) 2 Pb(HO) 2 ,— a heavy, 
white, opaque powder, odorless, tasteless and insoluble in water or alcohol, but soluble 
with effervescence in acetic or in diluted nitric acid. Used locally as ointment, powder, 
or white paint. 

Plumbi Iodidum, Lead Iodide, Pbl 2 , — a heavy, bright citron-yellow powder, odor- 
less and tasteless, fusible and volatilizable by heat, soluble in about 2000 of water at 59 
F., and in about 200 of boiling water. Used externally as an ointment. May be given 
internally in doses of gr. X twice daily. 

Plumbi Nitras, Lead Nitrate, Pb(N0 3 ) 2 , — colorless, opaque, octahedral crystals, 
odorless, of sweetish, astringent and metallic taste and acid reaction, soluble in 2 of water 
at 59 F. , almost insoluble in alcohol. Used locally as an astringent and deodorizer in 
solutions up to I per cent., also as an escharotic and a disinfectant. 

Plumbi Oxidum, Lead Oxide, Litharge, PbO, — a heavy, yellowish, or reddish- 
yellow powder, odorless, tasteless and insoluble in water or alcohol, but almost wholly 
soluble with slight effervescence in dilute nitric acid. When heated in contact with char- 
coal it is reduced to metallic lead. Used as Lead-Plaster and sometimes with oil as an 
external application. 

Preparations. 

Liquor Plumbi Subacetatis, Solution oj Lead Subacetate, Goulard 's Extract, — 
an aqueous solution containing about 25 per cent, of the salt, prepared from Acetate of 
Lead 170, Oxide of Lead 100, and Distilled water to 1000. It is a clear, colorless liquid, 
of sweetish, astringent taste and alkaline reaction, of sp. gr. 1.195, an< i when added to a 
solution of acacia it produces a dense, white precipitate. Used locally as an astringent 
and cooling lotion, diluted usually with an equal quantity of water. 

Liquor Plumbi Subacetatis Dilutus, Diluted Solution of Lead Subacetate, Lead 
Water, — has of the preceding 3, in Distilled Water to 1 00. Used locally as a mildly 
astringent and cooling lotion. 

Ceratum Plumbi Subacetatis, Cerate of Lead Subacetate, Goulards Cerate, — has 
of the same solution 20 parts with So of Camphor Cerate, freshly prepared, as it becomes 
rancid easily. Used as an astringent and protective application. 

Emplastrum Plumbi, Lead Plaster, Diachylon Plaster, — Oxide of Lead 32, Olive 
Oil 60, rubbed together and boiled with 10 parts of water. Is white, pliable and tena- 
cious, free from greasiness or stickiness, and should be entirely soluble in warm Oil of 
Turpentine. A good protective in abrasions and bed-sores, and the basis of many other 
plasters. 

Unguentum Diachylon, Diachylon Ointment, — has of Lead Plaster 50, Olive Oil 
49, Oil of Lavender Flowers I. Used locally in eczema and other cutaneous disorders. 

Unguentum Plumbi Carbonatis, Ointment of Lead Carbonate, — has of the Carbon- 
ate in very fine powder 10, Benzoinated Lard 90. Used as a dressing for burns. 

Unguentum Plumbi Iodidi, Ointment of Lead Iodide,— -has of the Iodide in very 
fine powder 10, Benzoinated Lard 90. Used locally to promote absorption of glandular 
tumors. 

Oleatum Plumbi, Oleate of Lead (Unofficial), — a 20 per cent, solution of Oxide of 
Lead in Oleic Acid. A soft, yellowish ointment, for local use. 

Physiological Action. 
Lead-salts are all more or less poisonous, but metallic Lead is inert 
until converted into a soluble salt by the acids of the stomach. The 
Acetate in large doses is emetic, so that acute lead-poisoning is rare. Its 
chief phenomena are intense gastro-intestinal irritation, vomiting, paraly- 
sis, coma and collapse. Chronic lead-poisoning (Plumbisni) has its 
principal sources in pure water conveyed by leaden pipes, the use of hair 
dyes, handling of printing-type, working in the smelting of lead ores, etc. 
It produces loss of appetite, emaciation, pallor and constipation, followed 



39^ PLUMBUM. 

by slowing of the heart's action, and accompanied by violent colic 
(enteralgia), muscular impairment evinced by paralysis of the extensor 
muscles of the forearm (drop-wrist), impaired sensibility and albuminuria. 
Occasionally aphonia, vertigo, gastralgia, headache, stupor and convul- 
sions are manifested. Rheumatism without fever or tenderness in the 
joints, which however are red and swollen, is a frequent symptom. A 
blue line (sulphide) is seen along the margins of the gums in those who do 
not clean their teeth. Neuralgic troubles may arise, and amaurosis often 
occurs from impairment of the optic nerve. The metal becomes deposited 
in the affected muscles and other tissues, and probably acts by impairing 
the isolating power of the nerve-fibres, thus enfeebling the nerve-currents. 
It also produces contraction of the smaller vessels, and may affect any 
muscles of the body, also the brain, producing delirium, coma, and con- 
vulsions. Abortion is a frequent result, either through an influence on 
the muscular tissue of the uterus, or from a toxic action on the foetus. 
Death may occur from extension of the paresis to the muscles of respiration, 
from gradual impairment of nutrition, or from convulsions and coma, a 
form of disease known as Lead-encephalopathy. 

Astringency is the chief quality of the lead salts ; they lessen secretion, 
contract muscular tissue and then destroy its contractile power, slow both 
the heart and the respiration, and in time destroy the red blood-corpus- 
cles. Lead enters the blood as an albuminate, in which form also it is 
retained by the tissues. It is slowly excreted by the liver, kidneys, skin 
and mammary glands. That which escapes by the bile is reabsorbed by 
the bowel, and is again excreted by the intestinal glands, escaping with 
the feces as a sulphide. It lessens the excretion of uric acid. 

Antidotes, Antagonists and Incompatibles. 

In acute poisoning by lead salts, as by the Acetate, the antidotes are Sodium or Mag- 
nesium Sulphate and Sodium Phosphate. The stomach should be evacuated, and albu- 
minous drinks and Opium given to allay irritation. Chronic poisoning is best treated by 
Atropine and Iodides, the latter to saturation of the system. Sulphurated Potassa Baths 
( ^j or more in water) are also very useful. Incompatibles are Mineral Acids and their 
salts, vegetable acids, alkalies, vegetable astringents, Potassium Iodide, albuminous solu- 
tions, Opium, and all natural waters containing Lime, Sulphates, Carbonates, and Car- 
bonic Acid. 

Therapeutics. 
Lead salts are chiefly used as astringents and hemostatics. The solu- 
tion of the Subacetate diluted with 4 parts of glycerin and water is locally 
employed in many skin-diseases, especially in eczema, lichen, impetigo, 
and erythema ; also in catarrhal discharges of muco-purulent character 
from the ear, vagina, and urethra, particularly in gonorrhoea and leu- 
corrhoea. Inflammations of external parts are constantly treated by the 
lotion of " Lead water and Laudanum" (Liquor Plumbi Subacetatis Di- 
lutus, 7 parts to 1 of Tinctura Opii). Though the constituents of this 



PODOPHYLLUM. 397 

lotion are chemically incompatible, it is a valuable sedative and astringent. 
The Acetate, in 5 -grain doses every three hours, is an efficient internal 
styptic in various hemorrhages, particularly in hemoptysis, hematemesis, 
and gastric ulcer, lowering the action of the heart and constringing the 
vessels. Its astringent action is well manifested in bronchorrhoea and 
other pulmonary affections with excessive secretion. It is well used in 
diarrhoeas, gr. ij with gr. j of pulverized Opium in choleriac diarrhoea, 
and smaller doses for the summer complaint of children. In caseous 
pneumonia the Acetate is highly recommended as the best remedial agent, 
combined with Opium and Digitalis ; and in cardiac hypertrophy it may 
be often used to lower the action of the heart. It is also serviceable in 
whooping-cough with profuse bronchial secretion, and in humid asthma. 

The Carbonate is only used externally, to protect irritated surfaces, as 
erythema, erysipelas, intertrigo, etc., in which it may be dusted over the 
surface if unbroken. The official ointment, or white paint mixed with 
linseed oil, is an excellent application to burns or scalds, but if applied 
on the broken cuticle it may prove rapidly poisonous. The Iodide is 
employed externally as an ointment to enlarged lymphatic glands and 
enlarged spleen, also to chronic eczema and psoriasis. It has been used 
internally to reduce a malarial spleen. 

The Nitrate is an efficient application to fissured nipples, gr. x to gj 
of glycerin. In powder, dusted over unhealthy granulations, and sanious 
ulcers resulting from onychia, it gives prompt relief after a brief period 
of pain. It is said to have cured cases of epithelioma when used in the 
same manner. In solution (gr. x to the g) it is a most efficient deodor- 
izer against the fetor from gangrenous sores, ozaena and other offensive 
discharges. Pharmaceutically it is used in the preparation of the Iodide. 
The Oxide is used in the preparation of plasters, and most of the other 
salts of lead. It is not employed internally, but may be used as an external 
application mixed with sweet oil in superficial burns, but care should be 
taken that it is only applied to the unbroken skin. 

PODOPHYLLUM, May Apple, — is the rhizome and rootlets of 
Podophyllum peltatum (the Mandrake), an herbaceous perennial of the nat. 
ord. Berberideae, growing in the woodlands of Canada and the U. S., 
having a pale-green stem about a foot high, with a single white flower at its 
summit. Its active principle is a Resin which is official, and is a com- 
pound of several resins. It probably contains the alkaloid Berberine, 
which is also found in Berberis, Hydrastis and several other plants. Dose, 
gr.v-xx. 

Preparations. 

Extractum Podophylli, Extract of Podophyllum. — Dose, gr.v-x. 

Extractum Podophylli Fluidum, Fluid Ext. of Podophyllum. — Dose, rry-xxx. 



39§ POLYGONUM PONGAMIA POTASSIUM. 

Resina Podophylli, Resin of Podophyllum, Podophyllin, — is precipitated from a 
concentrated tincture by acidulated water. Soluble in alkaline liquids and partly so in 
ether. Contains Podophyllotoxin, Picropodophyllin, Podophyllinic and Protocatechuic 
Acids. Dose, gr.^-j, in pill. Is an ingredient of Pilulae Catharticae Vegetabiles. 

Podophyllum is a tonic-astringent and resin-bearing purgative, having 
action similar to that of Jalap but slower, like Calomel taking 6 to 10 
hours to produce its cathartic effect. It increases the intestinal secretions 
and the flow of bile, causing copious watery stools, with considerable 
griping pain and some nausea. The powder is irritant to the respiratory- 
passages and to the skin. 

The Resin is an excellent purgative in cases of habitual constipation or 
portal congestion, and is a useful cholagogue. Laxative effects are pro- 
duced by small doses (gr.^j-^), but grain-doses are necessary for its full 
action. It should be combined with Hyoscyamus, Belladonna or Can- 
nabis Indica, in order to counteract its griping tendency. It is an effi- 
cient derivative in cases of catarrhal or malarial jaundice, and is recom- 
mended in very small doses for prolapse of the rectum, remittent fevers of 
children, dyspepsia, hepatic derangement, bilious vomiting and headache, 
and in the vomiting and diarrhoea of gastro-enteritis. 



POLYGONUM, Smart-Weed, Water-pepper (Unofficial),— is the plant Polygonum 
Hydropiperoides, nat. ord. Polygonacea, indigenous to the U. S. , having narrow, lance- 
olated leaves and slender spikes of whitish flowers. It contains Tannin and an active 
principle, Polygonic Acid, which is green, crystallizable, insoluble in water, but soluble in 
alcohol, ether, and chloroform. 

Extractum Polygoni Fluidum, Fluid Extract of Polygonum (Unofficial). — Dose, 

Extractum Polygoni, Extract of Polygonum (Unofficial). — Dose, gr. j-v. 

Smart- weed has a pungent, acrid taste, producing a sensation of heat in the stomach, 
and a peculiar tingling throughout the system. It stimulates the action of the heart, raises 
the arterial tension, increases the warmth of the surface, promotes the cutaneous, bronchial 
and renal secretions and the menstrual flow. It is an efficient diuretic, emmenagogue 
and aphrodisiac. The juice applied to the skin excites inflammation and vesication. 

Amenorrhcea from functional inactivity of the uterine system is remarkably benefited 
by this remedy in % ss doses of the fluid extract four times daily for a week before the 
expected period. It has considerable influence over functional impotence, but produces 
aching pains in the hips and loins, and a sense of weight and fullness within the pelvis. 
It has also been used with benefit in diarrhoea, dysentery and gravel ; and locally in mer- 
curial salivation and the sore mouth of nursing women. 



PONGAMIA, Kurung Oil (Unofficial), — is a yellow oil expressed from the seeds of 
Pongamia glabra, an Indian tree of the nat. ord. Leguminosae. It has been used for 
many years in India for skin affections, and in professional hands has proven an excellent 
application in pityriasis versicolor, rubbed in twice daily. It promises to be a valuable 
remedy in parasitic diseases of the skin, is not irritating and does not discolor the surface 
to which it is applied. 



POTASSIUM, Kalium, K, — is represented by a number of official 
salts, which are colorless or white, sometimes anhydrous, and generally 
soluble readily in water. The metal itself is not official. The chief 



potassium. 399 

source of its salts is the ash remaining after the combustion of plants or 
trees, which contains the Carbonate, from which most of the other salts 
are prepared. There are also two subsidiary sources, viz. — the Nitrate, 
which is found native ; and the Bitartrate, which, under the name of 
Crude Tartar or Argol, is deposited during the fermentation of wine. It 
is distinguished from all other bases (except Magnesium, Sodium and 
Ammonium) by not being precipitated by Ammonium Sulphide or Am- 
monium Carbonate. It is positively known by the violet color it imparts 
to flame, by its very sparing solubility when converted into the Bitartrate, 
and by its precipitation by Platinum Perchloride. 

Potassium Salts and their Preparations. 

Potassa, Potassium Hydrate, Caustic Potash, KOH, — a very deliquescent, white, 
hard and dry solid, of very acrid and caustic taste and strongly alkaline reaction, soluble 
in 0.5 of water and in 2 of alcohol. It is a powerful and deeply-acting escharotic, and 
should be kept in well-stoppered bottles made of hard glass. 

Potassa cum Calce, Potassa with Lime, Vienna Paste, — a grayish-white, deliques- 
cent powder, consisting of equal parts of Potassa and Lime rubbed together. A milder 
and more manageable caustic than the preceding. 

Liquor Potassae, Solution of Potassa, — contains about 5 per cent, of Potassium Hy- 
drate, and is prepared by dissolving Potassium Bicarbonate 85, in 400 of Distilled Water, 
40 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradti- 
ally, again boiling, and when cold adding Water up to 1000 parts, straining, settling, and 
decanting the clear solution. Or, by dissolving 56 of Potassa in 944 of Distilled Water. 
Is a clear, colorless, odorless liquid, of acrid and caustic taste, and strongly alkaline 
reaction. Dose, n\v- 3 ss, well diluted with water. 

Potassii Acetas, Potassium Acetate, KC 2 H 3 2 , — a white, satiny, crystalline mass, 
very deliquescent, odorless, of pungent, saline taste, and a neutral or faintly alkaline 
reaction, soluble in 0.4 of water and in 1.9 of alcohol at 59 F. Dose, gr.v— gj. 

Potassii Carbonas, Potassium Carbonate, K 2 C0 3 , — a white, crystalline or granular 
powder, very deliquescent, odorless, of alkaline taste and reaction, soluble in 1. 1 of water 
at 59 F., insoluble in alcohol. Dose, gr. ij-xx. 

Potassii Bicarbonas, Potassium Bicarbonate, — KHC0 3 , — colorless prisms of saline 
and alkaline taste and alkaline reaction, soluble in 3.2 of water at 59 F., decomposed by 
boiling water, almost insoluble in alcohol. Dose, gr.v-xxx. 

Potassii Chloras, Potassium Chlorate, KC10 3 , — colorless prisms or plates, of pearly 
lustre, of cooling, saline taste and neutral reaction, soluble in 16. 7 of water at 59 F. and 
in 1.7 of boiling water; slightly soluble in mixtures of alcohol and water, insoluble in 
absolute alcohol. Dose, gr.v-xx. 

Potassium Chlorate should be kept in glass-stoppered bottles, and great caution should 
be observed in handling the salt, as dangerous explosions are liable to occur when it is 
mixed with organic matters (cork, tannic acid, sugar, etc.), or with sulphur, antimony 
sulphide, phosphorus, or other easily oxidizable substances, and either heated directly or 
subjected to trituration or concussion. It should not be mixed with glycerin in the 
presence of a free acid. 

Trochisci Potassii Chloratis, Troches of Potassium Chlorate, — each troche contains 
about 4^ grains of the salt, with sugar, tragacanth, and spirit of lemon. Dose, j-iij, 
slowly dissolved in the mouth. 

Potassii Citras, Potassium Citrate, K 3 C 6 H 5 7 -|- H 2 0, — transparent, prismatic crys- 
tals, odorless, of cooling, saline taste, and neutral reaction, soluble in 0.6 of water, very 
soluble in boiling water, sparingly soluble in alcohol. Dose, gr. x-xxx. 

Potassii Citras Effervescens, Effervescent Potassium Citrate, — consists of Pot. 
Bicarb. 90, Citric Acid 63, Sugar 47, powdered, mixed to a paste, dried and again pow- 
dered. Dose, 3J-ij, in a glass of water, as an effervescent drink. 

Liquor Potassii Citratis, Solution of Potassium Citrate, A/istura Potassii Citratis, — 
contains about 9 per cent, of the anhydrous salt, together with small amounts of citric 



400 POTASSIUM. 

and carbonic acids. Prepared by dissolving Citric Acid 6, and Pot. Bicarb. 8, each in 
water 40, filtering the solutions separately, and adding in each case enough water to bring 
to 50 parts, then mixing the two together. Dose, ^ ss-^ j or more. 

Potassii Nitras, Potassium A r itrate, Saltpetre , Nitre , KN0 3 , — colorless, transparent 
prisms of a crystalline powder, of pungent, cooling and saline taste and neutral reaction ; 
soluble in 4 of water at 59° F. and in 0.4 of boiling water ; almost insoluble in alcohol. 
Is a constituent of Argenti Nitras Dilutus. Dose, gr.v-xx, well diluted. 

Charta Potassii Nitratis, Potassium AHtrate Paper, — is unsized paper immersed in 
a solution of 20 parts of the salt in 80 of distilled water, and dried. Used for inhalation, 
the fumes from the burning paper being inhaled in asthma. 

Potassii Sulphas, Potassium Sulphate, K 2 S0 4 , — colorless, hard, rhombic prisms, of 
sharp, saline and bitter taste and neutral reaction, soluble in about 9.5 of water at 59 
F., and in 4 of boiling water, insoluble in alcohol. Dose, gr. xx-^ ss, well diluted. 

Potassii Bitartras, Potassium Bitartrate, Acid Tartrate of Potash, Cream of 
Tartar, KHC 4 H 4 6 , — colorless rhombic crystals, or a white, gritty powder, of acidulous 
taste and acid reaction ; soluble in about 201 of water at 59 F., and in about 16.7 of 
boiling water, very slightly soluble in alcohol. Is a constituent of Pulvis Jalapae Com- 
positus. Dose, gr. xx-3 j (diuretic and refrigerant), ^ ss-j (purgative). 

Potassii et Sodii Tartras, Potassium aiid Sodium Tartrate, Rochelle Salt, 
KNaC i H 4 6 -f- 4H 2 0, — colorless, rhombic crystals, or a white powder, of cooling and 
slightly saline and bitter taste, and neutral reaction ; soluble in 1. 4 of water at 59 F., 
very soluble in boiling water, almost insoluble in alcohol. Is a constituent of the following 
preparation. Dose,^ss-j. 

Pulvis Effervescens Compositus, Compound Effervescing Powder, Seidlitz Pow- 
der, — each powder has of the preceding salt 120 grains, of Sodium Bicarbonate 40 grains, 
mixed in one paper ; and of Tartaric Acid 35 grains in another paper. Dose, I or 2 pair, 
dissolved separately in water and the solutions poured together. 

Potassii Silicas, Potassium Silicate, Soluble Glass, K 2 Si0 3 (Unofficial), — is used in 
solution of a syrupy consistence for the preparation of immovable dressings for fractured 
limbs, etc. [See under Silicates.] » 

The Arsenite is described under Arsenum, — the Bromide under Bromum, — the 
Bichromate under Acidum Chromicum, — the Iodide under Iodum, — the Cyanide 
and Ferrocyanide under Acidum Hydrocyanicum, — the Hypophosphite under 
Phosphorus, — the Permanganate under Manganum, — the Nitrite under Amyl 
Nitris, — and Sulphurated Potassa under Sulphur. 

' Physiological Action. 
Caustic Potash, like other caustic alkalies, destroys the tissues by 
combining with their water, dissolving the albumen and saponifying the 
fats, converting the tissue to which it is applied into a moist, gray slough, 
with considerable surrounding inflammation. Internally it acts as a pow- 
erful corrosive poison, destroying the mucous membrane of the parts with 
which it comes in contact, and giving rise to intense pain, diarrhoea, con- 
vulsions and delirium. Unless speedily rejected or neutralized it causes 
death from inflammation of the larynx, from the gastro-intestinal lesions, 
or after some time from stricture of the oesophagus. Liquor Potass^, 
containing over 5 per cent, of the pure Potash, possesses in a degree the 
same caustic properties, and should never be administered undiluted. It 
neutralizes the acids in the stomach, and in the blood exists chiefly as the 
Carbonate, being eliminated with the urine, which it renders alkaline. 
If its use be continued too long it impairs the blood, and renders the sub- 
ject anaemic. 



POTASSIUM. 401 

Potassium Salts in large doses are cardiac poisons, muscular para- 
lyzers, poisonous to protoplasm, especially nerve tissue, and destructive to 
the ozonizing functions of the blood. They increase the saliva, promote 
oxidation and stimulate retrograde metamorphosis ; and are therefore 
waste-producers. In small doses on an empty stomach they promote the 
formation of acid gastric juice by favoring the outward osmosis of its con- 
stituents from the blood ; in larger doses they act chemically on the 
stomach contents, neutralizing its free acids, and disordering digestion. 
The Bicarbonate, given on an empty stomach, enters the blood unchanged, 
meets the neutral phosphate of sodium and is decomposed, acid phosphate 
of sodium being formed, which renders the urine more acid. On a full 
stomach it is decomposed by the acids of the gastric juice, increases the 
alkalinity of the blood and makes the urine less acid. The Salts of 
Potassium with Vegetable Acids (Acetate, Citrate, Tartrate, etc.) enter the 
blood in their own form, are there decomposed, forming free C0 2 , and 
are converted into alkaline carbonates, in which form they are eliminated, 
alkalinizing the blood and the urine. They are diuretics also, increasing 
the urinary water and solids, but decreasing the uric acid by causing in- 
creased oxidation. The Mineral Salts (Nitrate, Chlorate, etc.) are not 
decomposed in the blood, but are eliminated in their own form, the Ni- 
trate being a most active diuretic, the Chlorate irritating the kidneys, 
depressing the heart, causing albuminuria, and impairing the ozonizing 
function of the blood. In large doses these salts decompose the red 
blood-corpuscles and paralyze the motor ganglia of the heart. The Chlo- 
rate does not part with its oxygen in the system, as generally believed. 
The Sulphate is chiefly purgative in its action, but acts harshly, and in 
overdoses has caused death. 

The action of the remaining Potassium salts is described under the 
titles of their acid and other constituents, to which their effects are chiefly 

referable. 

• 

Antidotes and Incompatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
lemon-juice ; — then demulcent drinks and oils to protect the mucous membrane, and the 
usual measures to support vitality. The Alkalies and their Carbonates are incompatible 
with the acids and also with metallic salts, and the Caustic Alkalies decompose most of 
the alkaloids. 

Therapeutics. 
Caustic Potash is used locally to destroy morbid or cicatricial tissue, 
to cauterize the wounds resulting from bites of animals or stings of insects, 
to form issues or to open deep-seated abscesses, and to destroy chancres, 
malignant pustules, nasvi, warts, etc. Its action is deep and severe, and 
it is best employed in the form of Potassa cum Calce, which is a far more 
manageable preparation. 

26 



402 POTASSIUM. 

Liquor Potass^ is used internally as a free alkali to neutralize excess 
of acid in the stomach, blood and secretions, as an antilithic in the uric 
acid diathesis, also for acne, boils, and obesity. Locally it is employed 
to soften the nail in in-growing toe-nail, and diluted to relieve pruritus 
and remove scales in various skin-diseases. In small doses with a vegetable 
bitter tonic before meals it acts well in atonic dyspepsia, increasing the 
flow of the gastric juice by direct stimulation of the gastric mucous mem- 
brane. If given after meals in acid dyspepsia large doses are necessary 
for temporary alleviation by neutralizing the food acids. These remarks 
concerning acidity and dyspepsia apply equally well to the Bicarbonate, 
which is used for the same purpose, and while possessing all the virtues of 
the potassium salts, is without any corrosive or irritant action. It is also 
useful in simple gastralgia or cardialgia ; and in cystitis, gonorrhoea, etc., 
where there is acid urine, it renders the urine less irritating and soothes 
the inflamed surfaces. Acute and chronic rheumatism and rheumatoid 
arthritis are much benefited by an alkaline treatment in patients of suffi- 
cient bodily vigor to stand its lowering effects. The Bicarbonate is also 
used to alkalinize the blood and secretions in lithaemia, jaundice, many 
cutaneous eruptions, and in diabetes ; also locally as a lotion for fetid 
perspiration of the feet and axillae, acne, and acute eczema. The Car- 
bonate is diuretic, antacid and antilithic, but is seldom used internally, 
being too irritant, and the Bicarbonate having all its virtues without its 
objectionable qualities. Locally a solution (3J to the g) is said to be 
effectual as a remedy for pruritus vulvae, and one of half the above strength 
is used in freckles, sunburn and tan of the epidermis, in moist eczema and 
the itching of urticaria. 

The Acetate, Citrate and Tartrate are good purgatives in doses of 
31'j to giv, and in smaller doses are much employed as alkalinizers of the 
blood and urine, diuretics, etc. Of these vegetable potassium salts the 
Acetate is the most certain diuretic, the Bitartrate is the most active ca- 
thartic, while the Citrate is the most reliable diaphoretic and the best 
agent to use for any length of time to alkalinize the urine, it having the 
least injurious effect on the blood or on the digestion. In lithaemia these 
salts are given to promote oxidation, and by keeping the urine alkaline 
they may reduce small calculi of the uric acid variety. In acute rheuma- 
tism and fevers they act as antacids in the blood, as febrifuges by promot- 
ing diaphoresis, and as sedatives to the general nervous system. As an 
agreeable laxative no preparation surpasses the Bitartrate in 2 to 4 drachm 
doses made into a paste with orange marmalade or any other conserve. 
It is also used in Infusion of Juniper as a diuretic in general cardiac dropsy, 
and without the Juniper in acute desquamative nephritis. In cases of 
acute dysentery with scorbutic symptoms, as seen among miners, sailors, 
etc., a full purgative dose of this salt (^ss or more), has acted most bene- 



POTASSIUM. 4O3 

ficially as a preliminary to other treatment; and in many cases has proven 
to be the only remedy required. 

Potassium Chlorate is much employed locally in solution (^ss to the 
5) as a deodorizer and detergent wash in inflamed, ulcerated and aphthous 
conditions of the mouth. On unhealthy mucous membranes generally it 
exercises an alterative action for the better, but if too long used it will 
keep up a state of chronic irritation. In mercurial salivation it is of great 
benefit, and in dilute solution (gr. x to the 3) it is an efficient application 
to unhealthy sores and ulcers, as a wash for foul sinuses or cavities, and as 
an injection in chronic affections of the bladder. The powdered salt may 
be applied to aphthae, and dusted over epithelioma will alter the action, 
diminish the pain, check the growth and promote cicatrization. Inter- 
nally this salt has been administered in the mistaken idea that it parts 
with its oxygen in the system, but it is now shown that it is excreted un- 
changed. Setting up congestion and irritation of the kidneys it is highly 
dangerous in large doses or if used for any length of time, but is constantly 
administered in diphtheria, chronic bronchitis, purpura, hematuria, ova- 
rian tumor, pseudo-membranous laryngitis, scarlatina, typhoid fever, 
chronic cystitis, etc. When used internally it should be given in small 
doses (gr. xx in 24 hours for an infant, gr. xxx in 24 hours for a child of 2 
to 4 years, and ^iss for an adult in the same time), and the action of the 
heart and the kidneys should be carefully watched. It should never be 
prescribed with Potassium Iodide lest the poisonous Iodate be formed, 
nor with the Syrup of the Iodide of Iron, lest it liberate the Iodine, and 
cause severe gastritis. Strong acids and acid sulphates decompose it, 
and it forms explosive compounds with easily oxidizable substances, as 
Sugar, Sulphur, Tannin, Sodium or Potassium Hypophosphites, Catechu, 
Glycerin, etc. For the combination of Potassium Chlorate with the Tinc- 
ture of the Chloride of Iron, as a gargle, see under Chlorum. 

The Nitrate has been much employed as a refrigerant diaphoretic and 
diuretic in febrile and inflammatory affections, especially in inflammation 
of the trachea and bronchi, pneumonia and rheumatism, but its action is 
uncertain, and it is now giving place in these disorders to more efficient 
agents. The fumes of burning nitre paper (Charta Potassii Nitratis) are 
a useful inhalation in some forms of spasmodic asthma. The Sulphate 
is used in teaspoonful doses in water as an hepatic stimulant and a mild 
cathartic, increasing the secretions of the intestinal glandular apparatus. 
Its action is sometimes harsh, and death has resulted from overdoses. 
Potassium and Sodium Tartrate, or Rochelle Salt, is the chief aperient 
agent in Seidlitz Powders. In doses of 3SS-J it is a gentle and cooling 
laxative, and in drachm doses frequently repeated it is used to render the 
urine alkaline, and as an antilithic. 



4O4 PRINOS PRUNUM PRUNUS VIRGINIANA. 

The therapeutics of the other Potassium Salts are described under the 
titles mentioned on page 346. 



PRINOS, Black Alder (Unofficial), — is the bark of Prinos verticillatus, or Winter- 
berry, a shrub of the nat. ord. Aquifoliaceae, indigenous in Canada and the U. S., having 
small, white flowers, and a globose, six-seeded, bright-red berry, which grows in clusters 
and is persistent all winter. It contains an amorphous, yellow and bitter principle, also 
tannin, sugar, starch, wax, resin, etc. The bark may be given in substance in doses of 
3 ss, or a decoction ( 3 ij in Oiij boiled to a quart) in doses of 3 j-ij. 

Black Alder is astringent and tonic, and has been used in intermittent fever, diarrhoea, 
and chronic cutaneous diseases. In the latter class of disorders it may be applied locally. 



PRUNUM, Prune, — is the fruit of Primus domestica, the Plum tree (nat. ord. Rosa- 
ceae), indigenous to "Western Asia, but cultivated in most countries of temperate climate. 
Prunes contain sugar, pectin, albumen, malic acid and salts. They are a constituent of 
Confectio Sennae. 

Prunes are laxative and nutritious, and are freely used as a food and sweetmeat, but in 
excess may give rise to flatulent colic from the indigestibility of their skins. Stewed 
prunes is an excellent dish for constipation in children, and may be made more effective 
by the addition of a little Senna. 



PRUNUS VIRGINIANA, Wild Cherry— is the bark of Pru- 
nus serotina, or Wild Cherry, a large forest tree of the nat. ord. Rosacea^, 
growing in Canada and the U. S. On maceration in water it develops a 
distinct odor of bitter almonds. It contains tannin, gallic acid, resin, 
starch, etc., also Amygdalin and Emulsin, which by their mutual reaction 
in the presence of water, produce Hydrocyanic Acid and a Volatile Oil 
resembling that of Bitter Almond. [See ante, pa^es 87 and 125.] Dose 
of the powdered bark, ^ss-j. 

Preparations. 
Extractum Pruni Virginianae Fluidum, Fl. Extr. of Wild Cherry. — Dose, .^ss-j. 
Infusum Pruni Virginianae, Infusion of Wild Cherry, — 4 per cent. Dose, 3 ss— ij . 
Should be made with cold water. 

Syrupus Pruni Virginianae, Syrup of Wild Cherry, — 15 per cent. Dose, 3J-iv. 

Physiological Action and Therapeutics. 

Wild Cherry is an aromatic bitter tonic, increasing appetite, aiding 
digestion, and thus promoting the constructive metamorphosis. The pres- 
ence of a volatile oil gives it a local stimulating action on the alimentary 
canal in common with Serpentaria, Cascarilla and other members of the 
same class. Hydrocyanic Acid being yielded by it in the presence of 
cold water, results in imparting a sedative action to its preparations, calm- 
ing irritation and diminishing nervous excitability. Very large doses re- 
duce the action of the heart. 

The preparations of Wild Cherry are used in catarrhal conditions of 
the bronchial mucous membrane, in the hectic of phthisis and scrofula, 
with palpitation of the heart, and a debilitated stomach ; a collection of 



PULSATILLA. 405 

symptoms often observed in consumptive subjects, to whom it is a very 
useful palliative. Cough is supposed to be especially amenable to its in- 
fluence, and hence it has become a matter of daily routine to prescribe 
the syrup as an ingredient of cough-mixtures. The infusion is an excel- 
lent stomachic tonic, and may be administered with great benefit in dys- 
pepsia and in convalescence from acute disease. 



PULSATILLA, — is the herb, collected soon after flowering, of Ane- 
mone Pulsatilla and Anemone pratensis {Pulsatilla nigricans), the Pasque- 
flower or Meadow Anemone, small herbal plants of the Ranunculacese, to 
which order Aconite also belongs. They inhabit Europe and Siberia, and 
have large, purple flowers, which are inodorous and very acrid. Pulsatilla 
contains an acrid yellow oil, which in the presence of water is gradually 
changed into Anemonin, C 15 H 12 6 , or Pulsatilla camphor, the active prin- 
ciple, and Anemonic Acid, C 15 H u 7 , a white, crystalline, tasteless and 
apparently inert substance, which may also be formed by the action of 
alkalies on Anemonin. The herb should be carefully preserved and not 
kept longer than one year. Dose, gr.j-v. 

Anemone patens or Pulsatilla nuttaliana, is an inhabitant of the United States, some- 
times has whitish-colored flowers, and was formerly one of the official sources of the drug. 

Preparations. 

The herb alone is official, but a tincture may be prepared according to the pharmaco- 
pceial directions for Tincturce Herbarum Recentium (1 part in 2 of alcohol), the dose 
of which is Tr^ Jg— ir^x, several times a day. The imported German homoeopathic tinc- 
ture contains equal parts of the expressed juice and alcohol, and is an efficient preparation ; 
but tinctures or fluid extracts made from the imported dried plant are not trustworthy. 

Anemoninum, Anemonin (Unofficial), — a volatile, unstable, camphoraceous prin- 
ciple, crystallizable, soluble in chloroform and in hot alcohol, almost insoluble in water and 
in ether. Dose, gr. \—\ in pill ; but much larger doses may be taken without inconvenience, 
as much as two grains producing no physiological symptoms in man (Schroff ). 

Physiological Action. 
Pulsatilla is an active irritant when locally used ; the oil vesicates the 
skin, and the fresh juice produces tingling and burning sensations in a part 
to which it is applied. It may excite a violent dermatitis, with a vesicular 
or pustular eruption, and inflammation and even gangrene of the entire 
limb has followed the application of the bruised root to the calf of the leg 
for rheumatism. Inhalation of its dust has produced itching of the eyes, 
colic, vomiting and diarrhoea ; and swallowing the fresh herb may cause 
severe irritation of the gastro-intestinal mucous membrane. The fresh 
juice applied to the tongue gives rise to tingling and burning sensations 
followed by numbness, symptoms very like those caused by Aconite. 
Internally administered Pulsatilla is diuretic, diaphoretic and emmen- 
agogue, and also acts as a cardiac and vascular sedative, lowering the action 
of the heart, the arterial tension and the body temperature. In overdoses 



406 PULSATILLA. 

it strongly affects the mucous membranes, and produces nausea and vom- 
iting, slimy diarrhoea, bloody urine, profuse and offensive sweats, coryza 
and cough, also vesicular and pustular eruptions on the skin and peculiar 
pains in the eyes and dimness of vision. Its primary action is that of a 
spinal irritant, secondarily it produces exhaustion and paralysis of both 
motion and sensation. Stupor, coma and convulsions may be caused by 
a toxic dose, also paralysis of the cord and medulla. Most of these effects 
have been observed on rabbits, and the pharmacology of the drug is not 
yet accurately worked out. The homoeopathic writers credit it with 
specific influence on the synovial membranes, the veins, the ears, and the 
generative apparatus of both sexes. 

Anemonin was discovered in 1771 by Storck, and has been studied to 
some extent on animals. When applied to the conjunctiva it caused 
slight inflammation thereof, and placed on the human tongue it left a 
slight burning sensation. When melted, its vapor produced intense in- 
flammation of the eyes and pricking sensations in the tongue followed by 
numbness and white patches thereon. The symptoms following its in- 
ternal administration in fatal doses were a slow and feeble pulse, slow 
respiration, lowered body temperature, frequent diarrhoea, paralysis of 
first the hind- and then the fore-legs, dyspnoea, mydriasis followed by 
myosis, stupor and death without convulsions. The absence of the latter 
is thought to be due to a paralyzing action of this principle on the cerebral 
motor centres, as in poisoning by extract of Pulsatilla convulsions are al- 
ways present. The autopsies showed congestion and oedema of the 
lungs, also marked hypersemia of the cerebral and spinal membranes, 
especially in the vicinity of the medulla. The heart walls were relaxed, 
and its cavities and the great vessels filled with dark and clotted blood, 
while the blood elsewhere was fluid. The liver, spleen, kidneys and ab- 
dominal viscera were found to be healthy. 

Antagonists and Incompatibles. 

Alcohol, Opium and Digitalis are its physiological antagonists. Tannic Acid, the 
caustic alkalies and the metallic salts are chemically incompatible with preparations con- 
taining Pulsatilla or Anemonin. 

Therapeutics. 
The ancient writers credited different species of Anemone with many 
medicinal virtues, but the modern use of this drug dates from the time of 
Baron Storck and his contemporaries (17 70-1800) who highly praised the 
Pulsatilla nigricans as a remedy for corneal opacities, cataract, paralysis, 
rheumatism, amenorrhcea, melancholia, secondary syphilis, old ulcers and 
scaly skin diseases. Later therapeutists differ widely as to the medicinal 
value of this drug, some giving it extravagant praise, and others finding 
no efficacy in it. It is quite possible that no effects whatever would be 
obtained if an old preparation or even a fresh one from the dried herb 



PULSATILLA. 407 

were employed. It has proved very efficient in acute catarrhal affections 
of the mucous membranes, especially rhinitis and conjunctivitis, in the 
early stage of the purulent ophthalmia of children and in gonorrhceal 
ophthalmia, also in subacute and chronic bronchitis of delicate persons 
accompanied with profuse mucous expectoration, and in chronic catarrh 
of the bladder. It is used with benefit in chronic nasal catarrh with a 
thick though bland discharge, also in acute and subacute inflammation of 
the middle ear and the lining of the external auditory canal so often seen 
in children, where the membrane is red and swollen, with severe pain, 
and later on a thin, acrid discharge, which is often bloody and soan be- 
comes puriform. In these affections medium doses (n^v) of the tincture 
may be given internally every four hours to adults, and a lotion composed 
of gj-ij in 5VJ of warm water may be applied to accessible parts. A similar 
use of this agent has been of decided benefit in many cutaneous affections, 
especially eczematous eruptions, syphilides, and indolent ulcers. 

In acute and chronic dyspepsia, characterized by gastric catarrh or sub- 
acute gastritis with a white-coated tongue, no taste or a greasy sensation in 
the mouth, nausea, flatulence, heart-burn, sick headache, anorexia, de- 
pression, diarrhoea, etc., Pulsatilla is a very efficient remedy, given in 
medium doses, n^v of the tincture every four hours. It does good service 
in intestinal catarrhs, shown by passive, mucous diarrhoea with little pain, 
and frequently seen in the febrile affections of childhood, especially 
measles, mumps, chicken-pox and remittent fever. 

Pulsatilla is generally credited with specific therapeutical action on the 
generative organs of both sexes. Epididymitis and orchitis have been 
often controlled and entirely dissipated by its administration in very 
small doses, a few drops of the tincture in a glass of water, of which 3J 
is given every two hours (Piffard, Sturgis). In more than 24 cases of 
acute uncomplicated epididymitis, doses of two drops of the tincture 
every two hours gave immediate relief, the patients wearing a suspensory 
bandage but not being confined to bed (Borcherin). Doses of five 
drops aggravated this disorder, while those of ^yrj every three hours 
proved curative (Piffard). In functional amenorrhoea, in scanty or 
delayed menstruation, and in suppression thereof from fright or cold, 
in ovaritis and in simple leucorrhcea with back-pains and nervous depres- 
sion, It has been found to be an excellent remedy. Dysmenorrhcea has 
been removed in several cases by two-drop doses of the tincture given 
thrice daily for several days before the menstrual epoch (Piffard). Ex- 
travagant opinions as to its virtues in the puerperal state and during par- 
turition are promulgated by the homceopathists, and their authorities on 
materia medica credit this drug with power to rectify false presentations 
during labor by causing version of the child. 

Besides the catarrhal affections of the ocular mucous membrane already 



408 PYRETHRUM QUASSIA. 

mentioned, Pulsatilla has remedial power in certain affections of the eye- 
lids. Its internal administration is said to effectually blight a stye if 
given early, but will not prevent its recurrence. It is an efficient remedy 
in recent blepharophthalmia, with profuse lachrymation and meibomian 
secretion ; and it is said to stop twitching of the lids accompanied by 
photophobia. It has been used with decided benefit in the earache of 
children and in recent catarrhal deafness, also in acute cerebral and spinal 
meningitis, eclampsia from various causes, asthma, subacute rheumatism 
of the small joints, acute rheumatic gout, left-sided clavus, hemicrania 
and infra- mammary pain. Denian used this drug with benefit in several 
nervous affections, and concludes that it is a direct sedative of nervous 
irritability, but only indirectly a sedative to the circulation. Tucker 
found it especially serviceable in the nervous headache produced by over- 
taxing the mind. An extract of the root has proved to be an efficient 
tseniafuge. 

Coughs which are loose by day, but dry and tickling in character on 
lying down at night, are greatly benefited by small doses of the tincture 
frequently repeated ; and Anemonin, in doses of gr. ss-j, has been ex- 
tremely useful in whooping-cough and coughs of irritative character. 



PYRETHRUM, Pellitory,— is the root of Anacyclus Pyrethrum, a plant of the 
nat. ord. Compositse, native of Northern Africa, but cultivated in Europe. It contains 
an alkaloid, Pyrethrine, also inulin, tannin, mucilage, etc., with a brown Resin and two 
fixed oils. Dose, as a masticatory, 3 ss-j. 

Pyrethrum Roseum, Persian Pellitory ( Unofficial), — is indigenous to Western Asia, 
and resembles Chamomile in appearance. The flower-heads are used in powder to kill 
insects, 4 grains killing a fly in a vial in 2 or 3 minutes. 

Tinctura Pyrethri, Tincture of Pyrethrum, — 20 per cent. Not used internally. 

Pellitory is an irritant sialogogue. When chewed it causes a pricking sensation in the 
tongue and fauces, with heat, acridity, pungency and a copious flow of saliva and buccal 
mucus. Large doses may cause bloody diarrhoea, tetanoid spasms, accelerated pulse, 
and profound stupor. Applied to the skin it acts as a rubefacient, the powder inhaled as 
a sternutatory. It stimulates the local nerves and vessels of the mouth and salivary glands 
by direct irritant action, but soon depresses the nerves and blunts their sensibility. 

Pellitory is chewed as a masticatory and sialogogue in paralysis of the tongue, rheu- 
matic and neuralgic affections of the head and face, and pain from carious teeth. Its 
powder has been recommended as a sternutatory in chronic catarrh of the frontal sinuses. 
As a gargle or lotion ( 3 iij to Oj) it is very useful for relaxed uvula and as a mouth- wash. 
When used for toothache a few drops of the tincture should be inserted into the cavity on 
cotton or wool. Used as a sialogogue it is an efficient agent to secure the rapid elimina- 
tion of Iodine from the system in chronic poisoning thereby. « 



QUASSIA, — is the wood of Pici-cena excelsa, a large tree of the nat. 
ord. Simarubese, indigenous to Jamaica and other West Indian islands. 
Surinam Quassia, used in Europe, is the wood of Quassia amara. Both 
varieties, as met with in the shops, are in the form of chips or raspings, 
of a yellowish-white color, inodorous but of intensely bitter taste. The 
wood is also turned into cups, which are sold under the name of quassia- 



QUERCUS ALBA. 4O9 

or bitter-cups. It contains a bitter principle, Quassin, C 31 H 42 9 , which is 
crystalline, soluble in hot alcohol and in chloroform, slowly in cold water, 
faster in alkaline or acidulated water. Dose of the powdered wood, gr. 

XX— XXX. 

Preparations. 

Extractum Quassiae, Extract of Quassia, — aqueous. Dose, gr. j-iij. 

Extractum Quassiae Fluidum, Fluid Extract of Quassia. — Dose, g ss-j. 

Tinctura Quassiae, Tincture of Quassia, — strength 10 per cent. Dose, rt\v-gj. 

Infusum Quassiae, Infusion of Quassia (Unofficial), — made with cold water %x, 
Quassia chips gj, macerated for l / z hour and strained. Or water poured into a quassia- 
cup and left standing will give a good infusion. Dose, 3j j-iij. 

Physiological Action and Therapeutics. 

Quassia is a simple bitter, having no flavor, but is intensely bitter and 
less agreeable than either Gentian or Chiretta. It is fatal to flies and fish, 
and makes an excellent anthelmintic enema against the thread-worm. A 
concentrated preparation is poisonous to rabbits and dogs, and has pro- 
duced very alarming narcotic symptoms in a four-year old child. As 
usually administered its action is that of a bitter stomachic tonic, as 
described under Calumba. 

The preparations of Quassia contain no tannin and hence may. be pre- 
scribed with salts of Iron. It is chiefly employed in atonic dyspepsia with 
pain after eating, and vomiting or regurgitation of food, also in atonic 
diarrhoea depending on indigestion or an irritable condition of the intes- 
tinal mucous membrane. It is useful in convalescence to promote the 
appetite and digestion, and with Sodium Bicarbonate in gastric vertigo. 
As an enema the strong infusion is an effective remedy for ascarides of the 
rectum. It has been used as a feeble antiperiodic, and *in hysteria its 
repulsiveness is an aid to its medicinal action. 

QUERCUS ALBA, White Oak,— is the bark of Quercus alba, 
the White-oak tree (nat. ord. Cupuliferae). It contains a variety of Tan- 
nin named Quercitannic Acid, C 28 H 2i 12 , also Pectin and a bitter principle 
named Quercin, but no Gallic Acid. There are no official preparations, but 
a decoction (g ad Oj) may be used in doses of §ss-j. 

Quercus Tinctoria, Black Oak Bark, — was formerly official. It contains a coloring 
principle Quercitrin, which stains the saliva yellow when the bark is chewed, also Quer- 
citannic Acid, etc. 

Quercus Lusitanica is the source of Galls (see under Galla). 

Oak-bark is astringent and tonic, but is seldom used internally. Its 
action and uses are those of Tannic Acid. The decoction is much used 
in country practice as a cheap astringent application for injection in 
ieucorrhcea, prolapsus ani, hemorrhoids, etc., and as a gargle in faucial 
inflammation and prolapsed uvula. It has also been used as an injection 



410 QUILLAJA RESINA. 

into dropsical cysts, and as a lotion for flabby ulcers and suppurating 
wounds. The powdered bark as a poultice has proved an excellent appli- 
cation in gangrene, and in finely pulverized state it is a useful ingredient 
of tooth-powders. A concentrated fluid extract is used in the Heaton- 
Warren operation for the radical cure of hernia, by injection into the 
tissues around the margin of the ring, with the object of exciting inflam- 
mation and occlusion of the opening. 



QUILLAJA, Soap Bark, — is the inner bark of Quillaja Saponaria, a tree of the 
nat. ord. Rosaceae, indigenous to Peru and Chili. It contains Calcium Sulphate crystals, 
starch, and the glucoside, Saponin, C 32 H 54 18 , a white, amorphous, sternutatory powder, 
soluble in water and in dilute alcohol. The Infusion of Quillaja foams like soap-water. 
The only official preparation is the tincture. 

Tinctura Quillaja, Tincture of Quillaja, — 20 per cent. Dose, rt\v-xxx. 

Quillaja in powder is sternutatory and causes the water in which it is macerated to 
froth, making emulsions of oils, and being used instead of soap for washing purposes in 
various affections of the skin, and to stimulate the growth of the hair in alopecia. Its 
properties are due to the glucoside Saponin, which is found also in Senega and in a 
number of other plants, and is a violent irritant of the respiratory passages, a local anaes- 
thetic, an antipyretic, a powerful paralyzant of the heart and respiration, and a poison to 
the voluntary muscles. It has not been made use of in practical medicine. 

A decoction of the bark (5 to 200) has been employed in doses of % j-ij according to 
age, as a substitute for Senega in the treatment of diseases of the respiratory organs 
where a pleasant expectorant is indicated. Its expectorant properties are well established, 
and children take it readily. It does not provoke diarrhoea or vomiting, and has a sweet- 
ish, agreeable taste. 



RESINA, Resin {Colophony), C 44 H 62 4 ,— is the residue left after 
distilling off the volatile oil from Turpentine. It is a transparent, amber- 
colored substance, hard and brittle, with a glossy and shallow conchoidal 
fracture, and a faintly terebinthinate odor and taste, soluble in alcohol, 
ether, fixed or volatile oils, and in its own weight t>f oil of turpentine. 
Chemically it is considered as the Anhydride of Abietic Acid, C 44 H 64 5 , into 
which acid it is converted by agitation with warm diluted alcohol. Silvic, 
Pinic, and Palmaric Acids are decomposition products, not constituents 
of resin as was formerly taught. 

For the definition of a Resin see ante, page 22, also the title Resins, in Part II. 
Other official resins are Resina Copaiba, Resina Jalaps, Resina Podophylli and 
Resina Scammonii, which are severally described under the titles of the plants forming 
their respective sources. 

Preparations. 

Ceratum Resinae, Resin Cerate, Basilicon Ointi?ient, — consists of Resin 35, Yellow 
Wax 15, and Lard 50 parts. It forms 65 per cent, of Turpentine Liniment. 

Emplastrum Resinae, Resin Plaster, Adhesive Plaster, consists of Resin 14, Lead 
Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of surgery, and an 
ingredient of the official Arnica, Belladonna and Capsicum Plasters. 

Resin itself is an ingredient of Cantharides Cerate. 

Resin gives consistence and adhesiveness to plasters and cerates, and 
generally acts as a mild local stimulant, but the writer has seen persons 



RESORCINUM. 4 1 I 

with so susceptible a skin that the ordinary adhesive plaster would pro- 
duce on them a high degree of cutaneous irritation. It is never employed 
internally, but in chronic bronchial catarrh the fumes from boiling resin 
are inhaled with considerable advantage. Resin Cerate is one of the most 
commonly used applications to promote the healing of indolent ulcers, 
blistered surfaces, burns, scalds, chilblains, etc. 

RESORCINUM, Resorcin (Resorcinol, Metadioxy benzol), C 6 H 4 - 
(OH) 2 — is a diatomic phenol, isomeric with Pyrocatechin and Hydro- 
quinone, obtained by fusing certain resins with a caustic alkali, but best 
prepared by fusing Potassium Benzol-disulphonate with caustic Potassa, 
the salt being 'decomposed into Potassium Sulphite and Resorcin. It 
crystallizes in colorless, rhombic prisms or plates of neutral reaction, 
odorless, and of sweetish, acrid taste, very soluble in water, also in alco- 
hol, ether, etc. Dose, gr.v-xv ; — as an antipyretic gss-j, not repeated for 
several hours, or gr.v every 2 hours. 

Physiological Action. 
Resorcin is closely allied to Carbolic Acid, but possesses an advantage 
over the latter in that it is odorless, more soluble and almost non-irritant. 
It is equally powerful as an antiseptic and antiferment, arresting decom- 
position and destroying low organisms. Injected beneath the integument 
in solution it produces very little irritation, and never causes inflammation 
or abscess. Vesication results from its application to the mucous mem- 
brane. Internally a 30- to 60-grain dose causes a sense of heat, discom- 
fort and oppression, followed by profuse perspiration and languor ; if fever 
be present the temperature of the body is lowered several degrees, but 
rises again after a rigor in from 2 to 4 hours. Larger doses (150 grains) 
have produced deafness, dizziness, salivation, confused vision, vertigo, 
unconsciousness, general clonic convulsions, and tetanic rigidity of the 
muscles of the neck, with no decline of temperature in feverless subjects. 
Toxic doses (gr. xv to each 35 ozs. of weight) cause in animals trembling 
succeeded by epileptiform convulsions, which increase in severity and 
then decline ; the respiration is quickened and enfeebled, the heart's 
action becomes rapid, weak, and irregular, and death results from paralysis 
of respiration, the drug paralyzing the motor tracts in the spinal cord, 
but not affecting the general sensibility. It is eliminated chiefly by the 
urine, which it colors a bluish-violet hue, and with great rapidity, about 
one hour serving for its excretion. The best test of its presence is the 
solution of the Perchloride of Iron, which produces with it a dark-violet, 

almost black color. 

Antagonists. 

Atropine and other cardiac and respiratory stimulants, cerebral excitants, and agents 
which raise the arterial tension, are physiologically antagonistic. 



412 RHAMNUS PURSHIANA. 

Therapeutics. 

Resorcin is employed as an antipyretic and antiseptic, being preferred 
to carbolic acid for internal and subcutaneous use. A 3 per cent, solu- 
tion gives good results in stomach complaints, as gastralgia, gastric catarrh, 
gastritis, gastric ulcer and cancer, fermentative indigestion, etc. In ulcer 
of the stomach its analgesic property is so marked that the stomach is 
enabled to tolerate food. It has given very great satisfaction in the treat- 
ment of diarrhoea of children ; and is highly recommended by some 
observers in intermittent fevers and malarial diseases generally, while 
others have been much disappointed with its action therein. As an anti- 
pyretic it has been used in erysipelas, puerperal fever, septicaemia, and 
diphtheria, and in the latter disease it has been locally employed in crys- 
tals with decided benefit. As a local application to tuberculous and 
other ulcerations of the larynx, in diphtheria, tonsillitis, pharyngitis, 
chronic rhinitis, etc., strong, even supersaturated solutions are employed 
with increasing satisfaction, being highly efficient and quite painless. 
Applied to the peri-laryngeal mucous membrane, it has proved very use- 
ful in the treatment and prophylaxis of pertussis. A 2 per cent, solution 
has given great satisfaction as a local antiseptic application to wounds, 
parasitic skin diseases, cystitis, gonorrhoea, anthrax, and syphilitic sores 
of unhealthy character. As spray a similar solution is well applied to 
catarrhal or ulcerative affections of the respiratory passages. As a caustic 
it may be applied in undiluted form to chancres, papillomata, carbuncles, 
etc. A saturated ethereal solution is a good application where the caustic 
action of the drug is required. 

A paste of equal parts of Resorcin and Zinc Oxide has been lately 
applied to the face to promote peeling of the skin in the treatment of acne 
rosacea. In three or four days the skin becomes like parchment, when 
the application must be stopped, in order to avoid the cracking of the 
skin, which begins at that stage. A dressing of gelatin, glycerin, zinc 
oxide and hot water is then applied, covered with cotton wool. In a few 
more days the dressing comes off, bringing the epidermis with it. Some 
few dangerous and unfavorable results have followed this method, but 
a number of very satisfactory cases are reported. Freckles and other 
superficial spots on the skin may be removed by the same treatment. 



RHAMNUS PURSHIANA, Cascara Sagrada [Chittem Bark, Sacred Bark) — 
is the bark of Rhamnus Purshiana, the California Buckthorn, a small tree of the nat. ord. 
Rhamneae, growing on the Pacific coast of the United States. It contains a Volatile Oil, 
a neutral crystalline substance, several Resins, with tannic, malic and oxalic acids. It has 
been found very serviceable in the treatment of chronic gout and chronic constipation, 
given in gradually diminished doses. It produces large, soft and painless evacuations, 
and the bowels are said to act naturally and regularly after its disuse. 

Another species of the same order, Rhamnus Frangula, is official under the title Fran- 
gula, which see. 



RHEUM. 413 

Extractum Rhamni Purshianae Fluidum, Fluid Extract of Cascara Sagrada, — 
is made with diluted alcohol. Dose, % ss-jss, two or three times a day. 

Cascara Cordial is a trade preparation, intended as a remedy for constipation, dys- 
pepsia and hemorrhoids, and as a pleasant excipient for nauseous and bitter drugs. A 
similar preparation may be made by combining the fluid extract with the official Elixir 
Aromaticum in the proportion of 3 j to £ij, of which teaspoonful doses or more may be 
administered. 



RHEUM, Rhubarb, — is the root of Rheum officinale, a perennial 
plant of the nat. ord. Polygonacese, a native of Thibet. There are many 
other undetermined species of Rheum, several of which are cultivated in 
Europe and America, their leaf-stalks being used as a fruit. The com- 
monly accepted medicinal Rhubarb is the Chinese variety, and is imported 
from Shanghai and Canton. It imparts its virtues to water and alcohol, 
and contains several substances of greater or less activity, the least im- 
portant being Phceoretin, C 32 H 32 O u , the rhubarb-resin, — Erythroretin, 
C 38 H 36 O u , and Chrysophan, H 27 O 30 C u , the latter of which is split by acids 
into sugar and Chrysophanic Acid. (See Chrysarobinum.) It also con- 
tains Rheo-tannic Acid, C 52 H 52 28 , Rheumic Acid, C 40 H 32 Oi 8 , and probably 
a principle which is identical with Cathartic Acid (see Senna), on which 
its purgative activity may depend. Dose of Rhubarb as a stomachic, 
gr. j-v ; as a purgative, gr. x-xxx. 

Preparations. 

Extractum Rhei, Extract of Rhubarb. — Dose, gr. j-x. 

Extractum Rhei Fluidum, Fluid Extract of Rhubarb. — Dose, rr\x-3J. 

Pilulae Rhei, Pills of Rhubarb, — are composed of Rhubarb 60, Soap 6, Water to 
100 ; each pill containing about 3 grains of powdered Rhubarb. Dose, j— v pills. 

Pilulae Rhei Compositae, Compound Pills of Rhubarb, — each pill contains of Rhu- 
barb about 2 grains, Aloes 1*4, Myrrh I, Oil of Peppermint j 1 ^ grain. Dose, ij-v pills. 
A safe and efficient laxative. 

Tinctura Rhei, Tincture of Rhubarb, — has of Rhubarb 10, Cardamom 2, Glycerin 
10, Alcohol and Water to 100. Dose, 3 j-iv. 

Tinctura Rhei Aromatica, Aromatic Tincture of Rhubarb, — has of Rhubarb 20, 
Cinnamon 4, Cloves 4, Nutmeg 2, Glycerin 10, Alcohol, Water and Diluted Alcohol to 
100. Dose, 3 j-iv. 

Tinctura Rhei Dulcis, Sweet Tincture of Rhubarb, — has of Rhubarb 10, Glycyr- 
rhiza 4, Anise 4, Cardamom I, Glycerin 10, Alcohol, Water and Diluted Water to 100. 
Dose, Jss-ij. 

Syrupus Rhei, Syrup of Rhubarb , — has of the Fluid Extract 10, Spirit of Cinnamon 
0.4, Potassium Carbonate I, Glycerin 5, Water 5, Syrup to 100. Dose, for an infant, 5 j ; 
for older children, 3; ij-iv. 

Syrupus Rhei Aromaticus, Aromatic Syrup of Rhubarb, — has of the Aromatic 
Tincture 15, Syrup 85. Dose, as the Syrup. 

Pulvis Rhei Compositus, Compound Powder of Rhubarb , — has of Rhubarb 25, 
Magnesia 65, Ginger 10. Dose, a teaspoonful. 

Mistura Rhei et Sodae, Mixture of Rhubarb and Soda, — has of Sodium Bicarb. 
3><,Fluid Extract of Rhubarb 1%, Fluid Extract of Ipecac y^, Glycerin 35, Spirit of 
Peppermint 1]4, Water to 100. Dose, 5jij-^ij. 



414 rhinacanthus rhus aromatica. 

Physiological Action and Therapeutics. 

Rhubarb is classed among the tonic-astringent and resin-bearing pur- 
gatives, which increase the circulation of the glandular appendages of the 
intestinal canal, and stimulate the muscular layer of the bowel. In small 
doses (gr. j-v) its action is that of a stomachic and intestinal astringent, 
the influence of the bitter principle and the rheo-tannic acid probably 
predominating. In larger doses (gr. xxx-lx), its cathartic action prevails, 
producing in 6 to 8 hours copious yellow, pultaceous stools, with some 
griping and considerable hepatic stimulation. After the cathartic prin- 
ciple is expelled, the astringent quality of its tannin asserts itself and 
constipation is likely to result. The yellow color of the stools is partly 
due to the rhubarb pigment and partly to excess of bile, the drug having 
marked cholagogue properties, in all probability due to its resin, Phaeo- 
retin. Its pigment stains the milk, urine and sweat, the milk acquiring a 
bitter taste and purgative properties. The cathartic action of Rhubarb 
may be obtained from its application locally to ulcers, by being rubbed 
into the moist skin, or applied to the abdomen as a poultice. 

Rhubarb is highly esteemed as a cathartic for children, from the mild- 
ness of its action, as, though occasionally producing quite severe griping, 
it never inflames the gastro-enteric mucous membrane. The tonic and 
astringent action following its catharsis makes it a valuable agent in 
diarrhoeas due to the presence of irritating matter in the bowel, and to 
correct atonic indigestion accompanied by diarrhoea. For hemorrhoids 
with constipation its gentle action makes it peculiarly suitable, its astrin- 
gent after-effect being entirely overcome by 2 to 4 drachm doses of olive 
oil nightly. It may be combined with a mercurial or with Sodium Bicar- 
bonate, the latter being supposed to overcome its astringent action and to 
disguise its taste in some degree. In small doses the tincture is a very 
efficient stomachic tonic, improving appetite, increasing the flow of the 
gastric juice, assisting digestion, and promoting the action of the liver 
without producing any cathartic results. The preparations most in use 
for children are the Aromatic Syrup and the Mistura Rhei et Sodse. 



RHINACANTHUS (Unofficial), — the leaves and root of Rhinacanthus communis, 
a shrub of the nat. ord. Acanthaceae, indigenous to India and China. The root contains 
a quinone-like body named Rhinacanthin , C u H ]8 4 , which forms with alkalies intensely 
red compounds which are decomposed by benzin. It is known in China as Hong-Pang- 
Chong, and is employed as a local remedy for ringworm and parasitic skin diseases, the 
leaves being bruised and mixed with lime-juice. Used internally a tincture of the root 
has some reputation as a feeble tonic and antiperiodic. The same preparation is applied 
locally in chronic eczema, tinea and psoriasis. 



RHUS AROMATICA, Sweet Sumach (Unofficial),— is an indigenous shrub of the 
nat. ord. Terebinthaceee, growing about 5 feet high, and having yellow flowers in spikes. 
The root-bark contains a volatile oil, several resins, fat, tannin, etc. A fluid extract is 



RHUS GLABRA RHUS TOXICODENDRON. 415 

prepared from the bark of the root according to the general pharmacopceial rule, and 
may be given in doses of TTLx-xxx, every 2 or 3 hours. 

Rhus Aromatica has astringent properties, and seems to possess a selective action upon 
the urinary tract. Its action is not yet clearly made out. Therapeutically it has been 
used with advantage in cystitis, night-sweats, hematuria, menorrhagia, diabetes insipidus, 
diarrhoea and dysentery. As a remedy for incontinence of urine in children it has 
attracted considerable attention, having been extremely efficient in doses of rr^xv of a 
good fluid extract four times daily, administered in glycerin and water, or any other suit- 
able excipient. It is reported to be equally effective in hysterical enuresis of adults, but 
larger doses (rr^xx-xxx several times a day) are required. Diabetes insipidus is remark- 
ably benefited by its continued use, and even in diabetes mellitus its employment has 
occasionally seemed to have been followed by curative results. 



RHUS GLABRA, Smooth Sumach, — is the fruit of Rhus glabra, an indigenous 
shrub of the nat. ord. Anacardiea: , growing in rocky and barren soil to a height of 8 to 
12 feet. The leaves and bark have an astringent and bitter taste, and are also used 
medicinally. It contains tannin, coloring matter, potassium and calcium malates. 

Extractum Rhois Glabrae Fluidum, Fluid Extract of Rhus Glabra. — Dose, gj-ij. 

Sumach-berries form a useful acidulous and astringent drink or gargle in catarrhal 
pharyngitis, stomatitis, aphthae, etc. An infusion ( gj to the pint) or the official fluid ex- 
tract may be used as a wash and dressing for ulcers and wounds. Internally they are 
useful remedies for mild catarrhal affections of the stomach and bowels. 



RHUS TOXICODENDRON, Poison Ivy,— is the fresh leaves 
of Rhus radicans, a plant of the nat. ord. Anacardiea, indigenous to 
Canada and the greater part of the eastern United States. This climbing 
plant is not by itself a distinct species, but a variety of the erect shrub, 
Rhus Toxicodendron, the Poison Oak, formerly official as a source of the 
drug ; both of which when wounded exuding a poisonous, acrid, milky 
juice which turns dark on exposure. The poisonous principle of the plant 
is Toxicodendric Acid, which is volatile, and also exists in Rhus venenata 
or Swamp sumach, Rhus pumila, and Rhus diversiloba, the former of which 
is probably the most poisonous of the four. The dose of the leaves is 
generally placed at gr. j-iv, but if old and dry they will generally prove 
to be inert. There are no official preparations. 

Tinctura Rhoi's Toxicodendri, Tincture of Rhus Toxicodendron (Unofficial), — may 
be prepared according to the formula of the Pharmacopoeia for Tincturae Herbarum 
Recentium (Tinctures of Fresh Herbs), one part of the fresh leaves to two of Alcohol. 
Dose, r^ T V-n\ij. 

Extractum Rho'is Toxicodendri, Extract of Rhus Toxicodendron, — has been used 
in France in large doses. It is probably inert. 

Physiological Action. 
The effects of Rhus Toxicodendron upon the skin are familiar to all 
who have suffered from contact with poison-oak or ivy. Some persons 
are so susceptible to the poison that the exhalations from the plant will 
produce on them its characteristic action. Others are apparently insus- 
ceptible to its influence, and can with impunity rub the juice into their 
skin, or even chew its leaves. 



4l6 RHUS TOXICODENDRON. 

The action of the plant when locally applied is that of a cutaneous 
irritant, causing redness and swelling of the affected parts, with a vesicu- 
lar eruption and intolerable itching, which may spread rapidly over the 
surface of the body and extend to the mucous membranes, producing 
conjunctivitis, redness and tumefaction of the mouth and throat, thirst, 
cough, nausea and vomiting, vertigo, stupefaction, etc. Colicky pains 
are experienced in the abdomen, are worse at night and are aggravated 
by food or drink. Diarrhoea may occur, with tenesmus and bloody 
stools, also diuresis, bloody urine, or even complete retention. Fever 
with delirium is frequently present, and may be typhoid in character, or 
intermittent with profuse perspiration. Pains of rheumatoid type are ex- 
perienced throughout the body, but particularly in the joints and lumbar 
region, apparently intensified by rest and heat. The fibrous structures 
are evidently the seat of its selective action, and a sensation of numb- 
ness in the lower extremities is frequently experienced. Similar phe- 
nomena attend its internal administration, but fatal results have not 
followed in any case of poisoning recorded. The effects of the poison 
usually last from ten to fifteen days, and are then followed by desquama- 
tion of the epidermis. 

Antidotes and Antagonists. 

Cocaine Hydrochlorate, in 4 to 8 per cent, solution, is the best lotion to relieve the in- 
tolerable itching and burning. Grindelia Robusta makes one of the best local applica- 
tions, and a solution of Mercuric Chloride is also a very serviceable lotion, also Lime- 
water with Linseed-oil, solution of Plumbum Acetate, solution of Chlorinated Soda, and 
Alum-curd are all very useful. Rest, low diet and laxatives are appropriate, and Opium 
or strong black coffee to relieve the irritability of the nervous system. 

Therapeutics. 
Rhus Toxicodendron was used medicinally by Dufresnoy in France and 
by Alderson in England about the close of the eighteenth century. The 
attention of the former was attracted to it by the accidental poisoning of 
a student who was afflicted with chronic eczema, which disappeared on 
the subsidence of the Rhus symptoms. It is a favorite remedy with the 
so-called homceopathists, who ascribe to it extraordinary virtues in acute 
cutaneous affections of vesicular type, subacute and chronic rheumatism, 
vesicular erysipelas and typhoid fever. Among regular authorities it meets 
with very little favor as a remedial agent, but Dr. Phillips recommends 
it strongly in rheumatic affections of the fibrous tissues, erythema and ery- 
sipelas, eczema, herpes zoster and pemphigus. Dr. Piffard corroborates 
these opinions of its therapeutical value, and states that when rheumatic 
pain is " worse at night " prompt relief may be expected from Rhus. It 
was used by Dufresnoy in paralyses with a certain degree of success, and 
Eberle reports a case of paralysis in which it proved curative. It is ad- 
mitted by many observers to be a useful remedy in paralytic affections of 
the lower extremities depending on a rheumatic diathesis, or resulting 



RTCINI OLEUM. 417 

from exposure to cold and wet. As an external application it is efficacious 
in sprains and other affections of ligaments and tendons, also to extensive 
but superficial burns, stings of insects, and chilblains. For these affections 
a lotion of about ^ss of the tincture to a pint of water is usually employed. 



RICINI OLEUM, Castor Oil, — is a fixed oil expressed from the 
seeds of Ricinus communis, a tree of the nat. ord. Euphorbiaceae, indigen- 
ous to India, but extensively cultivated in the United States. The oil is 
an almost colorless, transparent, viscid liquid, of faint odor, bland or 
slightly acrid taste, neutral reaction, soluble in an equal weight of alcohol, 
and congealing at about — o. 4 F. It consists mainly of Ricinolein, the 
glyceride of ricinoleic acid, also palmitin, stearin and myristin in small 
quantities, and an acrid principle. The seeds contain a highly toxic 
ferment or phytalbumose named Ricin, and an alkaloid, Ricinine, which 
seems to be inert. 

Castor Oil is an ingredient of Collodium Flexile in the proportion of 3 per cent., also 
of Linimentum Sinapis Compositum, 15 per cent., and of Piluke Antimonii Compositae. 

Physiological Action. 
Used externally pure Castor Oil is perfectly bland. Internally admin- 
istered it is non-irritant until it reaches the duodenum, where it is decom- 
posed by the pancreatic juice, setting free the Ricinoleic Acid, which 
produces purgation by a mildly irritant action on the bowel, stimulating 
the intestinal glands and muscular coat, but not the liver. It is a simple 
purgative, acting in four to six hours, producing one or more liquid stools 
without pain or tenesmus, and followed by a sedative effect on the intes- 
tines. The leaves are believed to possess galactagogue properties when 
locally applied as a poultice to the breasts. Ricinoleic Acid enters the 
blood and the tissues, and is excreted with the various secretions of the 
body, imparting its purgative qualities to the milk of the nursing mother. 
Ricin, given either hypodermically or by the mouth, produces violent 
gastro- enteritis, nephritis and cystitis, also inflammation of the mucous 
lining of the biliary duct. To it is ascribed the jaundice and anuria ob- 
served in some cases of poisoning by castor-oil seeds. 

Therapeutics. 
Castor Oil is one of the best of the simple purgatives, and is used 
where a free evacuation of the bowels is alone indicated, or when only a 
laxative action is desired, as in the constipation of typhoid fever, in 
pregnancy and post-partum conditions, diarrhoea from the presence of 
irritating matter in the bowels, and after operations on the abdominal or 
pelvic organs. It is often used as a purgative for children, also for the 
aged and infirm. Infants bear a larger relative dose than adults, prob- 
27 



41 o ROSA. 

ably from their ability to digest a larger quantity of what is taken. It is 
employed with great benefit as a laxative in irritation or inflammation of 
the bowels, in hemorrhoids, inflammatory or spasmodic affections of the 
genito-urinary organs, nephritis or cystitis, gonorrhoea, calculi, and 
stricture of the urethra and rectum. In cases of dysentery 10 to 20 drops 
of Laudanum may be added to each dose to counteract the pain, tenesmus 
and exhaustion resulting from the frequency of the passages. If much 
depression exists, as shown by lowered arterial tension and a dry, glazed 
tongue, 5 drops of Oil of Turpentine should also be added. 

Castor Oil is much used in the puerperal state and greatly abused. 
There is considerable evidence in support of the charge that it induces 
hemorrhoids by congesting the rectal vessels. Its purgative action is 
milder in proportion to the purity of the sample employed. Externally, 
the pure oil is employed as a local sedative and protective, as in neutral- 
izing the effects of lime upon the conjunctiva. The leaves of the castor- 
oil plant are used to promote the secretion of milk. They may be applied 
to the breast in poultice, and a decoction or fluid extract given internally 
at the same time. 

A dm in istration . 

The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. Emul- 
sions are not a success. Capsules containing the requisite dose are easily obtained. In 
the absence of these the best way to administer a dose of oil is to smear the sides of a 
clean wineglass with very thick cream, then to pour in the oil, covering it with a little 
more cream. A teaspoonful of cream being then taken into the patient's mouth, he is 
directed to bolt the dose at one gulp. Some prefer it floated on orange-juice, strong 
coffee, gruel or wine. One of the best vehicles for it is foaming beer. Glycerin increases 
its purgative power, when given conjointly. 



ROSA, Rose, — is represented in pharmacy by the petals of two 
species and the volatile oil from a third. 

Rosa Centifolia, Pale Rose, — is the petals of Rosa centifolia, the 
Cabbage Rose, a well-known and cultivated shrub of the nat. ord. Rosa- 
cese. The odor is due to a minute quantity of a volatile oil, besides 
which the petals contain tannin, fat, resin, sugar, etc. If it is desired to 
keep Pale Rose fresh for any length of time, it should be mixed with 
one-half its weight of Sodium Chloride and pressed into a jar, which 
should be kept in a cool place, well closed. 

Rosa Damascena, Damask Rose, — is the source of the official Oil 
of Rose, which is distilled from the fresh flowers. This variety of the 
nat. ord. Rosacese is largely cultivated in Roumelia, on the southern 
slope of the Balkan mountains, from which section comes nearly all of 
the oil supplied to commerce. 

Rosa Gallica, Red Rose, — is the petals of Rosa gallica, collected 
before expanding. They contain an aromatic oil, Tannic and Gallic 
Acids, Quercitrin, coloring matter, salts, etc. 



ROSMARINUS. 419 

Preparations of Rosa Damascena. 

Oleum Rosae, Oil of Rose, Attar of Rose, — is a volatile oil distilled from the fresh 
flowers of Rosa damascena. It is a pale-yellowish, transparent liquid, having a strong 
odor of rose, a sweetish taste and a slightly acid reaction, but slightly soluble in alcohol. 
It consists of an aromatic oxygenated elaeopten and an odorless solid stearopten (rose- 
camphor). Being very expensive it is much adulterated with other volatile oils. It is 
used chiefly for perfuming cosmetic preparations, ointments and lotions, and as the basis 
of the following : 

Aqua Rosae Fortior, Stronger Rose Water, Triple Rose Water, — is water saturated 
with the volatile oil of Rose petals, obtained as a by-product in the distillation of Oil of 
Rose. An agreeable excipient and flavoring agent. Dose, 3ss-j. 

Aqua Rosae, Rose Water, — consists of equal volumes of the preceding and distilled 
water, mixed together immediately before use. It is an ingredient of Mistura Ferri Com- 
posita. Dose, gj-ij. 

Unguentum Aquas Rosae, Ointment of Rose Water, Cold Cream, — has of Stronger 
Rose Water 19, Expressed Oil of Almond 60, Spermaceti 12^, White Wax 12, and 
Sodium Borate l / z . For local use. 

Preparations of Rosa Gallic a. 

Extractum Rosae Fluidum, Fluid Extract of Rose, — prepared with glycerin and 
diluted alcohol. Dose, TT\ V- 3J- 

Confectio Rosae, Confection of Rose, — has of Red Rose 8, Sugar 64, Honey 12, 
Stronger Rose Water 16, beaten together into a mass, which is used as a basis for pills. 
Dose, gr. x-^j. 

Mel Rosae, Honey of Rose, — has of the Fluid Extract 12, and Clarified Honey to 
100. Dose, ^j-ij. 

Syrupus Rosae, Syrup of Rose, — has of the Fluid Extract 12^, with Syrup 87^. 
Dose, 3J-ij, for flavoring. 

Red Rose is an ingredient of Pil. Aloes et Mastiches. 

Pale Rose petals are only used for odoriferous purposes. Rose Water 
has no strictly medicinal properties, but is an agreeable excipient for 
lotions, collyria and urethral injections. The ointment, commonly termed 
" cold cream," is a pleasant emollient and protective, generally used for 
chapped hands and other superficial skin affections. Red Rose is classed 
, among the astringents, as it contains an appreciable amount of tannic 
and gallic acids. A Compound Infusion, containing sugar and dilute 
sulphuric acid, was formerly official, and is used as an agreeable gargle 
for the throat and mouth in inflamed and ulcerated conditions. The chief 
uses of the rose preparations, however, are as vehicles for other agents, or 
to impart flavor and odor to extemporaneous prescriptions. 



ROSMARINUS, Rosemary, — the source of the official Oil of Rosemary, is the 
leaves of Rosmarinus officinalis, a shrub of the nat. ord. Labiatae, cultivated in gardens 
for the sake of its large, pale-blue flowers. They are pungently aromatic and somewhat 
camphoraceous, and contain the volatile oil, a little tannin, some resin and a bitter 
principle. 

Oleum Rosmarini, Oil of Rosemary , — is the volatile oil distilled from Rosemary, a 
colorless or yellowish liquid, having the characteristic odor of the plant, a camphoraceous 
taste, and is readily soluble in alcohol. It consists of a terpene, isomeric with Turpen- 
tine, C 10 H 16 , and a body allied to camphor. It is an ingredient of Linim. Saponis, Spir- 
itus Odoratus and Tinct. Lavandulae Comp. Dose, TT\J-v. 

Rosemary was formerly considered emmenagogue, galactagogue and diuretic, but is 



420 RUBIDIUM RUBUS RUMEX. 

now never employed in substance. Its Oil is somewhat stimulant and carminative, and 
in excessive quantity has caused death. It is chiefly employed as an external stimulant 
in liniments and lotions, especially to the scalp in alopecia, where it is supposed to increase 
the blood-supply to the hair bulbs, and is usually combined with cantharides. Inhaled 
it reduces the body temperature and gives the urine a violaceous odor. 

RUBIDIUM, Rubidium, Rb, (Unofficial), — is one of the rarer metals, belonging 
to the group of alkaline metals of which potassium and sodium are typical. It has a 
molecular weight of 85, that of Potassium being 39, and that of Sodium 23. Its salts are 
supposed to act more promptly and efficiently than those of the latter, upon the theory 
that the physiological action of salts is as much a periodic function of the atomic weights 
of their elements as are their physical and chemical characters. The principal salt of 
Rubidium is — 

Rubidii Iodidum, Rubidium Iodide, Rb I, (Unofficial), — occurs in white, non-efflor- 
escent crystals, odorless, of milder taste and greater solubility in water than Potassium 
Iodide. Dose, gr.v-xxx or more. 

Rubidium Iodide has generally the same physiological and therapeutical action as 
Potassium Iodide, but has a far less toxic action upon the cardiac muscle. It is well borne 
by the stomach, does not disturb the appetite or give rise to digestive derangements, and 
does not affect the circulation. It rarely produces iodism, and even when the iododerma 
and catarrh were present as a result of the administration of potassium iodide, the change 
to the rubidium salt has resulted in decrease of these symptoms. It has been employed 
in lieu of the potassium salt, with greater efficiency and less disturbance, in most of the 
affections for which the iodides are indicated. In eye affections requiring an absorptive 
treatment it is employed internally and externally as a 5 per cent, vaselin ointment or in 
the form of 5 per cent, drops (gj in 3 ijss). 

RUBUS, Blackberry-Bark, — is the bark of the root of Rubus mllosus, the common 
Blackberry, Rubus canadensis , the Dewberry, and Rubus trivialis, the Bush Blackberry 
of the Southern States, all of the nat. ord. Rosacea?. It contains over 10 per cent, of 
Tannin. Dose, gr. xv-xxx. 

Extractum Rubi Fluidum, Fluid Extract of Rubus. — Dose, n\x-3j. 

Syrupus Rubi, Syrup of Ruhis, — has of the Fluid Extract 25, Syrup 75. Dose, 

Syrupus Rubi Aromaticus, Aromatic Syrup of Rubus (Unofficial), — contains Rubus, 
Cinnamon, Cloves and Mace. Each fl J has 30 grains of the drug. Dose, 3J-^j. 

Blackberry-bark derives its virtues from its tannin. It is strongly astringent, and may 
be used in decoction, wine or the above-named preparations. It is highly esteemed in 
summer and infantile diarrhoeas. 



RUBUS IDjEUS, Raspberry,— is the fruit of Rubus idccus, the Raspberry bush, 
nat. ord. Rosacea. It contains sugar, malic and citric acids, proteids, pectin, etc., also a 
Volatile Oil consisting of compound ethers, to which the odor is due. Its sole use in 
medicine is to prepare a pleasantly flavored syrup. The closely allied, light-red fruit of 
Rubus strigosus, the wild Red Raspberry, and the purplish-black fruit of Rubzis occident- 
alis, the Thimble-berry, may be employed in place of the above. 

Syrupus Rubi Idaei, Raspberry Syrup, — has of Raspberries and Sugar any convenient 
quantity, boiled (but not in tinned vessels) and strained. Dose, ad libitum. It has a 
bright-red color, a fruity, agreeable odor, a pleasant, acidulous taste and an acid reaction. 
It has no special medicinal virtues, but forms an agreeable flavoring for mixtures, and 
mixed with water a pleasant drink in febrile conditions. 

The leaves of the wild Red Raspberry [Rubus strigoszts) are considerably astringent, 
and in infusion, ^j to the pint, are a popular domestic remedy for diarrhoeas. 

RUMEX, Yellow Dock, — is the root of Rumex crispus, and of some other species of 
Rumex, plants of the nat. ord. Polygonaceae, growing as common weeds along roadsides. 
Several species of Rumex have sour leaves, and are popularly called Sorrel to distinguish 



RUTA. 421 

them from the others which are called Dock. The official root contains tannin, mucilage, 
starch, calcium oxalate, and two principles named Rumicin and Lapathin, which are 
shown to be identical with Chrysophanic Acid. Its constituents are nearly identical with 
those of Rhubarb. Dose, gr. xv-gj. 

Extractum Rumicis Fluidum, Fluid Extract of Rumex. — Dose, TT^xv-^j. 

Decoctum Rumicis, Decoction of Rumex (Unofficial), — 3 ij of the fresh root, or ^j 
of the dry root to Oj of water. Dose, § j-ij. 

Rumex is astringent, tonic and laxative. It has also been considered alterative and 
anti-scorbutic. It has been employed chiefly in chronic cutaneous disorders, glandular 
swellings, and other symptoms of the strumous diathesis. It seems to possess a selective 
action on the mucous membrane of the larynx, and in many cases of laryngeal irritation 
with catarrhal symptoms, dry, violent cough, and a sense of soreness behind the sternum, 
it will give prompt relief. The Rumex Acetosa has a popular reputation as a local appli- 
cation for cancer. 



RUTA, Rue (Unofficial), — is the source of Oil of Rue, which is dis- 
tilled from the leaves of Ruta graveofens, an herbaceous perennial of the 
nat. ord. Rutaceae, growing wild throughout Southern Europe, and fre- 
quently cultivated in gardens for its yellowish flowers. The fresh leaves 
only should be used, and as drying impairs their qualities the oil is gen- 
erally employed. 

Oleum Rutae, Oil of Rue (Unofficial), — the volatile oil distilled from Ruta graveo- 
lens ; a colorless, or greenish-yellow liquid, of disagreeable but aromatic odor, pungent 
acrid taste and neutral reaction, soluble in an equal weight of alcohol. Dose, rr\j-v, in 
mucilage. 

Physiological Action and Therapeutics. 

Rue is an active irritant, locally a rubefacient, the oil producing heat, 
inflammation and vesication. In the ordinary dose it causes a sensation 
of heat in the stomach and skin, increases the action of the heart, and 
stimulates the bronchial, cutaneous and renal secretions, the odor of the 
oil being distinctly perceptible in the breath, sweat and urine. After 
toxic doses of the oil violent gastro-enteritis results, with extreme pros- 
tration, convulsions, strangury and suppression of the urine, and the 
symptoms of a narcotic poison ensue if the dose is large enough. Abor- 
tion may be produced by large doses, but with great danger to life. Rue 
is an efficient emmenagogue, and in men aphrodisiac ; it is also con- 
sidered antispasmodic and carminative. 

The Oil of Rue is employed internally in amenorrhcea, menorrhagia 
and metrorrhagia, hysteria, convulsions and flatulence. As an emmena- 
gogue it is very efficient when the condition is one of functional inactivity 
of the uterus and ovaries. In small doses it has been well used in metror- 
rhagia from debility and after abortion. A decoction of the fresh leaves 
is often employed by injection against ascarides, and internally to remove 
lumbricoid worms. Externally the same preparation has been applied to 
the chest in chronic bronchitis, also in various scaly eruptions and gland- 
ular enlargements. Used as an abortifacient it has frequently caused 
death, preceded by symptoms of irritant and narcotic poisoning. Even 



42 2 SABINA. 

in poisonous doses its abortifacient action is very uncertain, so that only 
the most ignorant criminals employ it with such purpose. It was formerly 
official, but has been dismissed from the last edition of the pharmacopoeia. 



SABINA, Savine, — the tops of Juniperus Sabina, a small evergreen 
shrub of the nat. ord. Coniferse, growing in Northern Europe, Asia and 
America. It closely resembles Red Cedar {Juniperus virginiana), but is 
distinguished from the latter by its smaller size and by its larger fruit. 
It contains a Volatile Oil (which is official), also tannin, resin, extrac- 
tive matters, chlorophyll, etc. Dose, gr.v-x. 

Preparations. 

Extractum Sabinae Fluidum, Fluid Extract of Savine. — Dose, TTLv-xv. 

Ceratum Sabinae, Savine Cerate (Unofficial), — may be prepared by incorporating the 
Fluid Extract 25 in Resin Cerate 90, melted and cooled. Formerly official, but dismissed 
from the last edition of the pharmacopoeia. 

Oleum Sabinae, Oil of Savine, — a volatile oil distilled from Savine, existing in the 
fresh tops in the proportion of 2^ per cent., and in the berries 10 per cent. It is a 
colorless, or yellowish liquid, isomeric with oil of turpentine, C 10 H lfi , having a peculiar, 
terebinthinate odor, a pungent camphoraceous taste, and neutral reaction, and soluble in 
an equal volume of alcohol. Dose, ff\j-v. 

Physiological Action and Therapeutics. 

Externally the action of Savine resembles that of Turpentine, except 
that it is more irritant, the oil producing vesication if applied sufficiently 
long. Internally a full medicinal dose causes heat sensations, nauseous 
eructations, flatulence, increased cardiac action, stimulation of the cuta- 
neous, bronchial and renal secretions, irritation of the kidneys, hyperse- 
mia of the ovaries and uterus and increased menstrual activity. In large 
doses it produces hematuria, dysuria, and intense gastro-enteritis, with 
violent vomiting and purging. Toxic doses produce the symptoms of an 
irritant and narcotic poison. It may originate uterine contractions in 
the pregnant female, but its abortifacient effect can only be produced by 
a quantity sufficient to endanger life. The oil diffuses into the blood and 
is excreted by the various excretory channels. 

As an emmenagogue Savine is highly esteemed by many authorities, 
Dr. Phillips considering it " one of the most certain and powerful ' ' agents 
of this class, " with the additional advantage that it can be given with 
perfect freedom from risk of doing harm." So irritant an agent, however, 
requires the exercise of great caution in its use. It has been found ex- 
tremely efficient in dysmenorrhcea when not due to mechanical causes ; 
also in menorrhagia and hemorrhage after abortion. In chronic gout 
and the joint affections of chronic rheumatism, it was formerly much em- 
ployed. Externally the Cerate is used to prolong the discharge from 
blisters, setons or issues, and to stimulate the healing of indolent ulcers. 



SACCHARINUM SACCHARUM. 423 

For these purposes it is considered safer than Cantharides, as its prolonged 
employment does not bring on strangury or vesical irritation. As a 
caustic it is efficient for the destruction of warts and other excrescences, 
and the moistened powder is used as a paste on venereal condylomata, in 
combination with burnt alum or cupric subacetate. The Oil is the most 
efficient preparation for internal administration. 



SACCHARINUM, Saccharin (Unofficial), — is a sweet imide de- 
rivable from a coal-tar product, Toluene, from which it is prepared by a 
complicated process. It has the chemical title Benzoyl-sulphonic-imide , 
and the formula C 6 H 4 (CO)(S0 2 )NH. It occurs as a white, amorphous 
powder, with a very sweet taste, and a faint flavor of bitter almonds, is 
soluble in alcohol and in ether [Sugar is not soluble in ether], sparingly 
in cold water, more so in hot water. Saccharin is official in the British 
Pharmacopoeia under the title Glusidum, Gluside (Glucusimide). 

Saccharin is 220 times sweeter than sugar to the taste, and is also an 
efficient antiseptic. It is not a food, like sugar ; and has no injurious 
action on man. It is useful as a substitute for sugar in cases of diabetes, 
but it has no curative action upon that disease. Dose, gr. xx-xxv daily, 
given with sodium bicarbonate (3 parts to 2) which renders it soluble. 

Dulcin, Paraphenetol Carbamide (Unofficial), — is an aromatic urea derivative, allied 
to phenacetin. It has a pure, sweet taste, and excels Saccharin in sweetness some 200 
to 250 times. In reasonable doses it is harmless and does not bring about any decom- 
position of the blood. It is soluble in 800 parts of water, in 50 of hot water, and in 25 
of alcohol. In diabetes it must be used in relatively small doses, not exceeding gr. xxx 
dailv. 



SACCHARUM, Sugar (Cane-sugar), C r2 U 22 O u , — is the refined sugar 
obtained from Saccharum officinarum, the Sugar-cane, a perennial plant 
of the nat. ord. Graminese, indigenous to India and adjoining countries, 
but cultivated in tropical regions throughout the world. It is also obtained 
from various species or varieties of Sorghum (nat. ord. Gramineae), and 
from one or more varieties of Beta vulgaris, the Sugar-beet (nat. ord. 
Chenopodiacese). It is present in several other grasses, as Zea Mays, 
Maize; in the juice of various trees (maple, birch, palm, etc.); and in 
many roots. 

Cane-sugar occurs in white, dry, hard crystalline granules, permanent in the air, odor- 
less, of purely sweet taste and neutral reaction, soluble in 0.5 of water and in 175 of 
alcohol at 59 F., in 0.2 of boiling water and in 28 of boiling alcohol, insoluble in ether. 
The aqueous solution, saturated at 59 F. , has the sp. gr. 1. 345, and is miscible with alco- 
hol in all proportions. Its freedom from Grape-sugar (glucose) and from more than a 
slight quantity of Inverted Sugar (glucose plus levulose) is ascertained by dissolving I 
gram in 10 Cc. of boiling water, then mixing with the solution 4 or 5 drops of test- 
solution of Silver Nitrate and about 2 Cc. of Aqua Ammonia, and quickly heating to 
boiling, when not more than a slight coloration, but no black precipitate should appear 
after standing at rest for 5 minutes. 



424 SACCHARUM. 

Other Sugars. 

Saccharum Lactis, Sugar of Milk, Lactose, C 12 H 22 O u + H 2 0, — see next page. 

Glucose, Dextrose, Grape-sugar, Starch-sugar, C 6 H 12 6 , or hydrated C 6 H ]2 6 -f- H 2 
(Unofficial), also known as liver-sugar, diabetic sugar, — forms yellowish nodules or crys- 
tals, very soluble in water and in alcohol, has a sweet taste, less marked than that of cane- 
sugar, may be obtained artificially from cane-sugar or from starch, by boiling with a dilute 
mineral acid, or by the action of Diastase, a vegetable ferment formed during the ger- 
mination of grain. Boiling solutions of the alkalies convert it into a brown substance 
(melassic acid). 

Levulose, Fruit-sugar, C 6 H ]2 6 (Unofficial), — frequently found with grape-sugar in 
fruits, also in honey. See also Diabetin, below. 

Inosit, Phaseo-mannit, C 6 H 12 6 -f- 2H 2 (Unofficial), exists in the juice of some 
meats, in asparagus, etc. Is very sweet, but does not undergo alcoholic fermentation. 

Allied Substances. 

Theriaca, Treacle, Sugar-house Molasses (Unofficial), — is the uncrystallizable residue 
of the process for refining sugar, — a thick, brown, fermentable syrup, very sweet and of 
sp. gr. about 1. 40. It is official in the B. P., and is used in making up some of the 
official pills of that pharmacopoeia. 

Amylum, Starch, C 6 H 10 O 5 , — when boiled with dilute mineral acids or when subjected 
to the action of diastase, ptyalin, or pancreatin, starch is converted into glucose. (See 
ante, article Amylum.) 

Cellulose, C 6 H 10 O 5 (Unofficial), — forms the basis of all vegetable fibre, and is isomeric 
with starch. It exists almost pure in cotton and in Swedish filter paper. Pyroxylin, 
Gun-cotton, is dinitro-cellulose. 

Glycogen (Unofficial), — closely resembles starch in its properties, being converted into 
glucose by the same agents which so act on starch. It exists in the liver of all animals. 

Dextrin (Unofficial) , — is produced by the action of dilute acids on starch, and is an 
intermediate product in the conversion of starch into glucose. It is a transparent, brittle 
solid, looking like gum, soluble in water and dilute alcohol, is not fermentable, nor is it 
colored by Iodine. 

Preparations. 

Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri Iodidi, Ferri Carbonas Saccha- 
ratus, Mistura Ferri Composita, Pulvis Cretse Compositus, Pulvis Glycyrrhizae Compositus, 
and the Troches, Syrups, Compound Syrups, etc. 

Physiological Action and Therapeutics. 
Sugar is employed in pharmacy and therapeutics chiefly as a vehicle, a 
corrigent, a preservative and an antiseptic. Syrups protect the active 
ingredients against putrefaction, but not always against fermentation. 
They also protect certain ferruginous preparations against oxidation. As 
an ingredient in troches, powders and extemporaneous mixtures sugar is 
used to cover the taste or to make insoluble substances more easily mis- 
cible with water. It increases the solubility of Lime in water. As a food 
it possesses well-known properties, being a nutrient to adipose tissue and 
a respiratory fuel, and is decidedly diuretic in its action upon healthy 
kidneys. Sugar and sugar-forming food constitute more than one-half of 
the nourishment needed by a healthy person, and when withheld, as in 
diabetes, the patient is actually starved, and undergoes progressive and 
rapid emaciation. Levulose is found to be more easily consumed in the 
system than is cane-sugar, and in the treatment of diabetic patients may 
be used with benefit for some time. Heretofore its cost has been very 



SACCHARUM LACTIS SALICINUM. 425 

great, but it is now being manufactured in large quantities, and sold at a 
reasonable price, under the trade-name Diabetin. 



SACCHARUM LACTIS, Sugar of Milk, Lactose,— C 12 H 22 O n + H 2 — is one 

of the constituents of the milk of mammals, and is officially described as a peculiar, 
crystalline sugar obtained from the whey of cow's milk by evaporation and purified by 
re-crystallization. Occurs in white, hard, crystalline masses, yielding a gritty, white 
powder, odorless, permanent in the air, of faintly sweet taste and neutral reaction, solu- 
ble in about 6 of water at 59 F. and in I of boiling water, insoluble in alcohol, ether 
or chloroform. On adding to a solution of sugar of milk in an equal weight of boiling 
water some solution of soda, the liquid turns brownish, and on further addition of test- 
solution of Cupric Sulphate a brick-red precipitate separates. 

Sugar of Milk is the least soluble of all sugars in water and is insoluble in alcohol. It 
enters into alcoholic fermentation with difficulty. In the presence of decomposing albu- 
minous matter and under certain other influences, it undergoes the lactic fermentation, 
which results in the formation of Lactic Acid, Carbon Dioxide and Alcohol. It readily 
reacts with the reduction tests. 

Lactose has been shown to act as a powerful diuretic, especially in cardiac dropsy, in 
which Dr. See considers it " the best and most certain diuretic we possess, the excretion 
of urine caused by it being greater than that due to any other drug." He found that it 
acts similarly to, though more powerfully than, Caffeine, while possessing none of the dis- 
advantages of the latter. Its diuretic action is but very little in cases where extensive 
renal disease exists, and it has no power over dyspnoea. 

Sugar of Milk is used in the Triturations, also in Dover's Powder, Deodorized Opium, 
etc., as a diluent. Being much harder than cane-sugar it is considered a valuable exci- 
pientfor powders requiring fine trituration and the minute subdivision of their medicinal 
constituent. It is less sweet than cane-sugar, and being less apt to ferment in the stomach 
and bowels is better than the latter for use with infants' food. 



SALICINUM, Salicin, C 13 H 18 7 , — is a neutral principle obtained 
from several species of Salix (Willow) and Populus (Poplar), trees of the 
nat. ord. Salicaceae. It is found also in Gaultheria procumbens, Winter- 
green (nat. ord. Ericaceae), and in Betula lenta, the Sweet Birch (nat. 
ord. Betulaceaa), the volatile oils of which, distilled from the leaves of the 
former and from the bark of the latter, consist almost entirely of methyl 
salicylate. (See below.) 

Salix Nigra, the Pussy Willow, grows along streams in the Southern 
States. A fluid extract is on the market, and may be used in doses of gss 
thrice daily, as a sexual sedative. 

Salicin occurs in colorless or white and silky, shining crystalline needles, or a crystal- 
line powder, odorless, of very bitter taste, permanent in the air, of neutral reaction ; 
soluble in 28 of water and in 30 of alcohol, in 0.7 of boiling water and in 2 of boiling 
alcohol ; almost insoluble in ether or chloroform. Dose, gr. x-gj. 

Acidum Salicylicum, Salicylic Acid, HC 7 H 3 3 , — is an organic acid, 
existing naturally in combination in various plants, but most largely pre- 
pared synthetically from carbolic acid. It occurs in light, fine, white, 
prismatic needles, or a crystalline powder, odorless, of sweetish, after- 
wards acrid taste and acid reaction, permanent in the air; soluble in 
about 450 of water, but readily soluble in water containing 8 per cent, of 
Borax or 10 per cent, of Sodium Phosphate. It is soluble in 2^/0 of 



426 SALICINUM. 

alcohol, in 14 of boiling water, in 2 of ether, in 80 of chloroform, and is 
very soluble in boiling alcohol. Dose, gr.v-£j. 

Salicylic Acid is a derivative of Salicin, probably by double oxidation ; but may also be 
considered as a substitution-derivative of Benzene, formed by replacing 2 atoms of its 
hydrogen, the one by hydroxyl, and the other by carboxyl. (See page 239, ante.) It is 
obtained, therefore, either synthetically by combining the elements of Carbolic Acid with 
those of Carbonic Acid, and subsequent purification, — or from natural Salicylates as the 
Oils of Wintergreen and Sweet-Birch, — or from Salicin, by heating with caustic potash 
and treating the mass with hydrochloric acid. The acid prepared from natural sources is 
purer and more efficient than that prepared artificially, and will often be tolerated by a 
patient who cannot bear the latter. 

Official Preparations. 

Salol, Salol (Phenyl Salicylate), C 6 H 5 C 7 H-0 3 , — is the salicylic ether of phenol, now 
obtained from salicylic acid by heating up from 320 to 464 F., excluding the air; by 
which process the acid is converted into Salol, Water and C0 2 . It is a white, crystalline 
powder, odorless and almost tasteless, nearly insoluble in water, soluble in 10 of alcohol, 
and very soluble in ether, chloroform and oils. On being warmed with an alkali it splits 
up into Salicylic Acid 60, and Carbolic Acid 40. Dose, gr.v-xv, frequently repeated, in 
compressed tablets or in cachets, or suspended by mucilage of acacia or of tragacanth. 

Lithii Salicylas, Lithium Salicylate, LiC-H 5 3 , — a white, or grayish-white powder, 
odorless, sweetish, deliquescent, very soluble in water and in alcohol. Dose, gr.v-^j. 

Sodii Salicylas, Sodium Salicylate, NaC.H 5 3 . — a white, amorphous powder, odor- 
less, sweetish, permanent'; soluble in ^/ of water and in 6 of alcohol, also in glycerin. 
Dose, gr.v-^j. 

Physostigminae Salicylas, Physostigmine (or Eserine) Salicylate, — is described 
under Physostigma. Dose, gr. y i ¥ - -Jy. 

Methyl Salicylas, Methyl Salicylate, Artificial (Synthetic) Oil of Wintergreen, CH 3 - 
C 7 H 5 3 , — isacolorless liquid, having the characteristic odor and taste of Oil of Gaultheria, 
with the essential constituent of which it is identical. It is wholly identical with Oleum 
Betulse Volatile, and is soluble in all proportions in alcohol, carbon disulphide, or glacial 
acetic acid. Dose, niv-xv, suspended in water or in sugared water. 

Oleum Betulse Volatile, Volatile Oil of Betula, Oil of Siveet Birch, — is a volatile 
oil distilled from the bark of Betula lenta, the Sweet Birch. It is identical with Methyl 
Salicylate (see above), and nearly identical with Oil of Gaultheria. Russia leather derives 
its odor from this oil. Dose, TT^v-xv. 

Oleum Gaultheriae, Oil of Gaultheria, Oil of Wintergreen, — consists almost en- 
tirely of Methyl Salicylate, and is nearly identical with the preceding. It is described 
under the title Gaultheria. 

Unofficial Preparations. 

Salophen, Para-amidophenol Salicylate, — contains the equivalent of nearly 51 per 
cent, of Salicylic Acid, and occurs as minute, white, crystalline scales, odorless and taste- 
less, insoluble in water, soluble in alcohol ; decomposed by alkalies into Salicylic Acid 
and Acetyl-para-amidophenol ; also by the organism as demonstrated in the urine. Dose, 
gr.v-xv, up to 3J or jss in the 24 hours. 

Salipyrin, Antipyrin Salicylate, C 18 H 18 N 2 4 , — is produced by the combination of 
Salicylic Acid 57.7, and Antipyrin 42.3 parts. It is a white, crystalline, odorless powder, 
very soluble in alcohol, insoluble in water. Its claims to preference are based upon its 
comparative harmlessness ( 3 ijss having been taken within 3 or 4 hours without the slight- 
est ill effect) ; also its freedom from unpleasant after-results. Dose, gr.x-xxx every hour 
or 2 hours until gij have been taken. It is best administered in wafers as a powder, or 
in mixture, rubbed up with glycerin and flavored with raspberry syrup. 

Malakin, Salicyl-para-phenetidin, — is a combination of Salicyl anhydride and Phena- 
cetin. Its effects on the system are those of Salicylic Acid but are very mild, — hence its 
name (from malakos, mild). It has proved valuable in acute rheumatism and other 
febrile affections, as an antipyretic and analgesic. As it may be given for a long time 
without causing any disturbance, it is of especial service in habitual headaches. Dose, 
gr.viij-xv, repeated about six times in 24 hours. 



salicinum. 427 

Physiological Action. 

Willow-bark is highly astringent and antiperiodic and feebly tonic, 
but is never employed medicinally, owing to its bulk. Salicin is a bitter 
tonic, also antifermentive, antiseptic, and highly destructive to low organ- 
isms. It has slight antiperiodic power and is feebly antipyretic. It pre- 
vents the reaction between Amygdalin and Emulsin (see page 87), and 
also that of Ptyalin, etc. , on Starch (see page 1 28). It seems to be devoid 
of toxic power on man, and is mainly excreted as Salicylic, Salicyluric 
and Salicylous acids, being first changed in the bowel into Saligenin and 
Glucose. Salicin is well borne by the stomach. 

Salicylic Acid has properties similar to the above, but is much more 
energetic in its action, being a powerful antipyretic and antiseptic. It is 
also anhydrotic, checking local perspiration when locally applied. Inhaled 
it causes irritation of the respiratory passages, producing sneezing and 
cough. In small doses it stimulates the stomach, heart and respiration, 
but moderate quantities derange the stomach, causing nausea and vomit- 
ing, while large doses depress the heart's action and the respiration after 
a primary excitation of both, lower the arterial tension, relax the vessels, 
produce free perspiration, and reduce the temperature in fever. It causes 
vertigo, dilated pupils, tinnitus aurium, a sensation of tension in the 
frontal cerebrum, delirium, and may produce bed-sores from depression 
of the circulation, but does not affect the peripheral nerves as to either 
motion or sensation. In the blood it is first changed to Sodium Salicylate, 
but .a portion is again set free and uniting with glycocoll forms Salicyluric 
Acid (HC 9 H 8 N0 4 ), coloring the urine green. It is slowly excreted with 
the secretions generally, especially in the urine, sweat, saliva and bile. 
It stimulates the kidneys, at the same time disinfecting them and increas- 
ing the acidity of the urine, but may so irritate the kidneys as to produce 
albuminuria and hematuria. 

Salicylic acid is destructive to the torula and prevents alcoholic fermenta- 
tion, also that caused by the organic ferments (pepsin, ptyalin, etc.). In 
solutions containing bacteria, it will prevent their development, if in the 
proportion of 1 per cent.; and in that of 1 in 60 it will destroy them when 
in full activity. 

Sodium Salicylate is remarkably antipyretic in doses of gr. xv, given 
4 or 5 times in 24 hours. It is a powerful diaphoretic, and an efficient 
cholagogue, and it is supposed to possess the curious property of increas- 
ing the fluidity of the bile, at the same time that it promotes its secre- 
tion, — other cholagogues increasing the proportion of solids therein. 
(Brunton.) It has no antiseptic power unless in association with a strong 
mineral acid, which will liberate the salicylic acid. 

Salol is antiseptic, antipyretic, and germicide, in a higher degree than 
either of its constituents. As an antipyretic in fever it stands next after 



428 SALICINUM. 

Antipyrin, and it acts with such force as to frequently depress the tem- 
perature a degree or two below normal. It is sedative to the cerebro- 
spinal system, and somewhat analgesic. It causes profuse sweating, and 
in a few cases considerable depression has accompanied its antipyretic 
employment ; but it is not toxic, and may be used freely in its proper 
dosage, which ranges from 5 to 60 grains, up to 2 or 3 drachms in the 24 
hours. 

Therapeutics. 

Salicin and its derivatives are chiefly used in acute rheumatism, to 
lower temperature, relieve pain, and reduce articular swelling. They 
are most suitable to strong, vigorous patients, and if not promptly effi- 
cient they should be abandoned. The acid is much used as an antipy- 
retic in fevers, especially those of septicsemic character. It is a useful 
local application in gangrenous wounds, eczema of the hands or feet, 
cancer, burns, and in fetid perspirations, in the last affection being used 
in solution with borax. 

Sodium Salicylate is more soluble than the acid and less irritant to the 
stomach, while in doses about 50 per cent, larger it is equally efficient. 
It is employed in 3- to 5 -grain doses internally after meals, to arrest gas- 
tric fermentation, and to prevent acidity and flatulence. It is used instead 
of the acid in acute and chronic rheumatism, to relieve headaches, and 
for phlegmasia alba, in which it is considered very efficient, — also in cases 
where there is a tendency to the formation of gall-stones. It is consid- 
ered a very efficient remedy to cut short an attack of tonsillitis, a "bad 
cold," and also other acute affections of the respiratory mucous membrane. 
Lithium Salicylate is also non-irritant and is supposed to act towards 
uric acid in the same manner as the other salts of this metal. It is expected 
to be of especial value in acute rheumatism and rheumatic gout. 

Salol is one of the most efficient remedies for duodenal catarrh, catarrh 
of the bile-ducts and catarrhal jaundice; also in the bilious form of sick- 
headache, and in some forms of neuralgia. Its therapeutic value depends 
chiefly upon its property of splitting up in the alkaline fluids of the in- 
testine into Salicylic Acid and Phenol compounds, whereby it effects the 
thorough antisepsis of the intestinal tract and performs the work of its 
constituent elements upon the organism. In all affections associated with 
micro-organisms in the intestines, as acute diarrhoea, cholera, dysentery, 
etc., it has done most excellent service; even in Asiatic Cholera. It is 
highly praised in epidemic influenza (grippe), having proven itself re- 
markably efficient in the treatment of recent epidemics of that affection. 

Salol is a remedy of very great value in typhoid fever ; disinfecting the 
ulcerated intestines, it promotes the healing process therein, and hinders 
reinfection. It is highly recommended in dysentery, in cholera, and in 
infantile diarrhoea. Given in the latter affection, a dark staining of the 



SALVIA. 429 

child's diapers is often noticed, which is due to the development of car- 
bolic acid from the remedy. Its greatest power is manifested over acute 
rheumatism, in which disease many clinicians maintain that it has no 
superior, if given in 15- to 30-grain doses, up to 2 drachms in the 24 
hours, and continued for some time after the acute symptoms have sub- 
sided. In large doses, however, it is liable to induce symptoms of car- 
bolic acid poisoning, which may be met by administering sodium sulphate 
or any other sulphate. It proves to be an efficient disinfectant in catarrh 
of the bladder, its constituents being excreted with the urine, and coming 
in contact with the vesical mucous membrane for a considerable length 
of time. It is much quicker in its action upon the urine than ammonium 
benzoate, as in a day or two, ordinarily, the urine loses its foul odor and 
alkalinity and becomes clear. Dissolved in Retinol, it is considered 
especially useful in subacute cystitis, having conquered cases in which 
other remedies had proven ineffectual. 

Externally, it is employed as an antiseptic and deodorant powder, 
against impetigo, eczema, sycosis and other skin diseases ; and has done 
good service as an insufflation in the treatment of ozaena. In spirituous 
solutions (5 per cent.) it is used with various flavoring agents in the prepa- 
ration of mouth-washes, and dentifrices ; and it also enters into the 
composition of soaps, face powders, and other toilet articles. A mixture 
of equal parts of Camphor and Salol, heated together, has given good 
results in the treatment of suppurations of the middle ear ; giving no 
pain and setting up no inflammation of the parts. 

Salophen is considered non-toxic in action upon the organism, while affording all the 
medicinal qualities of Salol. It has been employed with success, in dosage of 3J to ^jss 
daily, in the treatment of acute rheumatism, acute rheumatic arthritis, typhoid fever, 
cholera and allied conditions ; also in neuralgia and sciatica, gastro-enteritis, pyelitis, and 
cystitis. In intestinal dyspepsia, with flatulence, and in gastrectasis it has been used with 
decided benefit, in the latter affection chiefly for the relief of the fermentive disturbances 
to which the dilated stomach is so liable. 

Salipyrin has been employed with excellent results in acute and chronic rheumatism, 
rheumatic sciatica, neuralgia, and influenza. In rheumatic fever 15-grain doses are given 
at short intervals ()4 hour to I hour), until about 3 ij have been taken, continuing with 
smaller doses for a long time after convalescence, to prevent relapses. A dose of 8 grains 
is often sufficient against neuralgia. It was extensively used during the epidemic of in- 
fluenza in 1891, and highly extolled for efficiency therein, as well as for its freedom from 
cardiac action. It has proved highly efficient in the treatment of metrorrhagia, espe- 
cially in that following labor or abortion. Orthmann employed it with most excellent 
results in 50 cases of metrorrhagia from various causes, giving gr. xv thrice daily up to a 
total of ^ ijss in some cases. In no instance were unpleasant effects observed. 

As it is not obtainable in this country, by reason of a legal conflict between its paten- 
tees and those of Antipyrin, and as it is a very loose combination at best, Dr. Squibb sug- 
gests that there is no good reason whatever why as good results should not be obtained 
from the administration of its constituents in conjunction, in proper doses to suit each in- 
dividual case, and in the proportion of about 3 of Salicylic Acid to 2 of Antipyrin. 



SALVIA, Sage, — the leaves of Salvia officinalis, the common garden Sage, a peren- 
nial plant of the nat. ord. Labiatae, native in Southern Europe, but cultivated in our gar- 
dens for its strong, fragrant odor. They contain tannin, resin, etc., and a volatile oil 



430 SAMBUCUS SANGUINARIA. 

which consists of Salviol (C 10 H 16 O), camphor and terpenes. There are no official prepa- 
rations. Dose of the powdered leaves, gr. xx-xxx, in infusion. 

Sage is aromatic, stimulant, tonic, astringent, and a vulnerary. It was highly esteemed 
in ancient times, and even yet is popular as a domestic cure-all with many people. In an 
infusion it may be used as a beverage in febrile conditions and to check sweating, also for 
the night-sweats of phthisis. Like other members of the same class it has a slight influ- 
ence over enteralgia and flatulence. It makes a good astringent and stimulating gargle. 



SAMBUCUS, Elder, — the flowers of Sambucus canadensis, the common Elder, a 
shrub of the nat. ord. Caprifoliaceae. The plant contains a small quantity of a volatile oil, 
also a resin and valerianic acid. The common Elder of Europe (S. nigra) is more of a 
tree, and is official in the B. P. There are no official preparations. Dose, gr. xxx-gj, 
in hot infusion. 

Elder-flowers are stimulant and diaphoretic, also perhaps diuretic in some degree. The 
berries are diaphoretic and laxative, while the inner bark is a hydragogue cathartic and in 
large doses emetic. Formerly the .inspissated juice of the berries was employed as an 
alterative in rheumatism and syphilis, but at present the flowers are used only for flavoring 
purposes. Elder-flower Water (Aqua Sambuci, B. P.) is a nice vehicle for collyria and 
lotions. 



SANGUINARIA, Blood-root, — is the rhizome, collected in 
autumn, of Sanguinaria canadensis, a. perennial plant of the nat. ord. 
Papaveracese, which grows abundantly throughout the U. S., being one of 
the earliest and most beautiful of the spring flowers. It has a single white 
flower on an erect stalk, the petals often tinged with rose or purple. It 
contains 3 alkaloids, — Sanguinarine, C 17 H 15 N0 4 , which is probably iden- 
tical with Chelerythrine (see Chelidonium), Porphyroxine, and Puccine, 
combined with Chelidonic and Sanguinarinic acids, — also resin, gum, 
albumen, sugar, etc. The salts of its alkaloids are of brilliant red and 
orange colors and are all soluble in water. Dose of the powdered root as 
an expectorant, gr. j-v ; as an emetic, gr. x-xxx ; best given in pill. 

Preparations. 

Extractum Sanguinariae Fluidum, Fluid Extract of Sanguinaria. — Dose, TT\j-v 
as expectorant and stimulant ; TT^x-lx as emetic, cautiously. 

Tinctura Sanguinariae, Tincture of Sanguinaria, — strength 15 per cent. Dose, 
as expectorant, rr^v-^j, as emetic 3J-iij. 

Sanguinarina, Sanguinarine, C 17 H 15 N0 4 (Unofficial), — is the chief alkaloid and prob- 
ably the active principle of the plant. Dose, as an expectorant, gr. ^— \ ; as an emetic, 
gr. y z repeated in 10 minutes will produce vomiting after the second or third dose. 

Physiological Action. 
Sanguinaria is sternutatory, sialagogue, expectorant and emmenagogue, 
a systemic emetic, a cardiac paralyzer, a violent irritant, an acro-narcotic 
poison and an alterative. Its taste is bitter and acrid. It causes violent 
sneezing when inhaled, increases secretion by irritating the secretory 
organs as it is eliminated, and in full doses produces salivation, catharsis 
and vomiting with great depression. Overdoses are violently irritant, the 
heart's action being at first increased, together with the arterial tension, 
then markedly depressed, and finally paralyzed by stimulation of its in- 



SANTALUM ALBUM. 43 I 

hibition. The reflexes are lowered by paralysis of the spinal centres, 
muscular contractility impaired, the pupils dilated, temperature lowered, 
cold sweats, great thirst and collapse supervene, and death occurs by 
paralysis of the cardiac and respiratory centres, often preceded by con- 
vulsions. Locally used, Sanguinaria is a feeble escharotic. 

Antagonists and Incompatibles. 

Amy I Nitrite, Opium, Atropine, etc. , to antagonize the depression of the circulation and 
the local irritant action. Incompatibles are alkalies, Tannin, and most of the metallic 
salts. 

Therapeutics. 

As a tonic to the stomach and a stimulant to the liver Sanguinaria or 
its active principle is well employed in small doses (gtt. iij of the tinc- 
ture or gr. y 1 ^ of the alkaloid) for atonic dyspepsia, duodenal catarrh and 
catarrh of the biliary ducts with jaundice. Respiratory affections are 
often remarkably amenable to its influence, particularly chronic nasal 
catarrh, asthma and acute bronchitis. In these affections expectorant 
doses are the best, namely, gtt. x of the tincture, and in the former the 
powder locally as a sternutatory. A decoction is a very efficient gargle 
in the sore-throat of scarlet fever. Sanguinaria is a very serviceable 
remedy in chronic bronchitis and in amenorrhoea of functional charac- 
ter, also in functional impotence from irritability of the organs, with 
daily losses and relaxation of the genitalia. By many practitioners it is 
considered a specific emetic in croup, but others look upon it with dis- 
favor as too uncertain and harsh in its action. It has been thought to 
have alterative properties, and hence is frequently used with Stillingia and 
other plants in the treatment of strumous and syphilitic affections. In 
pneumonia of typhoid type and in pleuro-pneumonia it has undoubtedly 
been of great service in many cases. 

Locally, the powdered root is well employed as an application to foul 
ulcers and fungous granulations, and by insufflation to nasal polypi, and 
for chronic hypertrophy of the nasal mucous membrane. 

Sanguinarine has been used with good results in pneumonia, bronchitis 
and atonic dyspepsia. Doses of gr. yL to ^-are expectorant without irri- 
tating the stomach ; and still smaller doses (gr. -^ to -fa) are stimulating 
to the gastric and intestinal secretions. 



SANTALUM ALBUM, White Sandalwood,— is the source 
of the official Oil of Santal (see below), but is not itself official. It is a 
tree of the nat. ord. Sautalacese, having its habitat in India but now nearly 
exterminated there ; — Santalum citrinum, the yellow Sandalwood, from the 
Sandwich and Feejee Islands, is more commonly met with in commerce. 



432 SANTALUM RUBRUM SANTONICA. 

Preparations. 

Oleum Santali, Oil of Santa I, Oil of Sandalwood, — a volatile oil distilled from the 
wood of Santalum album ; a pale-yellow liquid, soluble in alcohol, of peculiar and aro- 
matic odor, pungent taste and acid reaction. Dose, npc-xxx, in emulsion or capsule. 

Extractum Santali Fluidum, Fluid Extract of Santal (Unofficial), — made with 
alcohol as a menstruum. Dose, 3 j-iij. 

Sandalwood is a very agreeable perfume. The Oil is astringent to 
mucous membranes, producing dryness of the fauces, thirst, colic, and a 
sense of fulness in the renal regions. In concentrated form it is a local 
irritant, but the effects of large doses have not been studied. It is exten- 
sively used in chronic bronchitis and in gonorrhoea, forming the contents 
of proprietary capsules which are sold for the cure of the latter disease in 
all drug stores. As found in the shops it is extensively adulterated with 
Oil of Cedar, and hence is a very unreliable remedy. 



SANTALUM RUBRUM, Red Saunders,— is the wood of Pterocarpus santalinus, 
a tree of the nat. ord. Leguminosse, native in India. It comes in chips or as a coarse 
powder, nearly inodorous and tasteless, not imparting any red color to water when mac- 
erated in it, but coloring alcohol, ether and alkaline solutions a bright red. The wood 
has no medicinal properties and is employed solely for the purpose of coloring alcoholic 
preparations. It is a constituent of Tinctura Lavandulae Compositus. 



SANTONICA, Levant Wormseed, — is the unexpanded flower- 
heads of Arte?nisia fiauciflora, a small, perennial plant of the nat. ord. 
Composite, which grows in Asia Minor, Turkestan, etc., and contains a 
volatile oil and the peculiar, crystalline principle, Santonin (see below). 
Dose, gr. x-lx. 

Santoninum, Santonin, C 15 H 18 3 , — the neutral principle obtained from 
Santonica. Occurs in colorless, prismatic crystals, turning yellow on ex- 
posure to light, odorless, of bitter after-taste, and neutral reaction, nearly 
insoluble in cold water, but soluble in 250 of boiling water, in 40 of alco- 
hol, 3 of boiling alcohol, 140 of ether, 4 of chloroform, also in solutions 
of the caustic alkalies. Dose, gr.^-j for a child, gr. j-v for an adult, not 
repeated too soon, as the action of the drug is slow. 

Preparation. 

Trochisci Santonini, Troches of Santonin, — each troche contains about ^ grain of 
Santonin , with Sugar, Tragacanth, and Stronger Orange Flower Water. Dose, j-v troches, 
as per age. 

Santonin and its preparation are sensitive to light and should be kept in amber-colored 
bottles tightly corked. 

Physiological Action and Therapeutics. 
Santonin is anthelmintic to the round worm (Ascaris lumbricoides), 
also but in less degree to the thread-worm (Oxyuris vermicularis). It is 
taken into the blood as Sodium Santoninate, and affects the cerebral 



sapo. 433 

faculties and the vision, objects appearing at first blue, green or red, then 
yellow (chromatopsia), often succeeded by blindness for a week or more. 
Large doses disturb the consciousness of the patient, produce a sort of 
intoxication, tremors, weakness, with enfeebled respiration and slowing 
of the pulse, coldness of the surface, vomiting, sweating, mydriasis, con- 
vulsions and death from failure of respiration. A dose of 2 grains is said 
to have proved fatal to a feeble child of five years old. It is excreted by 
the kidneys, coloring the urine if acid a greenish-yellow, if alkaline a 
reddish-purple, and produces considerable enuresis. 

As an anthelmintic Santonin is the most certain agent against the round- 
worm, and is best administered in powder with Calomel at bedtime after 
a day of fasting, a Senna-draught or a dose of Castor Oil being used the 
following morning. It also acts fairly well in suppository against the 
thread-worm, but is inoperative against tape-worm. Some observers con- 
sider it more promptly efficient when given in Castor Oil, and that the 
oil lessens the risk of evil after-effects. It has also been prescribed with 
great benefit for nocturnal incontinence of urine, and for certain eye 
affections, particularly amaurosis from atrophic or inflammatory changes 
in the retina and optic nerve. It should never be given to children during 
a fever, nor when the bowels are constipated, for fear of toxic results. 



SAPO, Soap, WJiite Castile Soap, — is Soap prepared from soda and 
olive oil ; a whitish solid, hard, yet easily cut when fresh, of faint, peculiar 
odor free from rancidity, a disagreeable, alkaline taste, and alkaline 
reaction ; readily soluble in water and in alcohol. Is an ingredient of 
several of the official pills. 

Sapo Mollis, Soft Soap, Green Soap, — is Soap prepared from potassa 
and linseed oil ; a soft, unctuous mass, of a yellowish-brown color, soluble 
in about 5 of hot water and in 2 of hot alcohol. The name Green Soap 
is a misnomer, as it is not green in color. 

Insoluble Soaps are combinations of the oily acids with earths and 
metallic oxides. Two of them are official, viz., — the Soap of the Mon- 
oxide of Lead (Emplastrum Plumbi) and the Soap of Lime (Linimentum 
Calcis). 

Saponification is a process of double decomposition between a fat (stearate, palmitate 
or oleate of glyceryl) and an alkali, in which glycerin and the metallic salt of the fatty 
acid are formed. The glycerin, not being saponifiable, is set free, but the fatty acid 
(stearic, palmitic or oleic) unites with the salifiable base to form soaps, which are there- 
fore mixed stearates, oleates and palmitates of various bases. Nearly all soaps are oleates 
or palmitates (or both) of sodium or potassium (or both). Hard soaps are soda soaps, 
soft soaps are potassium soaps. [Compare the articles Oleum Olivae, Adeps, Acidum 
Oleicum, Glycerinum, etc.] 

Unofficial Soaps. 

Sapo Animalis, Curd Soap, — official in the Br. Phar. , — is made with Soda and a 
purified animal fat, consisting chiefly of Stearin. Used in pills and suppositories. 
28 



434 SARSAPARILLA. 

Sapo Medicatus, — official in the Fr. Codex, — is a Soda soap prepared from expressed 
Almond Oil. 

Preparations. 

Emplastrum Saponis, Soap Plaster, — has of Soap io, Lead Plaster 90, Water q. s. 

Linimentum Saponis, Soap Liniment, — has of Soap 7, Camphor 4^, Oil of Rose- 
mary I, Alcohol 75, Water to 100. Opodeldoc is a similar preparation. Soap Liniment 
is an ingredient of Chloroform Liniment. 

Linimentum Saponis Mollis, Liniment of Soft Soap, Tincture of Green Soap, — 
has of Soft Soap 65, Oil of Lavender 2, Alcohol 30, Water to 100. 

Physiological Action and Therapeutics. 

Soap is a laxative, antacid and antilithic ; externally it is a stimulating 
discutient, and is used for cleansing the skin, removing fatty substances 
and softening the epidermis, but if too long applied it may prove de- 
cidedly irritant. It is a good antidote in poisoning by acids, and should 
be administered freely in such cases until more energetic alkalies can be 
obtained. In aqueous solution it makes a useful enema for constipation, 
or a plug of soap may be inserted into the rectum. 

Soft Soap is a powerful detergent stimulant and is much employed in 
skin diseases, especially eczema rubrum, in which the tincture is well rubbed 
on, the diseased skin well washed and then covered with a bland oint- 
ment. The tincture is the most elegant form for use, and may be diluted 
with three parts of alcohol for shampooing the scalp. 

The Liniment is used with friction in sprains, bruises and stiff joints, 
being a little more stimulating than camphor-liniment. It makes a good 
basis for extemporaneous liniment prescriptions. 



SARSAPARILLA, — is the root oiSmilax officinalis, Smilax 7nedica i 
and of other undetermined species of Smi/ax, plants of the nat. ord. 
Liliaceae, growing in Mexico, Central America, Brazil, etc. There are six 
commercial varieties on the market, which are generally put up in differ- 
ently formed bundles. It contains starch, resin, calcium oxalate, an 
essential oil, and an acrid neutral principle named Parillin or Smilacin, 
which when acted on by dilute sulphuric acid affords another principle, 
Parigenin. 

Preparations. 

Extractum Sarsaparillae Fluidum, Fluid Extract of Sarsapari '//a. — Dose, gss-j. 

Extractum Sarsaparillae Fluidum Compositum, Compound Fluid Extract of 
Sarsaparilla, — has of Sarsaparilla 75, Glycyrrhiza 12, Sassafras 10, Mezereum3, Glycerin 
10, Water and Alcohol to 100. Dose, gss-j. 

Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla, — has of the 
Fluid Extract 20, Fl. Ext. of Glycyrrhiza i l / 2 , Fl. Ext. of Senna 1^, Sugar 65, Oils of 
Sassafras, Anise and Gaultheria, each 0.0 1, Water to 100. Dose, pjj-jfj- A good 
vehicle for Potassium Iodide. 

Decoctum Sarsaparillae Compositum, Compound Decoction of Sarsaparilla, — has 
of Sarsaparilla 10, Sassafras 2, Guaiacum Wood 2, Glycyrrhiza 2, Mezereum I, Water to 
100. Dose, Jj-iv. 



SASSAFRAS SCAMMONIUM. 435 

Syrup of Sarsaparilla (Unofficial), — so much used in flavoring soda-water, is a mix- 
ture of the oils of sassafras and gaultheria in syrup. 

Physiological Action and Therapeutics. 
Those who believe that Sarsaparilla has any action ascribe to it prop- 
erties as a diuretic, diaphoretic, tonic and alterative. So far careful 
physiological experiments with the drug and its principle have given 
negative results. It has been used as a so-called "blood-purifier" in 
scrofula, chronic abscesses, necrosis, old ulcers, many cutaneous diseases, 
etc., but is generally combined with other agents of undoubted activity. 
The compound decoction is considered a good agent in tertiary syphilis, 
especially in debilitated subjects ; while the other preparations are com- 
monly employed as vehicles for Potassium Iodide and Mercuric Chloride 
in syphilis of any form. Whenever used, the compound decoction will 
give the best results, the hot water and its other constituents having 
medicinal value, if the principal ingredient has none. 



SASSAFRAS, — is the root-bark of Sassafras variifolium, an indigenous tree of the 
nat. ord. Laurinese. The volatile oil is official, and contains, as its principal constituent, 
Safrol, which is largely used to disguise the odor of the fatty bases in soap manufacturing. 

Sassafras Medulla, Sassafras Pith, — is the pith of the tree described above. Macer- 
ated in water it forms a mucilaginous liquid which is not precipitated on the addition of 
alcohol. 

Mucilago Sassafras Medullas, Mucilage of Sassafras Pith, — has of the pith 2, in 
water loo. Dose, indefinite. 

Oleum Sassafras, Oil of Sassafras, — a volatile oil distilled from Sassafras, — a colorless 
or yellowish liquid, having the odor of Sassafras, a warm, aromatic taste and a neutral 
reaction, readily soluble in alcohol. Treated with cold nitric acid it becomes of a dark 
red color, and is finally converted into a red resin. Dose, rry-iv. 

Infusum Sassafras, Infusion of Sassafras (Unofficial), — is a popular " tea " which 
may be taken ad libitum. When made from the bark, and taken internally as well as 
applied locally, it is almost a specific for the rash produced by poison oak (Hinton). 

Sassafras is a constituent of the three compound Sarsaparilla preparations. It acts as a 
stimulant diaphoretic when used in quantity of the hot infusion. It enjoys a popular 
reputation as a " blood-purifier," and has a destructive influence on infusoria. It is 
employed chiefly in combination with Sarsaparilla and Guaiacum in cutaneous disorders 
and rheumatic and syphilitic affections. The mucilage of the pith is an excellent demul- 
cent drink in acute gastritis or enteritis, or in poisoning by irritant or corrosive agents. It 
may also be used in extemporaneous prescriptions to hold insoluble substances in suspen- 
sion and for flavoring purposes. The oil is chiefly used for flavoring in mixtures and 
confectionery. The syrup popularly known as "Sarsaparilla" is composed of Oil of 
Sassafras and Oil of Gaultheria, in syrup. 

Dr. J. Bartlett, of Chicago, in a paper on the toxic properties of Sassafras, published 
in the Pharmaceutical Journal, says that it appears to have some resemblance to 
three familiar dru r ^s — opium, strychnine, and ergot; for it has a narcotic and sudorific 
action ; a property of inducing tetanic and clonic spasms followed by paralysis, and a 
probable stimulant effect on the muscle of the uterus. 



SCAMMONIUM, Scammony, — is a resinous exudation from the 
root of Convolvulus Scammonia, a plant of the nat. ord. Convolvulaceae, 
growing chiefly in Syria and Asia Minor. It contains about 80 percent. 



436 SCILLA. 

of Resin, with gum, sugar, starch, etc. The active principle, Jalafiin, is 
probably identical with the Convolvulin of Jalap, and is contained in the 
root, the resin, etc. Dose, gr.v-x. 

Preparations. 
Resina Scammonii, Resin of Scammony, — soluble in ether. Dose, gr. iij-viij. 
Extractum Colocynthidis Compositum, — (see ante, page 250) contains 14 per 
cent, of Resin of Scammony, and is an ingredient of the Compound Cathartic Pill. 

Physiological Action and Therapeutics. 

Scammony is an active cathartic, stimulating the liver and the intestinal 
glands, and causing free purgation in a few hours, with considerable grip- 
ing. Its solution in the bile is necessary to its action, and it combines 
with the soda in that secretion. Though quite drastic in action it is 
somewhat uncertain as a purgative and is generally employed in combina- 
tion with similarly acting agents. It is anthelmintic against the tapeworm, 
and in overdoses produces a high degree of irritation. 

It is used as a drastic purgative for children with Calomel or Potassium 
Sulphate, when an active cathartic is indicated. In the same way it is the 
appropriate agent on the principle of derivation in dropsies and cerebral 
affections, also in torpid states of the intestines with much slimy intestinal 
mucus; but it is contraindicated in cases attended by irritability of the 
stomach and bowels. 



SCILLA, Squill, — is the sliced bulb of Urginea ??iariti?na, a peren- 
nial plant of the nat. ord. Liliacese, growing on the shores of the Medi- 
terranean. Its active principle has not yet been definitely isolated, but it 
is probably the acrid, bitter glucoside Scillitoxin. Other principles have 
been obtained and named Sciliipicrin, Scillitin and Scillin, also Sinistrin a 
peculiar carbo-hydrate or mucilage, and the usual constituents of plants. 
Dose, in powder, gr. j-iij. 

Preparations. 

Extractum Scillse Fluidum, Fluid Extract of Squill. — Dose, TT\j-v. 

Tinctura Scillae, Tincture of Squill, — 15 per cent. Dose, TTLv-xxx. 

Acetum Scillae, Vinegar of Squill, — 10 per cent. Dose, m^x— 5 j. 

Syrupus Scillae, Syrup of Squill, — has of the Acetum 45 parts, with Sugar 80, and 
Water to 100. Dose, 3 ss— ij . 

Syrupus Scillae Compositus, Compound Syrup of Squill, — has of the fluid extracts 
of Squill and Senega, each 8, Tartar Emetic 0.2, Calcium Phosphate I, Sugar 75, Water 
to 100. Is known popularly as Coxe's Hive Mixture, and contains a little less than one 
grain of Tartar Emetic to the fluid ounce (15 grains in 17 fl. ozs.). Dose, for chil- 
dren, lTLv-^j, the latter being an emetic dose ; for adults, as an expectorant, rr^xx-xxx. 

Physiological Action and Therapeutics. 
In small doses Squill is expectorant, in larger doses emetic and diuretic, 
and in overdoses it is a violent irritant poison, producing nausea, vomiting, 



scoparius. 437 

purging, gastroenteritis, strangury, bloody urine, perhaps suppression of 
urine, paralysis and convulsions, with death by paralysis of the heart in 
systole. Medicinal doses slow the heart, making the pulse stronger and 
slower, raising the arterial tension, and increasing the flow of urine (like 
Digitalis) Its active constituents diffuse into the blood, and its systemic 
effects follow on its application to the skin and seem to be exerted upon 
the mucous membrane of the secretory organs, especially affecting the 
bronchial, gastro-intestinal and genito-urinary. 

Squill is employed in medicine for its expectorant and diuretic effects. 
It is especially applicable in cardiac dropsy, combined with Digitalis or 
the saline diuretics, and in chronic bronchitis, in which it maybe associ- 
ated with Ipecac or Ammonia, Asafcetida, Benzoin, etc. It is also used 
in croup, but is usually combined in this affection with some other emetic, 
as Tartar Emetic in the Compound Syrup, a mixture which may produce 
very depressing effects and should be used with caution. In whooping- 
cough and other irritant coughs with tickling sensations in the throat the 
Syrup or Vinegar of Squill is often of great service. 

The action and uses of Squill should be studied in connection with 
those of Digitalis and Ipecacuanha. 



SCOPARIUS, Broom, — the tops of Cytisus Scoparius, the Broom- 
plant, a common garden shrub of the nat. ord. Leguminosae, having 
small, downy leaves and numerous large golden-yellow flowers. It con- 
tains Scoparin, C2iH 22 O 10 , a neutral, crystallizable principle ; and Spar- 
teine, C 15 H 26 N 2 , a volatile, liquid alkaloid, having no oxygen, but possess- 
ing very decided basic qualities and being highly poisonous. 

Preparations. 

Extractum Scoparii Fluidum, Fluid Extract of Scoparius, — made with diluted 
alcohol. Dose, 3 ss- ij- 

Decoctum Scoparii, Decoction of Broom-tops (Unofficial), — 5J to the pint. Dose, 
5J every three hours until a diuretic effect is produced. 

Sparteinse Sulphas, Sparteine Sulphate, — white, prismatic crystals, or a granular 
powder, of slightly saline and bitter taste, very soluble in water and alcohol. Dose, gr. 
y 1 — i, hypodermically ; — gr. ^-ij per orem. Small doses, gr. j-g—^, every five hours, for 
cardiac action ; — larger, gr. j-ij, for diuresis. (Clarke.) Larger doses are necessary, say 
gr. iss-iij, ter die. (Prior.) 

Physiological Action. 

Broom-tops are diuretic and laxative, also emetic and cathartic in large 
doses. In the form of decoction they have long been a favorite diuretic 
and vehicle for other diuretics, in the treatment of dropsies, both cardiac 
and renal, but are considered most reliable in the dropsy of renal origin. 

Sparteine has been thought to resemble Coniine in its action, paraly- 
zing the end-organs of the motor nerves and vagi, lowering the reflex 



438 scoparius. 

excitability of the cord, and causing death by paralyzing the respiratory 
centre in the medulla. Recent observations, however, place it in the 
Digitalis group, and in the front rank among the members thereof. In 
small doses Sparteine slows and strengthens the heart-beats, and raises 
arterial tension, at the same time increasing the cutaneous and renal cir- 
culation, so that the surface becomes flushed and moist, and in some cases 
marked diuresis and diaphoresis occur. The respiration, at first quick- 
ened, is soon slowed and deepened, — the patient having a sense of in- 
creased warmth and well-being, and if suffering from irregular cardiac 
action, prsecordial distress and dyspnoea, these symptoms are promptly re- 
lieved. If the pulse has been abnormally slow Sparteine will quicken it, 
though its general action is to slow the cardiac rate. An overdose brings 
on marked palpitation, a small and rapid pulse of very high tension, prse- 
cordial pain and a sense of " tightness " about the chest, with anxiety, and 
a feeling of intense debility, perhaps even muscular tremor. Death occurs 
by asphyxia from depression of both the centre and the muscles of respi- 
ration. 

Sparteine acts directly on the cardiac muscle, as well as upon the inhib- 
itory apparatus, thus giving greater force to the cardiac contractions, and 
regulating (generally slowing) the pulse-rate. It also stimulates the vaso- 
motor centre to contract the vessels throughout the splanchnic area, thus 
increasing the circulation in the skin and kidneys, and raising arterial 
tension generally. Its diuretic power on healthy persons is denied by some 
observers and affirmed by others, though all acknowledge it in disease. It 
is accompanied by increased excretion of urea, — is due to the increase of 
blood-pressure both behind and in front of the renal circulation, — and is 
produced only by large doses, gr.^-gr. ij. 

The action of Sparteine upon the circulation is manifested quickly as 
compared with that of other similarly acting drugs. In y^ hour after its 
ingestion the pulse is markedly slower, — in another y 2 hour the arterial 
tension rises, and both effects last from 5 to 6 hours. When taken regu- 
larly for several days or weeks its influence remains for nearly a week after 
its discontinuance. There is, however, no danger of cumulative action, 
and though the dosage employed has varied from gr. y 1 ^ every 4 hours, to 
gr. xij in 24 hours, no toxic action was observed, nor was there any evi- 
dence of accumulation, even when given continuously for 3 to 4 months. 
(Clarke.) Only from a dose of gr. xxxj were evil effects observed. (Prior.) 

Therapeutics. 
Broom-tops are a favorite remedy for dropsies of .cardiac origin, and 
for the general anasarca of chronic kidney disease, but are inadmissible 
in acute renal affections or where there is pulmonary congestion or in- 
flammation. 



SCUTELLARIA — SENEGA. 439 

Sparteine has been employed with very great benefit in cardiac affec- 
tions requiring stimulation of the heart's action with the smallest possible 
increase of arterial tension, relief of dyspnoea, praecordial pain, palpita- 
tion and oedema. In such cases small doses, gr. -^ to \, are best, and as 
the influence of the drug is remarkably sustained, they need not be re- 
peated oftener than once in 5 or 6 hours. It has given the most marked 
satisfaction in mitral regurgitation, in which it relieves all the symptoms; 
also in mitral stenosis, when the pulse is small, weak and irregular. In 
aortic regurgitation, it quiets excited action of the heart, without unduly 
prolonging the systole, and is of great value. Used in chronic Bright's 
disease, with hypertrophy and high arterial tension, it stimulates the heart 
without increasing the tension. In exophthalmos, it gives remarkable 
relief to all the symptoms. For cardiac palpitation and arrhythmia, small 
doses are of great service. In asthma it is of signal benefit, cutting short 
the paroxysms, and rendering their recurrence much less frequent. In 
the opium-habit it is used at periods of depression during the treatment, 
to overcome the " plateau " shown in the sphygmograph trace, by stimu- 
lating the cardiac action. (Jennings.) For this purpose, doses of gr.iss-iij 
three or four times daily are necessary. (Prior.) 



SCUTELLARIA, Skull-cap, — is the plant Scutellaria lateriflora, an indigenous, 
perennial herb of the nat. ord. Labiatse, growing in moist places and along ditches. It 
contains a little volatile oil, traces of a bitter principle, besides fat, tannin, sugar. 

Extractum Scutellariae Fluidum, Fluid Extract of Scutellaria.— Dose, gss-ij. 

Scutellaria produces no very obvious effects when taken internally. By some practi- 
tioners it is said to have tonic, nervine and antispasmodic powers, and it has been used in 
domestic practice to calm the nervous system in diseases characterized by restlessness, 
tremors, spasms, twitching of the muscles, hyperesthesia, etc., as chorea, delirium tremens, 
nervous exhaustion from fatigue or over-excitement, hydrophobia, hysteria and epilepsy. 
The Scutellarin of the eclectics is not a proximate principle, but an extract precipitated 
by alum from a concentrated aqueous tincture. It is given in dose of gr. j-iv. 



SENEGA, — is the root oi Poly gala Senega, an indigenous, perennial 
plant of the nat. ord. Polygalese, having small, white flowers in a close 
spike at the summit of the stem. Its principal constituent is the glucoside 
Senegin, C 32 H 54 18 , which is identical with Saponin, and closely allied to 
Digitonin. It is a white, amorphous powder, readily soluble in alcohol 
and hot water, forming a soapy emulsion when mixed with boiling water, 
and decomposed by HC1 into sugar and Sapogenin, C M H 22 2 . 

Preparations. 

Extractum Senegas Fluidum, Fluid Extract of Senega. — Dose, Tr^x-ocx. 

Syrupus Senegas, Syrup of Senega, — has of the fluid extract 20, Aqua Ammonias ^, 
Sugar 70, Water to 100. Dose, gj-ij. 

Syrupus Scillae Compositus, Compound Syrup of Squill, — contains 8 percent, of 
Senega. (See page 436.) Dose for children, Vt\v-^j ; for adults as an expectorant, 
rrixx-5ss. 



44° SENNA. 

Physiological Action and Therapeutics. 

Senega is a stimulating expectorant, a diuretic and a diaphoretic. It 
causes irritation of the throat, with some salivation and gastro-intestinal 
irritation, an inclination to cough, increased bronchial secretion, and 
perhaps some diuresis and diaphoresis. Inhaled as a snuff it is very irri- 
tant to the mucous membrane of the nose, causing cough, sneezing and 
nasal catarrh. Senegin is violently irritant and a powerful depressant to 
the heart, vessels, nervous and muscular systems. It is excreted by the 
bronchial mucous membrane, the kidneys and the skin, all of which it 
stimulates and in large quantity irritates. 

The use of Senega is chiefly that of a stimulating expectorant in chronic 
bronchitis, the second stage of acute bronchitis, typhoid pneumonia, 
asthma, croup, and as a diuretic in dropsy due to renal disease. It re- 
moves the tightness and oppression experienced in the subacute chest affec- 
tions, relieves the cough and rapidly promotes expectoration. When the 
mucus is tough and scanty this remedy is of no value. It has been used 
with benefit in amenorrhcea, given in saturated decoction for two weeks 
before the expected period. In chronic rheumatism and in rheumatic 
paralysis its stimulating and diaphoretic powers have been of great value. 
Senegin has been successfully used in 2-grain doses as a remedy for uterine 
hemorrhage. 

SENNA, — the leaflets of Cassia acutifolia (Alexandria Senna), and of 
Cassia angustifolia (India Senna), shrubs of the nat. ord. Leguminosae, 
growing in Egypt and India. They contain an amorphous glucoside, 
Cathartic Acid, C 180 H 192 N 2 SO 82 , which forms salts with bases and may be 
decomposed into glucose and Cathartogenic Acid. Other constituents 
are Sennapicri?i and Sennacrol, both glucosides ; — Catharto-mannite, a 
peculiar unfermentable sugar; also a coloring matter allied to Chrysa- 
robin and various vegetable salts. 

Preparations. 

Extractum Sennae Fluidum, Fluid Extract of Senna, — an excellent preparation. 
Dose, 3 ss- 3 ss. 

Syrupus Sennae, Syrup of Senna, — has of Alexandria Senna 25, Oil of Coriander 
]/ z , Alcohol 15, Sugar 70, Water to 100. Dose, 3J- £J. 

Confectio Sennae, Confection of Senna, — has of Senna 10, Cassia Fistula 16, Tama- 
rind 10, Prune 7, Fig 12, Sugar 55>£, Oil of Coriander ]/ z , Water to 100. Is sold under 
the trade names " Tamar-In'dien" " Tropical Fruit Laxative ," etc. Dose, 3J-ij. 

Infusum Sennae Compositum, Compound Infusion of Senna, Black Draught, — 
has of Senna 6, Manna 12, Magnesium Sulphate 12, Fennel 2, Boiling Water 80, Cold 
Water to 100. Dose, ^j-iij. 

Pulvis Glycyrrhizae Compositus, — Compound Liquorice Powder (See under Gly- 
cyrrhiza), — contains 18 per cent, of Senna. Dose, ^ss-gjss. 

Syrupus Sarsaparillae Compositus, Compound Syrup of Sarsaparilla (See under 
Sarsaparilla) , — contains l}i per cent, of the fluid extract of Senna. Dose, 3J~,oJ- 



SERPENTARIA. 44 1 

Physiological Action and Therapeutics. 

Senna is a very efficient and safe cathartic, producing, when taken in- 
ternally, copious yellow stools in about 4 hours, with considerable griping 
and flatulence, which may, however, be lessened by combining it with 
carminatives. Its action is chiefly expended on the small intestine, and 
it increases both peristalsis and secretion. It has no irritant quality in 
ordinary medicinal doses, and does not produce hypercatharsis, nor leave 
constipation as an after-result. Its infusion injected into the veins causes 
both vomiting and purging ; and in large doses per orem it produces nau- 
sea, vomiting, flatulence, excited pulse, and drastic purgation with severe 
tenesmus, but its effects are never poisonous. It may cause hemorrhoids 
and increase the menstrual flow in women. Given to a nursing mother 
her milk will acquire purgative powers. In some very susceptible persons 
the odor of the leaves or of the infusion will cause an evacuation of the 
bowels. Its odor and taste are particularly disagreeable, especially when 
administered in infusion. 

Senna would probably take rank as our best and safest cathartic but for 
the nauseousness of its smell and taste. It is a favorite laxative in England 
for children, and is used with great benefit in habitual constipation or 
where prompt evacuation of the bowels is required. In hemorrhoids and 
anal fissures it is employed to produce soft and easy motions ; but if a ten- 
dency to hemorrhoids exists, the use of this drug in cathartic doses will 
cause irritation of the part and induce an acute attack. For the same 
reason it is contraindicated in any such conditions as hemorrhage or in- 
flammation of the intestinal mucous membrane, hemorrhoids, menorrhagia, 
abortion, etc. The least disagreeable of its preparations are the Confection 
of Senna and the Compound Liquorice Powder. 



SERPENTARIA, Virginia Snake-Root,— is the rhizome and 
roots of Aristolochia Serpentaria and of Aristolochia reticulata, indigenous 
herbaceous plants of the nat. ord. Aristolochiacese, growing in rich, shady 
woods, with purple flowers arising from joints near the root. It contains 
a volatile oil, a. camphor-resin and a bitter principle named Aristolochine, 
which is soluble in both alcohol and water. All its preparations should 
be made from the fresh root, as it deteriorates by keeping. 



Preparations. 

Extractum Serpentariae Fluidum, Fluid Extract of Serpentaria. — Dose, ttlx -xxx. 
Tinctura Serpentariae, Tincture of Serpentaria, — 10 per cent. Dose, gss-ij. 
Tinctura Cinchonas Composita, Compound Tincture of Cinchona, — has two parts 
of Serpentaria in 100. (See ante, under Cinchona.) Dose, gj-ij. 



44 2 sesami oleum — sevum silicates. 

Physiological Action and Therapeutics. 

Serpentaria is a stimulant expectorant and tonic, also a cardiac stimu- 
lant, a diaphoretic, diuretic, emmenagogue, aphrodisiac, and somewhat of 
an antiperiodic. Its taste is warm and pungent, its odor characteristic. 
Small doses promote appetite and digestion, increase the bronchial and 
intestinal secretions, the action of the heart, the cutaneous circulation 
and the surface temperature, and produce considerable mental exhilara- 
tion. Large doses are irritant, causing nausea and vomiting, vertigo and 
headache, colic, borborygmi, rectal tenesmus, flatulent distention and fre- 
quent but not watery stools. The irritant action seems to produce gas 
rather than fluid. Pruritus ani and hemorrhoids are occasionally caused 
by its use. 

Serpentaria is chiefly employed as a vehicle for other stimulant drugs, 
but has many uses of its own. In bronchial affections it is extremely 
valuable as a stimulating expectorant. In typhoid pneumonia it is a good 
vehicle for ammonium carbonate, and in the exanthemata is extremely 
useful when much depression exists. It is indicated in typhoid conditions 
generally, and in the amenorrhcea of anaemia and chlorosis it is an efficient 
emmenagogue in many cases. It will often restore the waning sexual 
power in functional impotence, while in bilious vomiting it frequently 
checks the nausea and settles the stomach. It is used as a vehicle for cin- 
chona in remittent fever. In diphtheria, scarlatina, etc., an infusion forms 
an excellent gargle. Its diaphoretic and diuretic properties, though slight, 
are sometimes of avail in chronic rheumatism. 



SESAMI OLEUM, Oil of Sesamum, Teel Oil, Benne Oil,— is a fixed oil ex- 
pressed from the seeds of Sesamum indicum, or Benne plant (nat. ord. Pedaliaceae), which 
is a native of India, but is cultivated in the southern portion of the U. S. It is a yellow- 
ish or yellow, oily liquid, inodorous or nearly so, having a bland, nut-like taste and a 
neutral reaction. It is a bland fixed oil, very similar in its properties to olive oil, and 
may be used for the same purposes. It is rich in Olein (76 per cent.) and keeps better 
than olive oil. It is chiefly employed as a hair-oil. 

SEVUM, Suet, Mutton Suet, — is the internal fat of the abdomen of Ovis Aries 
(the Sheep) , purified by melting and straining. It should be kept in well-closed vessels 
and not used after it has become rancid, as it will on exposure to air. It is a white, 
smooth, solid fat, of bland taste and neutral reaction, insoluble in water or cold alcohol, 
soluble in 44 of boiling alcohol, 60 of ether, and slowly in 2 of benzin. It consists 
chiefly of Stearin, but also has Palmitin and Olein, and is a constituent of Unguentum 
Hydrargyri. It is a harder fat than lard and more liable to turn rancid. It is used in 
ointments and liniments to give them greater consistency, but may be applied alone as a 
dressing to ulcers. In physiological action and therapeutics it follows the other oils and 
fats. (See under Morrhu^; Oleum and Oliv^e Oleum, ante.) 



SILICATES of Sodium (Na 2 Si0 3 ), of Potassium (K 2 Si0 3 ), and of 
Magnesium (2Mg03Si0 2 ) are used in medicine and surgery, a solution of 
the Sodium Silicate being official. 



sinapis. 443 

Liquor Sodii Silicatis, Solution of Sodium Silicate, Soluble Glass 
Solution, — is a semi-transparent, colorless or yellowish, viscid liquid, 
odorless, of sharp saline and alkaline taste and alkaline reaction, of sp. 
gr. 1.300 to 1.400. A small quantity should not produce any caustic 
effect when applied to the skin. It usually contains about 20 per cent, 
of Silica and 10 per cent, of Soda, and is used on bandages to make 
immovable dressings, being lighter than plaster-of- Paris and stronger than 
starch. 

Liquor Potassii Silicatis, Solution of Potassium Silicate (Unofficial), — also known 
as Soluble Glass Solution, — is used for immovable dressings in the same manner as the 
preceding. A mixture of 2 parts of this solution with one of the soda salt solution is 
said to set more quickly and firmly than either solution separately. Diluted (i to 4) the 
solution of Potassium Silicate has been applied locally in erysipelas, gonorrhoea, cystitis, 
vaginitis, etc., as an antiseptic, and with good results. 

Magnesii Silicas Hydratus, Hydrated Magnesium Silicate, Meerschaum, 2MgO,- 
3Si0 2 -\- 2H 2 (Unofficial), — a mineral used for the manufacture of smoking-pipes, and 
employed in France as a substitute for Bismuth Subnitrate in obstinate choleraic diarrhoea, 
to protect the intestinal mucous membrane or as an absorbent. It is given in fine powder 
and in doses of gj-iv per diem. 

SINAPIS, Mustard, — is official under the two following titles, but 
the pharmacopceial preparations are directed to be made from Black Mus- 
tard only : — 

Sinapis Alba, White Mustard, — the seed of Brassica alba, an annual 
plant of the nat. ord. Cruciferae, cultivated in our gardens. It has yellow 
flowers in racemes, and ribbed pods with a long, ensiform beak. 

White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline substance, 
which reacting on each other in the presence of water produce Sulpho-cyanate of Acrinyl, 
a rubefacient principle allied to the volatile oil of black mustard. It also contains Sin- 
apine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil, all three contained also 
in Black Mustard. 

Sinapis Nigra, Black Mustard, — is the seed of Brassica nigra, an 
annual plant of the nat. ord. Cruciferae, native of Europe, but naturalized 
in the U. S. It has small, yellow flowers standing closely together on 
peduncles at the end of the branches, also smooth, erect pods with a 
short beak. 

Black Mustard contains Myrosin, a ferment, and Sinigrin (Potassium Myronate), 
which reacting on each other in the presence of water produce the Sulpho-cyanide of 
Ally I, or Volatile Oil of Mustard. It also contains Sinapitie, an alkaloid, Erucic or 
Brassic Acid, and a bland, fixed oil ; all three of which are contained also in White 
Mustard. 

Commercial Flour of Mustard (Unofficial), — is a mixture of white 
and black mustard seeds ground to a fine powder. It may be employed 
in lieu of either variety. Dose, as emetic, 3ij-iv. 



Oleum Sinapis Volatile, Volatile Oil of Mustard, Sulpho-cyanide of Ally 'I, C 4 H 5 - 
NS, — a colorless or pale yellow liquid, of very pungent and acrid odor and taste and 



444 sodium. 

neutral reaction, sp. gr. 1.018 to 1. 029, almost insoluble in water but freely soluble in 
alcohol and ether. Dose, ffL^-X* 

Charta Sinapis, Mustard Paper, — consists of Black Mustard, the fixed oil removed 
by percolation with Benzin, mixed with Solution of Gutta-Percha and spread on paper. 
Each square inch should contain about gr.vj of Mustard. For local use. 

Linimentum Sinapis Compositum, Compound Liniment of Mustard, — has of the 
Volatile Oil 3, Fl. Ext. of Mezereum 20, Camphor 6, Castor Oil 15, Alcohol to 100. For 
local use. 

Physiological Action and Therapeutics. 

Locally used, Mustard is rubefacient, counter-irritant, and a nervous 
stimulant, causing heat, redness and severe burning pain. Its prolonged 
application produces vesication by inducing local inflammation. Inter- 
nally it is a local emetic in full doses, in smaller a condiment and carmi- 
native. Its irritant effect on the gastric mucous membrane is much less 
powerful than on the skin. 

Mustard is commonly used as a local application to relieve local pain, 
to stimulate the viscera, and to produce counter-irritation. These objects 
find their application in muscular rheumatism, neuralgia, colic, gastralgia, 
inflammation of the throat, larynx, bronchi, lungs, pleurae and pericar- 
dium, also as a derivative in headache, cerebral congestion, and suppressed 
menstruation. It may also be used as a stimulant to the heart, vascular 
system and respiratory apparatus. When action of a mild character is 
desired it may be diluted with flaxseed or flour. 

Internally it may be employed as an emetic in indigestion or narcotic 
poisoning. Its use as a condiment is familiar, acting by stimulation of 
the gastric mucous membrane. In overdoses it may excite severe gastritis. 
White Mustard seed, unground, has been used as a laxative, as it produces 
no irritation. The Oil is one of the most irritant of the volatile oils, 
producing severe gastro-enteritis. It is used chiefly as an ingredient of 
stimulating liniments, but may be employed internally in small doses. 



SODIUM, Natrium, Na. — This metal is represented by a number 
of official salts, which are generally colorless or white, and with very few 
exceptions are readily soluble in water. Some of them are found native, 
as the Chloride (in sea-water, salt lakes, salt mines), — the Nitrate (in 
Peruvian deserts, etc.) and the Borate (in lakes of Persia, California, 
etc.). The Carbonate is found in the ashes of marine plants. From the 
Chloride is prepared the Sulphate, from this the Carbonate, and from the 
latter most of the other salts are prepared. All sodium salts impart a 
yellow color to flame, which should not appear more than transiently red 
when observed through a blue glass, which cuts off the yellow rays but 
allows the violet ones of Potassium to be seen. 

Sodium Compounds and their Preparations. 
Soda, Sodium Hydrate, Caustic Soda, NaOH, — a white, hard, opaque solid, deliques- 
cent in moist air, efflorescent in dry air, odorless, of intensely acrid and caustic taste and 



sodium. 445 

strongly alkaline reaction, soluble in 1.7 of water at 59 F. , and in 0.8 of boiling water, 
very soluble in alcohol. Is a powerful caustic, but milder than Potassa, and should be 
kept in well-stoppered bottles made of hard glass. 

Liquor Sodse, Solution of Soda, — contains about 5 per cent, of the hydrate, and is pre- 
pared by dissolving Sodium Carbonate 170, in 400 of boiling Distilled Water, also 50 of 
Lime in the same quantity of Di>tilled Water, boiling, mixing the solutions gradually, 
again boiling and when cold adding water up to 1000 parts, straining, settling, and then 
removing the clear solution. Or, by dissolving 56 of Soda in 944 of Distilled Water. It 
is a clear, colorless liquid, odorless, of acrid and caustic taste and strongly alkaline. 
Dose, TTlv-^ss, well diluted with water. 

Sodii Acetas, Sodium Acetate, XaC 2 H 3 2 -f- 3H 2 0, — large, transparent prisms, efflo- 
rescent in dry air, odorless, of saline, bitter taste and a neutral or faintly alkaline reaction, 
soluble in 1.4 of water and in 30 of alcohol at 59 F., in y z of boiling water and in 2 of 
boiling alcohol. Dose, gr. xx-gj. 

Sodii Carbonas, Sodium Carbonate, Xa 2 C0 3 4- ioH 2 0, — large, colorless crystals, 
rapidly efflorescent, with a harsh alkaline taste and strongly alkaline reaction ; very solu- 
ble in water, insoluble in alcohol. By heat it undergoes aqueous fusion and then dries 
up, losing 63 percent, of its weight. Of it 20 grains will neutralize 9.7 grains of Citric 
Acid, or \oy 2 grains of Tartaric Acid. Dose, gr. v-xxx. 

Sodii Carbonas Exsiccatus, Dried Sodium Carbonate, — is the Carbonate 200 parts 
dried at a heat of 113 F. , until it is converted into a white powder weighing 100 parts. 
Is chiefly used for pharmaceutical purposes. 

Sodii Bicarbonas, Sodium Bicarbo?tate, NaHC0 3 , — an opaque, white powder, per- 
manent in the air, odorless, of cooling, saline taste, and a slightly alkaline reaction ; solu- 
ble in II. 3 of water at 59 F., insoluble in alcohol, decomposed by hot water and con- 
verted into normal Carbonate. It is distinguished from the Carbonate by its solution in 
cold water giving a white and not a colored precipitate with solution of perchloride of 
mercury. Of it 20 grains neutralize 16.7 grains of Citric Acid, or 17.8 grains of Tartaric 
Acid. It is a constituent of Mistura Rhei et Sodas and of Pulvis Effervescens Compositus. 
Dose, gr. x-3J. 

Trochisci Sodii Bicarbonatis, Troches of Sodium Bicarbonate, — each troche contains 
of the Bicarbonate about 3 grains, with Sugar, Nutmeg and Mucilage of Tragacanth. 
Dose, as of the Bicarbonate. 

Sodii Chloras, Sodium Chlorate, NaC10 3 , — colorless, transparent tetrahedrons of the 
regular system, permanent in dry air, odorless ; of cooling, saline taste and neutral re- 
action, soluble in 1. 1 of water and in about 100 of alcohol at 59 F., also in 0.5 of boil- 
ing water and in about 40 of boiling alcohol. When heated it melts and then gives off 
a portion of its oxygen, leaving a residue of sodium chloride. Should be kept in well- 
stoppered bottles, and should not be mixed or heated or triturated with readily oxidizable 
or combustible substances. Dose, gr.v-xx. 

Sodii Chloridum, Sodium Chloride, Common Salt, XaCl, — white, hard, cubical 
crystals or a crystalline powder, permanent in the air, odorless, of a purely saline taste 
and neutral reaction; soluble in 2.8 of water at 59 F., and in 2.5 of boiling water. Al- 
most insoluble in alcohol. Dose, gr. x-gj. 

Sodii Nitras, Sodium Nitrate [Cubic Nitre, Chili Nitre, Chili Saltpetre), XaX0 3 , — 
colorless, transparent crystals, slightly deliquescent, odorless, of cooling, saline and bitter 
taste, and neutral reaction; soluble in 1.3 of water at 59 F., in 0.6 of boiling water, 
scarcely soluble in cold alcohol. Dose, ^j-ij. 

Sodii Sulphas. Sodium Sulphate, Glauber" 1 ' s Salt, Xa. 2 S0 4 -f- IoH 2 0, — large, color- 
less, transparent, monoclinic prisms, rapidly efflorescent in air; of cooling, saline taste 
and neutral reaction ; soluble in 2.8 of water at 59 F. , in 0.25 of water at 93. 2° F. , and 
in 0.47 of boiling water, insoluble in alcohol. Dose, gr.v-xx ; as a purgative 3 ss-j or 
a third of a teaspoonful in a large glass of water. 

Sodii Ethylas, Sodium Ethylate, Caustic Alcohol, C 2 H 5 XaO (Unofficial), — is a white 
powder, often having a brownish tinge, dissolving in water with a hissing sound. Upon 
contact with the smallest quantity of water or moist living tissue it splits into alcohol 
and caustic soda. An alcoholic solution is made by dissolving sodium in absolute 



446 SODIUM. 

alcohol, and is used as a caustic. Chloroform decomposes it at once into ether and 
sodium chloride. It should be kept in a cool place as it is liable to explode. 

The Arsenate is described under Arsenum ; — the Benzoate under Benzoinum ; — 
the Borate under Acidum Boricum ; — the Bromide under Bromum ; — the Solution 
of Chlorinated Soda under Chlorum ; — the Iodide under Iodum ; — the Hypophos- 
phite, Phosphate and Pyrophosphate under Phosphorus ; — the Nitrite under Amyl 
Nitris ; — the Salicylate under Salicin ; — the Sulphite, Bisulphite and Hyposul- 
phite under Acidum Sulphurosum; — and the Sulpho-carbolate under Acidum Car- 

BOLICUM. 

Physiological Action. 

The action of the Sodium salts is similar to that of the Potassium salts, 
except that the former are feebler as alkalies, are not so depressant, and 
are not so poisonous to the cardiac muscle or the nerves. They are dif- 
fused more slowly, are neither absorbed nor excreted so readily, and have 
not so marked a diuretic action. Locally applied in large doses to mus- 
cular and nervous tissue they are paralyzant, but not so powerfully as 
potassium salts. Sodium Urate is not soluble like the urates of lithium 
and potassium, and is therefore much less readily excreted, forming the 
masses called chalk-stones in gouty subjects. Soda is a less active eschar- 
otic than potash, having less affinity for water. Liquor Sod^e renders the 
blood and secretions more alkaline, but does not alter nutrition to the 
extent that liquor potassse does. The Acetate is converted into the 
Carbonate in the blood, and is a less active diuretic than the correspond- 
ing potassium salts. The Carbonate is chiefly used in the preparation 
of the other salts. The Bicarbonate is slightly irritant, stimulates the 
secretion of gastric juice, acts as an antacid and will increase the alka- 
linity of the blood. The Nitrate is a mild cathartic, and in solution is 
a solvent of false membranes. The Ethylate is an antiseptic, and a 
powerful but almost painless caustic. 

Sodium Chloride (common salt) is one of the most important and 
abundant of the saline constituents of the animal organism, existing nor- 
mally in the blood, where it keeps the fibrin and albumen in solution ; 
hence in inflammation, being thus needed, it accumulates at the seat of 
the morbid action, disappearing temporarily from the urine ; its reap- 
pearance therein being considered one of the surest signs of the patient's 
improvement. In very dilute solution it enables water to dissolve both 
albumins and globulins, and renders water non-irritant to the animal 
tissues and harmless to the red blood-corpuscles. For these purposes the 
solution employed is one of 0.65 per cent., known in experimental physi- 
ology as the " normal salt solution." In substance, however, or in con- 
centrated solution, the salt is very irritant to cut surfaces, mucous mem- 
branes, muscle and nerve tissues. Taken into the stomach in quantity it 
irritates that organ, and induces vomiting; and, when absorbed in excess 
of the normal requirements of the body, it causes, in great intensity, the 
peculiar nervous irritation which is expressed by the sense of thirst; and 



sodium. 447 

this is only relieved by the ingestion of water in sufficient quantity to 
enable the excess to be dissolved and excreted by the kidneys. It is 
rapidly absorbed, and equally rapidly excreted ; and, when consumed in 
excess, it increases tissue-change, and consequently the excretion of urea, — 
and also the excretion of potassium salts. On the other hand, the exces- 
sive ingestion of potassium salts (as in the cases of herbivorous animals 
and vegetarian cranks) increases the excretion of sodium chloride, by a 
double decomposition between these salts in the blood, forming potassium 
chloride and sodium phosphate, which, being foreign to the blood, are 
constantly excreted. In this way, by a continuous vegetable diet, the 
normal amount of sodium chloride in the organism may be greatly 
reduced ; and the animal will feel the want of it, and will travel hundreds 
of miles to visit a salt-lick. Besides being emetic, when given internally, 
Sodium Chloride also acts as a hemostatic, decreases the secretion of 
mucus, is a vermifuge against ascarides, promotes the absorption of 
pleuritic serous exudations and of dropsies, and has considerable power 
as an antiperiodic and an antiseptic. 

Sodium Sulphate, administered by the mouth in dilute solution, excites 
active secretion in the intestines, especially in the small intestine, by its 
bitterness in part, and also by its irritant quality and its specific property 
of stimulating the activity of the intestinal glands. This action is not an 
osmotic one, as was formerly taught. The stimulation caused by this 
salt extends to the liver and the pancreas, especially the former. The 
absorption of the secretions is impeded by the low diffusibility of the 
salt, so that the result is a large accumulation of fluid in the intestinal 
canal, which finds its way to the rectum and produces purgation. The 
more dilute the solution employed the more prompt will be the effect, 
but this salt will not produce catharsis if administered in concentrated 
form. When injected into the blood it excites no intestinal secretion, 
does not act as a purgative, and produces no toxic effect. [Magnesium 
Sulphate is toxic when so administered.] The quantity of Sodium Sul- 
phate to the pint of Carlsbad water (Sprudel) is 20 grains, in Friedrichs- 
thal 46^ grains, and in Hunyadi Janos from 122 to 173 grains ; the latter 
being the most active hepatic stimulant of the three. A mixture of the 
Sulphate and the Bicarbonate is sold as the natural salt obtained by 
evaporation of Carlsbad water. 

The action of the other Sodium salts is described under the titles of 
the respective constituents to which their effects are mainly referable. 



Antidotes and Inco?npatibles. 

Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, 
lemon-juice ; then demulcent drinks and oils to protect the mucous membrane, and the 
usual vital supporters. The alkalies and their carbonates are incdmpatible with the acids 
and also with metallic salts, and the caustic alkalies decompose most alkaloids. 



44^ SOLANUM CAROLINENSE SPIGELIA. 

Therapeutics. 

The Sodium salts treated of in the first paragraph above are not much 
used internally, the corresponding Potassium salts being preferred, especi- 
ally when it is desired to alkalinize the urine or to promote oxidation. In 
the alkaline treatment of stomach affections the Sodium salts are the most 
efficient, especially the Bicarbonate, in small doses before meals or on 
an empty stomach to increase the secretion of the gastric juice. This 
same salt is used in diabetes to lessen the amount of sugar, in frontal 
headache with constipation, the pain being seated at the junction of the 
forehead with the hairy scalp, also as a wash (gr. ij ad §j) in itching skin 
affections and as a lotion in burns and eczema. The Chloride is used 
internally as an antidote in poisoning by Silver Nitrate and as an emetic, 
and will often relieve hemoptysis and migraine. In bilious diarrhoea it 
is employed in doses of gr. x-3j, thrice daily. Locally in baths it is a 
good stimulant to the skin, and in solution (j4 to i per cent.) to wash 
wounds in place of water, to cleanse the nasal cavities, or to destroy 
ascarides, in which case it is given by enema of the strength of two 
tablespoonfuls to the pint. The Carbonate may be used in dilute solu- 
tion locally to prevent itching, but is chiefly employed in the preparation 
of the other salts. The Sulphate is a good purgative and hepatic stimu- 
lant, and is given, either alone or with the Bicarbonate in imitation of 
Carlsbad Salts, for bilious disorders, gouty affections, chronic constipa- 
tion, obesity and diabetes mellitus. The Chlorate has similar uses to 
those of Potassium Chlorate, and being more soluble can be used in 
stronger solutions, but this is of doubtful benefit for internal use, as it 
has all of the irritating power on the kidneys and destructive action on 
the blood possessed by the other salt. The Nitrate is employed as a 
mild cathartic, and in solution by atomization to destroy the false mem- 
brane in croup. The Ethylate has been of service as a caustic in cancer, 
lupus and n?evus, for the latter affection being painted over the growth 
with a glass rod. Caustic Soda is a better escharotic than caustic 
potassa, as it has less affinity for water, and hence does not destroy the 
tissues so deeply, nor has it the same tendency to run over adjacent parts. 

The therapeutics of the other sodium salts are described as mentioned 
on the preceding page. 

SOLANUM CAROLINENSE, Horse-nettle, Sand-brier (Unofficial), — is a weed 
belonging to the nat. ord. Solanaceae, a native of Florida and Carolina. In epilepsy a 
20 per cent, tincture of the berries is highly recommended, in doses of % ss-j thrice 
daily. It has also been used with benefit in convulsions due to the albuminuria of 
pregnancy and other convulsive affections. 

SPIGELIA, Pink-root, — is the rhizome and roots of Spigelia ma- 
rilandica, the Carolina Pink, an herbaceous perennial of the nat. ord. 



STAPH1SAGRIA STILLINGIA. 449 

Loganiaceae, native of the Southern States ; having large, showy flowers, 
scarlet or crimson externally, yellow within. It contains a bitter princi- 
ple and a volatile oil, also tannin, wax, resin, lignin and salts. Dose, 
5j-ij for an adult, gr. x-xx for a child of 3 years. 

Preparations. 

Extractum Spigelian Fluidum, Fluid Extract of Spigelia. — Dose for an adult, 
3 j-ij ; for a child of 3 years, TTlx-xx. 

Infusum Spigelian Compositum, Compound Infusion of Spigelia, Worm Tea (Un- 
official), — has of Spigelia 15, Senna 10, Fennel 10, Manna 30, Water 500. Dose, £ iss-v. 

Spigelia is anthelmintic against the round worm (Ascaris lumbricoides), 
and is in popular use as a vermifuge, administered usually with Senna. In 
large doses it is an uncertain cathartic, and may produce quite serious 
symptoms, as vertigo, dimness of vision, dilated pupils, spasms and even 
convulsions. These effects are most apt to occur when the drug fails 
to produce purgation, hence it is usually administered with an active 
cathartic. 

Spigelia Anthelmia, Demarara Pink-root, Worm-grass (Unofficial), — produces 
vomiting, dilated pupils, dyspnoea, convulsions, and death. If eaten by cattle they perish 
in great agony. It has been used with real benefit in cardiac affections of rheumatic ori- 
gin, also in rheumatic fever, and in cardiac palpitation with dyspnoea, due to mitral and 
aortic disease. A tincture (i to 8) may be used in doses of rr\v-xx. 



STAPHISAGRIA, Stavesacre, — is the seed of Delphinium Staphisagria, an annual 
or biennial plant of the nat. ord. Ranunculaceae, a native of Europe, having bluish or 
purple flowers, in terminal racemes ; and seeds in straight, oblong capsules. The seeds 
contain an alkaloid Delphinine, probably 3 other alkaloids, a bitter principle, a volatile 
oil and a fixed oil, etc. There are no official preparations. 

Unguentum Staphisagriae, Ointment of Staphisagria (Unofficial), — contains of the 
powdered seeds I part with 2 each of olive oil and lard. 

Delphinina, Delphinine, C 22 H 35 N0 6 (Unofficial), — is the active alkaloid, and exists 
in the fatty oil which is extracted by ether. Dose, gr. Jg— \. 

Stavesacre is a violent emetic and cathartic, also parasiticide. The alkaloid is irritant 
to the skin if locally used, producing tingling, burning and inflammation. Internally, it 
lowers the activity of the heart and respiration and produces a most profound adynamia, 
and may prove fatal from paralysis of the spinal cord and asphyxia. In many respects 
its alkaloid resembles Aconitine and Veratrine. 

The ointment is often employed as a parasiticide against pediculi and the acarus scabiei. 
The fixed oil is probably equally effective. Delphinine has been used internally in asthma, 
rheumatism and neuralgia, and in the latter affection is well employed as an ointment 
(gr. xx to 25 j), applied over the course of painful superficial nerves. It has been suggested 
as an antipyretic arid for dropsy. A tincture or fluid extract is a very efficient application 
against pediculi. 



STILLINGIA, Queen's Root, — is the root of Stillingia sylvatica, 
or Queen's Delight, an indigenous, perennial plant of the nat. ord. 
Euphorbiaceae. It contains a resin and a volatile oil, but its active prin- 
ciple has not yet been isolated. The fresh root should be used in making 
the preparations, as those from the dried root are almost inactive. Dose 
of the powdered root, gr. x-gj. 
29 



450 STRAMONIUM. 

Preparations. 

Extractum Stillingiae Fluidum, Fluid Extract of Stillingia. — Dose, m^x-sjj. 

Tinctura Stillingiae, Tincture of Stillingia (Unofficial). — Dose, % ss-ij. 

Decoctum Stillingiae, Decoction of Stillingia (Unofficial). — %] adOj. Dose, ,^j-ij. 

Syrupus Stillingiae Compositus, Compound Syrup of Stillingia (Unofficial), — is 
composed of Stillingia, Corydalis, Iris, Chimaphila, Coriander, Xanthoxylum, Sambucus, 
Sugar, Water and Alcohol. For the formula, see U. S. Dispensatory, 17th edition, page 
1286. 

Physiological Action and Therapeutics. 

Stillingia in large doses is emetic and cathartic, in smaller doses it is 
expectorant, diaphoretic, diuretic, sialagogue and cholagogue, possessing 
the various properties which are considered "alterative." Its taste is 
acrid and pungent, and it increases the action of the heart, skin, kid- 
neys, and bronchial mucous membrane ; and the gastric, hepatic, intes- 
tinal and salivary excretions. Full doses often excite epigastric pain, 
nausea and vomiting. 

Stillingia is much employed with Sarsaparilla and similarly acting drugs 
as an alterative in syphilitic affections, particularly in chronic cases of 
the tertiary form, in which the system is greatly reduced by the abuse of 
mercurials and iodides. In these cases it possesses considerable power 
and frequently cures. It is also valuable in strumous affections, in 
ascites due to hepatic changes, portal changes with jaundice following 
malaria, habitual constipation, hemorrhoids from hepatic obstruction, 
and intermittents. In the latter affection the fluid extract with Quinine 
or Arsenic is a very useful combination. A strong decoction is used to 
ward off an impending paroxysm of ague. The compound syrup, not- 
withstanding its reputation as a model of polypharmaceutical skill, is 
still largely used in the West and South. 

STRAMONIUM, Thornapple.— The plant Datura Stramonium, 
the Jamestown Weed or Thornapple (nat. ord. Solanacese), is official in 
two forms, the leaves and the seed. It is an annual, of rank and vigorous 
growth, having a green stem with large white flowers. It grows wild in 
Southern Russia and the middle United States, and contains an alkaloid, 
Daturine (see below), which is generally considered identical with 
Atropine both physiologically and chemically, — also malic acid, albumen, 
gum, resin, etc. 

Stramonii Folia, Stramonium Leaves, — the leaves of Datura Stra- 
monium, of bitter and nauseous taste. Dose, gr. ij-xx. 

Stramonii Semen, Stramonium Seed, — the seed of Datura Stra- 
monium, of unpleasant odor when bruised and an oily, bitter taste. Dose, 
gr. j. The official preparations are all made from the seed. 

Preparations. 
Extractum Stramonii Seminis, Extract of Stramonhun Seed. — Dose, gr. Yd-yi- 
Extractum Stramonii Seminis Fluidum, Ft. Ext. of St. Seed. — Dose, Try- v. 



STRONTIUM. 45 I 

Tinctura Stramonii Seminis, Tincture of Stramonium Seed, — 15 per cent. Dose, 
TTlv-xxx. 

Unguentum Stramonii, Stramonium Ointment, — has of the Extract 10, Diluted 
Alcohol 5, Benzoinated Lard 85. 

Daturina, D at urine, C 17 H 23 N0 3 (Unofficial), — is the alkaloid found in all parts of the 
plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric and identical with Atro- 
pine. Dose, gr. T ^~^. 

Physiological Action. 

The action of Stramonium is similar to that of Belladonna in almost 
every particular, except that Stramonium is more powerful and chiefly 
influences the sympathetic nervous system, not affecting the motor or 
sensory nerves. It excites a greater degree of cardiac irregularity and a 
more furious delirium, and seems to have a special affinity for the gen- 
erative apparatus, being decidedly aphrodisiac in full doses. [Compare 
Belladonna, ante, page 180.] 

As previously stated the alkaloids, Atropine, Daturine, Hyoscyamine, 
and Duboisine are chemically alike and almost identical physiologically. 
They all produce dilatation of the pupil, increase the cardiac action, the 
pulse and respiration rate, and cause delirium. Poisoning by one of 
them is indistinguishable from that by another. 

Antidotes, Antagonists and Incompatibles. 

These are the same as for Belladonna. Poisoning by Stramonium is not uncommon, as 
children may eat the seeds, which should be evacuated by an emetic. If physiological 
symptoms follow Opium must be exhibited as the antagonist, but cautiously, lest opium- 
narcosis be substituted. 

Therapeutics. 
Stramonium is chiefly used as an antispasmodic and to relieve pain. In 
asthma the leaves are smoked with advantage at the commencement of a 
paroxysm, the smoke being drawn into the lungs. In other spasmodic 
affections, as hepatic colic, laryngeal cough, chorea and stammering, it is 
very beneficial. In dysmenorrhcea and neuralgia it is used in combina- 
tion with Opium and Hyoscyamus, and in tic douloureux and sciatica it 
is often very efficient. In nymphomania with great mental depression it 
is frequently effective, and in mania of furious character, particularly the 
puerperal form with suicidal tendency, it is highly serviceable in 10-20 
minim doses of the tincture every 3 or 4 hours. The ointment is much 
used in irritable ulcers, and as an anodyne application in painful hemor- 
rhoids and certain cutaneous diseases. 



STRONTIUM, Sr.— The metal Strontium is represented in the 
pharmacopoeia by three of its salts, viz. : — 

Strontii Bromidum, Strontium Bromide, SrBr 2 -f- 6H. 2 0, — colorless, transparent, 
hexagonal crystals, very deliquescent, of bitter, saline taste ; very soluble in water and 
alcohol, insoluble in ether. Dose, gr.v-xxx. 



452 STRONTIUM. 

Strontii Iodidum, Strontium Iodide, Srl 2 -j- 6H 2 0, — hexagonal plates, colorless, 
transparent, of bitter, saline taste ; very soluble in water, also in alcohol and slightly so 
in ether. Dose, gr.v-xxx. 

Strontii Lactas, Strontium Lactate, Sr(C 3 H 5 3 ) 2 -j- 3H 2 0, — a white, granular 
powder, or crystalline nodules, of slightly bitter and saline taste, permanent in the air ; 
soluble in 4 of water, in less than l / 2 part of boiling water, soluble also in alcohol. 
Dose, gr.v-xxx. 

Strontii Salicylas, Strontium Salicylate (Unofficial), — is highly recommended by Dr. 
H. C. Wood. Dose, gr.v-xxx. 



Physiological Action and Therapeutics. 

The Strontium salts are among the most recent additions to the materia 
medica. Their marked anti-putrescent and antiseptic properties were first 
noticed in 1891 by Germain See, on patients suffering from gastric dila- 
tation. He found that, in such cases, the Bromide prevented the acetic 
and lactic fermentations, and the formation of the gases of decomposition. 
The toxic action, hitherto attributed to the salts of Strontium, has been 
ascertained to be due to Barium, which was present in the impure com- 
mercial products used. When pure, they may be safely employed in the 
same doses, and in the same cases, as the corresponding preparations of 
potassium and sodium ; while they are much less liable to cause eruptions, 
and are more rapidly and completely eliminated by the kidneys. 

The Iodide is analogous in action to Potassium Iodide, its intravenous 
injection producing at first a rapid elevation of arterial pressure with 
acceleration of the cardiac rate ; followed by slowing of the heart, and, 
later on, lowered blood-pressure with increased heart-rate. It has been 
used, with good results, in the treatment of scrofulous, rheumatoid and 
cardiac disorders ; especially scrofuloderma, scrofulous otorrhcea, and 
enlarged lymphatic glands; also in lupus vulgaris and ozaena. 

The Lactate has been successfully employed in diabetes, and in albu- 
minuria. It diminishes the amount of albumen excreted in Bright's 
disease, in the parenchymatous nephritis of rheumatic and scrofulous 
subjects, and in the albuminuria of pregnancy ; for which purpose it 
should be given in full doses (gr. xxx) thrice daily. It is contraindicated 
when there is scanty urine or symptoms of uraemia. Da Costa holds 
that, while the strontium salts are admirable as diuretics in renal affec- 
tions, they accomplish more good in the acute than in the chronic forms 
of nephritis. 

The Salicylate, according to Dr. H. C. Wood, in doses of gr.v, is one 
of the best intestinal antiseptics, yielding better results than salol, naph- 
talin and similar agents. In doses of gr. x-xv he says that it acts very 
decidedly as a salicylate in gouty and chronic rheumatic conditions, 
without producing gastric disturbance. In chronic gouty conditions and 
in lithaemia with intestinal indigestion, he considers it to be the most 
valuable drug we have. 



STROPHANTHUS. 453 

The uses of Strontium Bromide are mentioned with those of the other 
Bromides, on page 190, ante. 



STROPHANTHUS,— is the seed, deprived of its long awn, of 
Strophantus hispidus, an African climbing plant (nat. ord. Apocynacese), 
from which the natives extract a toxic preparation known as the Kombe 
arrow-poison. It contains a crystalline glucoside, named Strophanthine 
the active principle, which is bitter, slightly acid, soluble in water and 
in alcohol, but almost insoluble in ether, chloroform, benzin, etc. It is 
very plentiful in the seeds (8 to 10 per cent.), and is an agent of great 
energy, the frog being killed by a solution of 1 in 10,000,000. 

Preparations. 

Tinctura Strophanthi, Tincture of Strophanthus, (i in 20). — Dose, TT^v-x, or 
TT^^-ij frequently repeated. A stronger tincture (i in 8) is on the market. 

Strophanthinum, Strophanthin (Unofficial). — Dose, gr. T 2o~Fo hypodermically : gr. 
J^ has been used, the influence of the one injection upon the circulation lasting at least 
eight days. 

Physiological Action. 

Strophanthus acts primarily upon muscular tissue, by direct contact 
through the blood, and with great energy. It increases the contractile 
power of all striped muscle, and in poisonous quantity it fixes the mus- 
cular contraction into a condition of tetanic permanence, the muscle 
being unable to resume its normal condition of partial flexibility. As 
the heart receives much more blood in a given time than any other mus- 
cle in the body, it is quickly and markedly affected by the strophanthus- 
charged fluid, and by regulating the dosage, the cardiac muscle may be 
affected by a quantity which will not influence the other muscles. 

Small doses stimulate the cardiac contractions, increasing the force of 
the ventricular systole, and lowering the rate of the heart-beats. At the 
same time the general blood-pressure is raised, and diuresis produced, 
both being due to the vis a tergo, — the direct stimulation of the circula- 
tion from behind. Large doses paralyze the heart in systole, and leave 
the cardiac muscle in a state of contraction resembling cadaveric rigidity. 
It does not act through the nervous system, but paralyzes the muscular 
tissue, striated and non-striated, by direct contact ; — and when contract- 
ility has been once destroyed thereby, no stimulus will re-excite it. It 
does not affect the vascular system directly. 

Compared with Digitalis, then, we have in Strophanthus a powerful 
cardiac stimulant, differing from Digitalis in not producing vaso-motor 
constriction of the arterioles. It reduces the pulse, lowers body temper- 
ature somewhat, is not cumulative in action, and does not cause any 
gastro-intestinal disturbance. It is diuretic, by direct stimulation of the 



454 STYRAX. 

renal circulation; and has power over rigors, by its rapid cardiac action, 
stopping them, and preventing their recurrence. 

Therapeutics. 
Strophanthus is undoubtedly a valuable cardiac stimulant, from the 
rapidity and permanence of its action, as well as its non-interference 
with the calibre of the peripheral vessels. It promptly relieves cardiac 
dyspnoea, often modifies the pulse-rate in less than an hour, while the 
influence of a single dose upon the circulation persists for a long time. 
It may well replace Digitalis in the treatment of chronic Bright's disease 
and valvular lesions of the heart, when it is important that the work of 
the heart should not be increased by any additional resistance in the 
arterial system. It has been reported as exceedingly useful in the treat- 
ment of Bright's disease, for the dyspncea, orthopncea, dropsy and uraemia ; 
also in mitral insufficiency, with great anasarca and dyspncea ; in pal- 
pitation, exaggerated cardiac action, and in weak heart, and for exoph- 
thalmos, with tumultuous action of the heart ; also in pulmonary oedema, 
due to valvular lesions, or to pneumonia. It is useful in endocarditis, also 
in atheroma of the arteries ; in reflex palpitation of neurasthenia, hysteria 
and chlorosis, and for rigors due to catheterization, or operations on the 
urethra. These high claims, made by enthusiastic therapeutists, have not 
been maintained by the experience of the general profession, so that this 
drug is gradually falling into disuse, although but recently added to the 
official pharmacopoeia. 

Ouabain, C 30 H 46 O 12 (Unofficial), — is a glucoside obtained from the root and wood of 
Acocanthera Ouabaio, an apocynaceous tree of the Somali coast ; also from the seeds of 
Strophanthus glabrus, a climbing plant from Gaboon. The former furnishes an arrow 
poison, much used by the African natives. Ouabain occurs in white, odorless crystals, of 
feebly bitter taste ; soluble in hot water and in spirit, slightly in cold water, insoluble in 
absolute alcohol, chloroform and ether. Dose, gr. y^o every three hours, in children. 

Ouabain is an extremely active poison, paralyzing the cardiac muscle by direct action. 
It is a powerful emetic, especially when given hypodermically ; and a potent local anaes- 
thetic, being considered by many observers as superior to Cocaine in this respect. In thera- 
peutic doses it does not seem to affect the body temperature, but increases urination, either 
by stimulating the blood pressure or by paralyzing the sphincter vesicae. It also pro- 
motes defecation, probably by stimulating peristalsis. Very small doses give some evi- 
dence of action similar to that of Digitalis. It has been employed with striking benefit 
in all stages of pertussis ; and has been used to some extent as a local anaesthetic for the 
eye. 



STYRAX, Storax, — is a balsam prepared from the inner bark of Liquidambar ori- 
entalis, the Oriental Sweet-gum, a tree of the nat. ord. Hamamelaceae, growing in Asia 
Minor. It is semi-liquid, sticky, opaque and gray-colored, of agreeable odor and balsamic 
taste, completely soluble (except accidental impurities) in an equal weight of warm 
alcohol. It consists of a volatile oil named Styrol, C 8 H 8 , — a crystalline solid Styracin, 
which is a cinnamate of cinnamic ether, — two peculiar resins, one hard, the other soft, 
— and Cinnamic Acid, C 9 H 9 2 , a colorless, odorless, crystalline body, closely allied to 
Benzoic Acid, excreted in the urine partly as Hippuric Acid, and occurs also in the Bal- 
sams of Peru and Tolu. Dose of Storax, gr.v-xx. 



SUCCINUM — SULPHONAL. 455 

Tinctura Benzoini Composita, Compound Tincture of Benzoin^ Friar's Balsam, 
contains 8 per cent, of Storax. Dose, 5jss-ij. 

Storax is a stimulant expectorant, an antiseptic and a disinfectant, acting both locally 
and remotely, like Benzoin and the Balsams of Tolu and Peru. It is used with benefit 
in chronic bronchitis and other affections of the respiratory organs, also in chronic 
catarrhs of the genito-urinary passages, in gonorrhoea and in amenorrhcea. Externally it 
is employed in ointment as a detergent for foul ulcers, and as a parasiticide for scabies and 
phthiriasis. 



SUCCINUM, Amber (Unofficial), — the source of Oil of Amber, is a fossil resin, 
occurring in alluvial deposits, chiefly in Prussia, Bohemia, and Courland. It is usually 
associated with lignite, sometimes encloses insects and parts of vegetables, and consists of 
a volatile oil. a yellow resin, another resin, succinic acid and a bituminous principle. Its 
source is thought to be an extinct coniferous tree, the Pinites siucinifer, of which amber 
represents the exudation. 

Oleum Succini, Oil of Amber (Unofficial), — is a volatile oil obtained by the destruc- 
tive distillation of Amber, and purified by subsequent rectification ; — a pale yellow, thin 
liquid, of sp. gr. about 0.920, of empyreumatic and balsamic odor, warm, acrid taste, 
and neutral or faintly acid reaction, and readily soluble in alcohol. Dose, gtt.v-x. 

Oil of Amber is stimulant, antispasmodic and diuretic, when used internally. Exter- 
nally it is irritant and rubefacient. It has been employed with benefit in epilepsy, hysteria, 
convulsions, amenorrhcea, whooping-cough, etc. As a liniment it is often used in chronic 
rheumatism, and has been applied along the spine in infantile convulsions, mixed with an 
equal part of laudanum and diluted with olive oil or brandy. 



SULPHONAL, Sulphonal {Diethylsulphon - dimethyl - methane) , 
C 7 H 16 S 2 4 (Unofficial), — is a synthetical hypnotic which has recently 
been admitted to an official place in the pharmacopoeias of several 
countries, though unofficial as yet in the "United States. It is produced 
by the interaction of anhydrous Mercaptan (Ethyl Hydrosulphide) and 
anhydrous Acetone, in the presence of a stream of dry HC1. The re- 
sulting Mercaptol is separated, washed and oxidized by potassium per- 
manganate; yielding Sulphonal in colorless, prismatic crystals, soluble in 
15 of boiling water, in about 450 of cold water, and in about 50 of cold 
alcohol; very soluble in boiling alcohol and in ether. Sulphonal is a 
very stable body, being unaffected by concentrated acids, alkalies, or 
oxidizing agents, cold or warm. Dose, gr. xv-xl. 

Physiological Action and Therapeutics. 
Sulphonal was introduced about seven years ago as a harmless hypnotic, 
producing sound and quiet sleep without unpleasant after-effects, without 
intoxicant or narcotic action, and having no unfavorable effects on the 
heart or circulation, even in full doses. It rapidly came into general use 
as a hypnotic in mental diseases, in nervous insomnia, and in sleeplessness 
from various causes. Recently a number of competent observers have 
recorded instances of toxic action following its use, and opinions are now 
greatly divided as to its therapeutical value. If it were not for the very 
evident advantage of the drug when used with care, and under medical 
supervision, it would stand a very fair chance of being either excluded 



45^ SULPHONAL. 

from practice or restricted by legislative authority (Squibb). In many 
cases of serious poisoning thereby death has followed ; and its prolonged 
use may give rise to such minor toxic effects as noises in the ears, headache, 
vertigo, weakness and incapacity for mental or physical exertion. The 
patient may next pass into a condition of drowsiness or stupor, or he may 
suffer from difficulty of speech ; and ptosis, oedema of the eyelids and 
cyanosis may be experienced. The stopping of the drug in subjects of 
sulphonism is followed by vertigo, motor disturbances, general weakness, 
digestive troubles, etc., a condition resembling that in morphinism when 
the morphine is suddenly cut off (Lepine). In one reported case, a dose 
of 20 grains nightly for 15 months was accompanied by complete cessa- 
tion of menstruation. It has produced persistent skin eruptions in some 
cases, and severe functional disturbances in others. The chief character- 
istics of chronic poisoning by this drug are as follows : — disturbances of 
digestion, shown by vomiting and diarrhoea or constipation ; disturbances 
of the nervous system, as ataxy and feebleness of the limbs, ptosis and 
ascending paralysis ; also ischuria and oliguria, sometimes albuminuria, 
or the presence of hematoporphyrin (Karst). Recovery rapidly follows 
if the entire alimentary tract be thoroughly purged ; and as long as this 
is kept free, and the kidneys act efficiently and normally, the drug may 
be considered harmless (Fuerst). In order to secure elimination and to 
guard against cumulative action and consequent toxicity, its administration 
should be interrupted from time to time. Anorexia, vomiting, or pains 
in the stomach may be regarded as indications for immediate discontinu- 
ance (Karst). 

As a hypnotic Sulphonal acts admirably in many instances, if admin- 
istered in hot fluids and about two hours before its action is required ; but 
its efficacy decreases with use, and it is of no value whatever against 
insomnia due to pain. The average hypnotic dose is about 20 grains for 
a woman and 30 grains for a man. The dose is to be administered only 
once daily, and should be discontinued at the first sign of toxic action. In 
no case should its administration be continued over any great length of 
time. In cases of insomnia due to neuralgia and nervous excitement, the 
dose of Sulphonal may be advantageously combined with a small dose of 
Morphine, in proportion to suit individual cases, the mixture forming a 
safe and efficient hypnotic (Gonzales). 

Trional , Diethylsulphon-methyl-ethyl-methane, — differs from Sulphonal only in the sub- 
stitution of an ethyl for a methyl group. It occurs in lustrous, bitter, tabular crystals, 
soluble in 320 of cold water, readily soluble in alcohol and in ether. It is an efficient 
hypnotic, less liable to produce ill effects than Sulphonal, but must be given in doses fully 
as large, gr. xv-xl. It is said to be peculiarly valuable in cases of slight psychical excite- 
ment accompanied by obstinate insomnia, and to act promptly and usefully in many forms 
of delirium. When pain is present it may be administered in conjunction with Phenacetin 
or Acetanilid. A potent objection to its use is the fact that it is patented in this country, 
which is also true of the following agent. 



sulphur. 457 

Tetronal, Diethyhulphon-diethyl-methane, — contains 4 ethyl groups, to 3 in Trional, 
and but 2 in Sulphonal. Dr. Lauder Brunton holds of the physiological action of the di- 
sulphones, to which group these three substances belong, that only those containing ethyl 
groups are active, and that the hypnotic activity is increased with the number of such 
groups. This, if substantiated in practice, would make Tetronal the most powerful hyp- 
notic of the three. Trional is found to be, generally, more active, however, in this respect, 
and to be freer from unpleasant by-effects, Tetronal producing vomiting and other diges- 
tive disturbances in many cases. Neither of them has any value against insomnia due to 
pain. Dose, gr. xx-xxx, twice or thrice daily. 



SULPHUR, and SULPHIDES.— The non-metallic element Sul- 
phur, S, is a brittle solid of a pale yellow color, permanent in the air, of 
crystalline texture and susceptible of several allotropic states, which are 
for the most part induced by heat. It is obtained native in several vol- 
canic districts, or from the native Sulphides of Iron and Copper (iron and 
copper pyrites) by roasting, as it sublimes at about 238 F. It is official 
in three forms, viz. : — 

Sulphur Sublimatum, Sublimed Sulphur, S, — is prepared from crude 
Sulphur by sublimation and condensation. It is a fine citron-yellow 
powder, of faintly acid taste and acid reaction, insoluble in water or 
alcohol. Ignited it burns with a blue flame, forming sulphurous acid gas, 
and leaving no residue or only a trace. Dose, gr. x— xx-lx. 

Sulphur Lotum, Washed Sulphur, S, — prepared by digesting sub- 
limed Sulphur with dilute Water of Ammonia, thoroughly washing with 
water and passing through a No. 30 sieve. In this process the Ammonia 
dissolves out any Sulphide of Arsenic which may be present and neutral- 
izes any Sulphurous or Sulphuric Acid. [For solubility and dose see S. 
Pr^ecipitatum, below.] 

Sulphur Praecipitatum, Precipitated Sulphur, Lac Sulphuris, Milk 
of Sulphur, S, — is prepared by boiling sublimed Sulphur with slaked lime 
and water, thus forming the Sulphide and Hyposulphite of Calcium. 
These are then decomposed by HC1, and Sulphur is precipitated as a very 
fine powder which is next washed until the washings are tasteless, and it is 
dried with a gentle heat. The result is a very fine, yellowish-white, amor- 
phous powder, odorless and almost tasteless, insoluble in water or alcohol, 
but completely soluble in carbon disulphide or a boiling solution of soda. 
By heat it is completely volatilized. Dose, gr. x-^j. 

Preparations of Sulphur. 

Unguentum Sulphuris, Sulphur Ointment, — has of Sublimed Sulphur 30, Benzoin- 
ated Lard 70, rubbed together until thoroughly mixed. 

Pulvis Glycyrrhizae Compositus, Compound Liquorice Powder (see under Gly- 
CYRRHIZA ), — contains 8 per cent, of Washed Sulphur. 

Sulphurous Acid and the Sulphites are described under Acidum SULPHUROSUM; 
the Sulphates under the titles of their respective bases. For Sulphuric Acid see 
Acidum Sulphuricum. 



458 SULPHUR. 

Sulphides. 

Sulphuris Iodidum, Sulphur Iodide, Iodine Disulphide, I 2 S 2 , — is prepared by fusing 
together Washed Sulphur I part, and Iodine 4. It is a grayish -black crystalline solid, 
having the odor of iodine, an acrid taste and a faintly acid reaction, insoluble in water, 
but very soluble in disulphide of carbon and in about 60 of glycerin. Alcohol and ether 
dissolve out the iodine, leaving the sulphur. Only used as ointment, gr. xxx to the ^ . 

Calx Sulphurata, Sulphurated Lime, Crude Calcium Sulphide, — is a mixture of 
Calcium Monosulphide, CaS, Calcium Sulphate, CaS0 4 , and Carbon, in varying propor- 
tions, containing at least 60 per cent, of the former. A pale, gray powder, of offensive 
taste and smell, and alkaline reaction, insoluble in alcohol, very slightly soluble in water. 
Dose, gr. ^-\. 

Calcii Sulphidum, Calcium Sulphide, CaS (Unofficial), — a constituent of the preced- 
ing, is named Hepar Sulphuris, Liver of Sulphur, by the homceopathists, w T ho prepare it 
by mixing equal parts of powdered oyster-shell and sublimed sulphur, and heating at a 
white heat in a crucible hermetically sealed. Dose, gr. y 1 ^— |. 

Potassa Sulphurata, Sulphurated Potassa, Liver of Sulphur, — is a mixture of 
Potassium Trisulphide with small quantities of Potassium Hyposulphite and Potassium 
Sulphate; prepared by heating together Sublimed Sulphur I, Potassium Carbonate 2, in 
a covered crucible until melted. Occurs in irregular pieces, of liver-brown color, gradu- 
ally changing with age to a greenish- or brownish-yellow, of disagreeable odor, alkaline 
reaction, and alkaline, repulsive taste. Soluble in 2 of water, except a small residue. 
Alcohol dissolves only the potassium sulphide, leaving the other constituents undissolved. 
Do.se, gr. ij-x, in pill or solution. 

Hydrogenii Sulphidum, Hydrogen Sulphide, Sulphuretted Hydrogen, H 2 S, — is used 
only for test purposes ; a saturated, aqueous solution being one of the official reagents. It 
is a colorless gas, having the smell of rotten eggs ; and is prepared by the action of dilute 
sulphuric acid on iron sulphide, the resulting gas being passed into water, a solution is 
obtained. It precipitates most of the metals from acid solutions as sulphides ; that with 
Arsenic being yellow, — with Antimony, orange. — with Cadmium, yellow, — with Copper, 
Lead, Mercury and Silver, black, — with Bismuth, brown, — with Gold and Platinum, 
brownish-black. 

Carbon Disulphide is described under Carbo ; Antimony Sulphide and Sulphu- 
rated Antimony under Antimonium. 

Unofficial Allied Compounds. 

Ichthyolum, Ichthyol [Ammonium Sulpho-ichthyolate), C 28 H 36 S s 6 (NH 4 ) 2 , — is pre- 
pared from the product of the distillation of bituminous rocks from the Tyrol, which 
contain fossil fishes. It occurs as a viscous, reddish-brown mass, of tarry odor and ap- 
pearance, and feebly alkaline reaction ; soluble in water and in a mixture of alcohol and 
ether ; mixes in all proportions with glycerin, fats and oils. It contains a large proportion 
of Sulphur, about 10 per cent. Dose, internally, gr.v-xxx. 

Sulpho-ichthyolates of Lithium, Sodium and Zinc are also prepared, and are on 
the market. 

Thiolum, Thiol, — is prepared by the sulphuration of certain non-saturated hydrocar- 
bons, and is a product very similar to Ichthyol. It occurs in both dry and liquid form, 
the former, Thiolum siccum, as dark-brown lamellae or powder, of bituminous odor, and 
bitter, astringent taste ; soluble in water and in chloroform, sparingly in alcohol, insolu- 
ble in ether and in benzin. The liquid form, Thiolum liquidum, is a dark-colored, syrupy 
fluid, miscible in all proportions with water. Dose, internally, gr.v-xxx. 

Tumenolum, Tumenol, — is obtained by treating the unsaturated hydrocarbons of 
mineral oils with concentrated sulphuric acid. It occurs in several forms, solid and fluid, 
that known as Commercial Tumenol being considered the most generally useful. It is a 
dark-brown fluid, which can be employed in ointment and in tincture, externally. 

Physiological Action. 
Sulphur is a mild laxative and a diaphoretic. In contact with living 
protoplasm it enters into combination and produces either sulphuretted 
hydrogen or sulphurous acid ; taken into the intestinal canal a large por- 



sulphur. 459 

tion passes out unchanged, some of it being converted by the alkaline bile 
into sulphuretted hydrogen and sulphides. The former is excreted by the 
lungs, giving to the breath the smell of rotten eggs, and by the skin, dis- 
coloring silver articles carried about the person by forming a sulphide of 
silver. The Sulphides are partly absorbed into the blood, and are 
excreted in the urine, chiefly as sulphates, and in the feces, which they 
blacken and render soft. Given in full doses they are irritant to 
the stomach and intestines, extremely nauseous to the taste and smell, 
increase the secretions of the intestinal glands, also peristaltic action, and 
if used for any length of time they impair the blood, causing anaemia, 
emaciation, tremor and great debility. 

Sulphuretted Hydrogen is very destructive to plant life, and in ani- 
mals it destroys the tissue functions, decomposing the blood and para- 
lyzing the nervous and muscular systems. The symptoms of poisoning 
are those of asphyxia ; muscular tremors occur and are followed by con- 
vulsions and death. This gas is often found in cesspools in large quanti- 
ties, but in one case poisoning occurred from its excessive formation in 
the intestines and subsequent absorption into the blood. 

Calx Sulphurata and Potassa Sulphurata act like the sulphides as 
local irritants and in large doses as irritant poisons, producing narcotic 
symptoms and convulsions. In small doses they act like sulphur, and are 
supposed by many observers to have a peculiar influence on suppuration, 
to limit or prevent it if given in small doses frequently repeated. 

The Iodide is believed to possess some of the properties of both its 
elements. It is doubtful whether it is a distinct chemical compound or 
merely a physical mixture. As a parasiticide it is very efficient, and has 
been found remarkably alterative in many local affections of chronic char- 
acter, but may prove very irritant to the skin if improperly prepared. 

The action of Sulphuric Acid, of Sulphurous Acid and of the Sulphites 
are respectively described on pages 85 and 93, ante. 

Incompatibles and Antidotes. 

Solutions of the Sulphides are decomposed by the mineral acids and by solutions of 
metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium and Potassium, Sul- 
phate of Iron, etc. Poisoning by Sulphuretted Hydrogen is best treated by artificial 
respiration. 

Therapeutics. 
Sulphur is chiefly used as a laxative when pultaceous rather than liquid 
stools are required, as in hemorrhoids and anal fissure, also in constipa- 
tion. Scabies has long been treated by its local and internal use, but sul- 
phur alone does not kill the itch insect. The older sulphur ointments 
were made with sublimed sulphur, and probably contained a considerable 
amount of sulphurous acid on which their parasiticide property depended. 
The recent ointments, made with purified sulphur, all contain an alkaline 



4D0 SULPHUR. 

ingredient and develop sulphides, which are powerful insect poisons. 
Sulphur fumigations are practically applications of volatile sulphurous 
acid, while most of the sulphur baths and mineral waters are solutions of 
sulphuretted hydrogen or of the alkaline sulphides. They are of value in 
lead poisoning to favor the elimination of that metal, in chronic constipa- 
tion, chronic rheumatism and sciatica, and many skin diseases, especially 
chronic psoriasis, eczema, pityriasis and prurigo. The Ointment and the 
Alkaline Ointment are both used in scabies. 

The Iodide has been used internally in scrofula, glanders and cutaneous 
disorders, but it is chiefly employed as an ointment in lupus and parasitic 
skin diseases, especially herpes circinatus. Calx Sulphurata is ex- 
tremely efficient as an internal remedy in crops of boils, scrofulous sores, 
glandular enlargements, acne, etc., and will prevent or limit suppuration. 
For these purposes it must be used in small doses (gr. y 1 ^-) frequently re- 
peated. Potassa Sulphurata is only used externally as baths or oint- 
ment in skin diseases and mucous discharges, also in chronic rheumatism. 

Ichthyol was introduced about ten years ago, by Dr. Unna, the cele- 
brated dermatologist, as a promptly efficient remedy in certain chronic 
skin diseases, particularly eczema and psoriasis. It mixes with vaselin, 
lard and oils, is soluble in a mixture of ether and alcohol, and is not irri- 
tant locally, even if covered with oiled silk. 

In one case of eczema infantile, anointment was applied containing I part of Ichthyol 
to 5 of Vaselin, resulting in the child sinking into a stupor which lasted for 12 hours. A 
fatal case of poisoning thereby is reported by Bergerio, of Turin, in a woman whose 
uterus had been curetted the day previous. After the washing out of the uterine cavity 
with a solution of Ichthyol 33 to Glycerin 66, she complained of a putrid fish taste in 
her mouth, her pulse became like that in tachycardia, and symptoms of general depres- 
sion rapidly supervened, ending in death after about 12 hours. These instances show 
that this agent is not devoid of danger, and that care must be exercised in its employment. 

The particular value of Ichthyol, as a local remedy, is due to its non- 
irritant quality and to the large proportion of sulphur contained therein ; 
which, in any pharmaceutical combination, would excite a dermatitis. 
Its application in medicine depends chiefly upon its reducing property, 
its antiseptic powers, and its contractile action upon the vascular system. 
Most of the affections for which it has been recommended are caused by 
anomalous circulation, and especially capillary dilatation. Used internally, 
it retards the disintegration of albumins and favors their formation and 
accumulation. Upon exudations it has a remarkable effect, given in- 
ternally at the same time as applied externally, promoting their reabsorp- 
tion and promptly alleviating pain. For these purposes it has been 
highly praised in gynecology, and even in pleurisy. For chronic rheu- 
matism a 50 per cent, ointment is used locally and the remedy is also 
given internally. It has done excellent service in erysipelas, and ulcers 
of the leg, locally applied in ointment form with Lanolin, or pure ; and 
internally in various affections of the digestive and intestinal tract, also 



SUMBUL TABA.CUM. 46 1 

in phthisis, syphilis and leprosy. In gynecology it is combined with Gly- 
cerin (1 in 10) ; is used for rheumatism with Turpentine as a liniment, or 
with an equal weight of a mixture of Lanolin and Olive Oil and 30 per 
cent, of Chloroform; against erysipelas as a 10 to 20 per cent, collodion, 
with or without Castor Oil. 

Thiol, the German artificial Ichthyol, is largely used in place of Ichthyol, by gyne- 
cologists and dermatologists. It causes no pain, burning, or other irritation, and no 
bleeding from eroded surfaces ; promotes rapid absorption of effusions, and has many 
advantages over the natuial Ichthyol, among which is the ease with which the stains it 
produces on linen may be removed. The dry form, used as a dusting powder, is of 
especial service in erysipelas, and is employed with benefit in eczema, erythema, inter- 
trigo, impetigo, pemphigus and other cutaneous affections ; especially in acute, moist in- 
flammations of the skin and subjacent tissues, in chilblains, periphlebitis, contusions, 
subcutaneous hemorrhages and syphilitic ulcers. It is also an efficient application in 
pelvic exudations and endometritis. It may be applied as a powder, or collodion, in 
aqueous or glycerin solutions, as ointment, soap, plaster, etc. Internally, it is given 
in wine, or chocolate (1 to 2 per cent.), also in pills containing a grain each. Mixed 
with Talc, in the proportion of 10 to 20 per cent, of Thiol, it makes an excellent dusting 
powder for use on babies' skin. 

Tumenol is said to owe its therapeutic action to its powerful reducing property rather 
than to the sulphur in its composition. The tincture has been almost universally success- 
ful in all forms of pruritus. Moist eczema is especially benefited by it, and it generally 
gives good results when employed in erosions, excoriations, and superficial ulcerations. It 
is not anti -parasitic in action, and is of no service in erysipelas. 



SUMBUL, — is the root of Ferula Stwibul, a very large plant of the nat. ord. Umbel- 
liferse, which grows to the height of 8 feet in the mountains of Northern Asia. The root 
contains Angelic Acid, C 5 H 8 2 , Valerianic Acid, C 5 H 10 O 9 , also a volatile oil, two bal- 
samic resins, a bitter substance, etc. Dose, gr. xxx-^j or more, in infusion, decoction. 

Tinctura Sumbul, Tincttire of Swnbzd, — 10 per cent. Dose, ^j-iv. 

Sumbul is an efficient nerve tonic, having qualities closely resembling musk and vale- 
rian. It is used by the Russian physicians in very many morbid conditions, and seems 
to be a favorite remedy in that country for almost any disease. It is probably of some 
value in hysteria and other nervous derangements of delicate females, and may be used 
as a substitute for musk in typhoid conditions and fevers, asthma, delirium tremens and 
perhaps in epilepsy. 



TABACUM, Tobacco, — is the commercial dried leaf of Nicotiana 
Tabacum, an annual plant of the nat. ord. Solanaceae, native of tropical 
America, but cultivated in several parts of the world, especially in Cuba 
and Virginia. The leaves contain a very poisonous, oily fluid alkaloid 
named Nicotine, C 10 H U N 2 , which occurs as a malate, and in quantity 
varies greatly in different specimens. Tobacco contains also a volatizable, 
camphoraceous principle named Nicotianin, the existence of which is de- 
nied by some analysts, besides potassium and calcium salts (nitrates and 
phosphates), silica, gum, resin, and other substances. There are no official 
preparations. 

Nicotina, Nicotine, C 10 H U N 2 (Unofficial), — the alkaloid and active 
principle ; a colorless, oily fluid, having the odor of tobacco and an acrid 
taste ; readily soluble in water, and forming soluble salts with acids. 



462 TABACUM. 

Dose, ^l 2 1 - 1 V> U P to "UJ m two hours, in tetanus and strychnine poison- 
ing. [Other Liquid Alka loids besides Nicotine are — Coni'ine, Lobeline, 
Lupuline, Muscarine, Piperidine, Pyridine, Sparteine, and the alkaloidal 
compound Trimethylamine.] 

The proportion of Nicotine in tobacco is stated at 6 in 10,000 parts (0.06 per cent.) 
by Posselt and Reimann, but other analysts have found 2 per cent, in Havana tobacco 
and more than 8 per cent, in French tobacco. Turkish tobacco is said to contain little 
or none. The effect of curing undoubtedly produces chemical changes in tobacco, but 
chemists differ as to whether the proportion of nicotine is greater or less after that process. 

Composition of Tobacco-smoke. 

According to Zeise (1843), an d Vohl and Eulenberg (1872), tobacco-smoke contains no 
nicotine, but does contain a series of empyreumatic products, the result probably of its 
decomposition, viz. — pyridine, collidine, picoline, parvoline, etc. Of these, Pyridine, 
C 5 H 5 N, predominates when tobacco is smoked in a pipe, but Collidine, C 8 H n N, which 
is far less active, predominates when there is free access of air, as in smoking cigars. 
Tobacco-smoke also contains Carbon Dioxide, C0 2 , of which Krause determines the aver- 
age proportion to be 9.3 per cent. , and to which he credits much of the injurious effects of 
smoking in young subjects. It also contains creosote, hydrogen cyanide and sulphide 
gases, and several acids, including acetic, carbolic and valerianic. 

Unofficial Preparations and Salts, etc. 

Enema Tabaci, Enema of Tobacco (B. P. 1867), — gr. xx of the leaf infused in ^viij 
of boiling water for an hour, strained, and the whole administered as one enema. 

Oleum Tabaci, Oil of Tobacco, — is an empyreumatic product and a most virulent poi- 
son, obtained by distillation at a temperature above that of boiling water. 

Vinum Tabaci, Wine of Tobacco, — ^j to the pint. Dose, rr^v-^j. 

Pyridina, Pyridine, C 5 H 5 N, — a colorless, liquid alkaloid, of powerful odor, evaporating 
when exposed to air, mixing with water in all proportions, and forming salts like those of 
Chinolin. Dose, 3 j-^jss, allowed to evaporate in an open dish in a small room, in which 
the patient is exposed for 20 to 30 minutes thrice daily for the relief of asthma (See). 

Nicotinae Bitartras, Nicotine Bitartrate, — occurs in fine, white crystals, having a ten- 
dency to aggregate, readily soluble in water. This salt is stable, and keeps well, even in 
solution. It is recommended as the most suitable form of administering nicotine in tet- 
anus, strychnine poisoning, etc. Dose, gr. ^"To > U P to a maximum of gr. ij in 2 hours 
in such affections. 

Physiological Action. 
Tobacco is a very depressant nauseant, an emetic by irritant as well as 
by systemic action, and an antispasmodic ; also sternutatory, diuretic, dia- 
phoretic, cathartic, sedative and narcotic. It first stimulates and after- 
wards paralyzes the motor nerves of involuntary muscles, and the secret- 
ing nerves of the glands, also the spinal cord and the vagus; at first stim- 
ulating both the vagus-roots and its ends in the heart (slowing the pulse- 
rate), but afterwards paralyzing the latter (causing high pulse-rate). It 
increases the salivary and intestinal secretions, and produces diuresis, 
tremor, clonic spasms and a tetanic stage followed by paresis. It contracts 
the pupils, slows and depresses the heart, lowers arterial tension at first and 
afterwards raises it, reduces the body-temperature, and causes profuse 
sweating, cold and clammy skin, collapse, and death usually by paralysis 
of respiration, sometimes by paralysis of the heart. It does not impair the 



TABACUM. 463 

muscular irritability, nor does it act upon the cerebrum directly. Its em- 
pyreumatic products act similarly but less powerfully. Fatal results have 
followed on the inhalation of its vapor into the lungs. 

The continued use of Tobacco, by smoking or chewing it to excess, pro- 
duces granula* inflammation of the fauces and pharynx, atrophy of the 
retina, dyspepsia, lowered sexual power, sudden faints, nervous depression, 
cardiac irritability and occasionally angina pectoris. Used by the young 
it hinders the development of the higher nervous centres, and impairs the 
nutrition of the body by interfering with the processes of digestion and 
assimilation. It has been credited with causing cancer of the lips and 
tongue, blunting of the moral sense, mental aberration and even insanity. 
The so-called " tobacco heart " includes many forms of nervous, painful 
or oppressed cardiac action, depending on the age of the subject, the 
quantity consumed, and other circumstances. In mild cases an occasional 
palpitation or flutter is complained of; in more severe ones there is con- 
siderable cardiac irregularity and rapidity, and more or less distress experi- 
enced ; in some there is actual cardiac pain, decided irregularity and occa- 
sional intermittence of action, and the symptoms may represent those of 
a case of angina pectoris. There are no physical signs, as a rule, and the 
diagnosis is made by exclusion. The pathology is unknown, but probably 
involves some lesion of the vagus. In the young, excessive indulgence 
in tobacco may lead to cardiac hypertrophy, to dilatation, and even to 
valvular lesions (Osier). 

Nicotine in even minute doses (gr.-ij-) causes symptoms of intense gas- 
tric irritation with an extreme degree of collapse. It abolishes the func- 
tion of the motor nerves and paralyzes respiration. Its general action is 
that of tobacco, but it is one of the most powerful and rapidly-acting 
poisons known, death having occurred within three minutes after its inges- 
tion, the patient dropping instantly to the floor insensible, with no symp- 
toms except a wild stare and a deep sigh. The y 1 ^ of a grain has caused 
death in a human being, and ^ is fatal to cats and dogs. 

Antidotes and Antagonists. 

Strychnine is the true physiological antagonist to Nicotine (or Tobacco) and vice versa. 
Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., antagonize its action on the circu- 
lation. In poisoning by Tobacco the means resorted to are evacuation of the stomach, 
Tannin, Iodides, and artificial respiration. A curious synergism has been observed by the 
author between Opium and Tobacco. If a person, habituated to the use of the latter, 
either by smoking or chewing, begins to use Morphine, the smallest quantity of Tobacco 
will make him sick, the symptoms being those experienced by a novice in its use. For 
the depression due to excessive smoking, the best agent is Spiritus yEtheris Compositus 
(Hoffman's Anodyne). 

Therapeutics. 
Tobacco is now but little used in medicine ; the dangers attending its 
employment either internally or externally have caused it to be super- 
seded by less violently acting agents. The principal objects for which it 



464 TAMARINDUS TANACETUM TARAXACUM. 

is used are to relax spasm of the intestines, and to relieve local pain therein. 
Intestinal affections, like impaction of the caecum, intussusception and 
strangulated hernia, may be overcome by a tobacco-enema to relax spasm, 
but it is a dangerous expedient. In dropsy, especially the renal form, it 
makes a very efficient diuretic. In tetanus there is no more effective rem- 
edy than minim doses of the alkaloid every two hours by the stomach, or 
ni^ij by the rectum, or better still the wine in 10-minim doses repeated for 
effect. Strychnine-poisoning is best met by minute doses of Nicotine (gr. 
-fa) hypodermically, as a physiological antagonist. It may be employed 
with advantage in habitual constipation, for the dyspnoea of spasmodic 
asthma and emphysema, and in nymphomania and chordee. In all forms 
of asthma the inhalation of the fumes of Pyridine is beneficial, as it has 
a powerfully sedative action on the respiratory centre. 

The use of Tobacco in moderation, when under excessive exertion, aids 
in supporting the system and lessening the sense of fatigue. Smokers 
rarely suffer from constipation, but generally experience an immediate 
laxative result from their morning cigar. 



TAMARINDUS, Tamarind, — is the preserved pulp of the fruit of Tamarindus 
indica, a large tree of the nat. ord. Leguminosae, native in the East and West Indies. 
It contains citric, tartaric and malic acids, sugar, gum, potassium bitartrate, etc. 

Confectio Sennae, Confection 0/ Senna, — contains Tamarind to the amount of 10 per 
cent. Dose, ^j-ij. (See under Senna.) 

Tamarind is a laxative and refrigerant fruit. In infusion it may be used by convales- 
cents as a pleasant acidulous drink, or the pulp may be boiled with milk as a whey for 
the same purpose. As a laxative it is usually prescribed in connection with other agents 
having the same action. 



TANACETUM, Tansy, — the leaves and tops of Tanacetum vulgare, a perennial, 
herbaceous plant of the nat. ord. Compositse, indigenous in Europe, but cultivated in our 
gardens, and growing wild in roads and old fields. It contains a volatile oil, a bitter 
principle named Tanacetin, a tannic acid, etc. There are no official preparations, but a 
fluid extract may be prepared according to the general rule and administered in doses 
of TTLx-^j. The dose of the volatile oil (Oleum Tanaceti) is I to 3 drops. An infusion 
(Tansv Tea) mav be made in the proportion of ^j to the pint, and used in doses of 

Tansy is emmenagogue, diuretic and anthelmintic, an aromatic bitter and an irritant 
narcotic poison. Fatal results have frequently followed upon overdoses of the oil ( ^ ss-j ) 
or strong decoctions, preceded by clonic spasms, disturbed respiration and cessation of the 
heart's action. It is a useful remedy in amenorrhcea, but is in popular repute as an 
abortifacient, a virtue which it does not possess except in quantity dangerous to life. 



TARAXACUM, Dandelion, — is the root, gathered in autumn, of Taraxacum 

officinale, an herbaceous plant of the nat. ord. Composite. All parts of the plant con- 
tain a bitter, milky juice, exuding from any break or wound. Its constituents are a bitter 
amorphous principle named Taraxacin, a crystalline principle Taraxacerin, with potas- 
sium and calcium salts, Inulin, and resinoid bodies, etc. The French name for the plant 
is " Pissenlit. " 

Extractum Taraxaci, Extract of Taraxaciun. — Dose, gr.v-xxx. 

Extractum Taraxaci Fluidum, Fluid Extract of Taraxacum.. — Dose, 3J-^j- 



TEREBINTHINA. 465 

Taraxacum is a bitter tonic, a diuretic and an aperient. It has been supposed to act 
especially on the liver, and is chiefly used in dyspepsia with hepatic torpor. As found in 
the shops it is usually inert. The extract is probably only of value as an excipient for 
pills. 



TEREBINTHINA. — A Turpentine means a vegetable exudation, 
liquid or concrete, consisting of resin combined with a peculiar essential 
oil named Oil of Turpe?itine (C 10 H 16 ), and generally procured from various 
species of the nat. ord. Coniferse (cone-bearers). Of the many turpen- 
tines two only are official, viz. : — 

Terebinthina, Turpentine, — a concrete oleoresin obtained from Pinus 
palustris, the Yellow Pine, and from other species of Pinus, nat. ord. 
Coniferae. Occurs in tough, yellowish masses, brittle when cold, crummy- 
crystalline interiorly, of terebinthinate odor and taste. Dose, gr.v-xxx 
as a stimulant, antispasmodic or diuretic; gij— iv as an anthelmintic. 

Terebinthina Canadensis, Canada Turpentine, Balsam of Fir, — a 
liquid oleoresin obtained from Abies balsamea, the Silver Fir, or Balm of 
Gilead, a tree of the nat. ord. Coniferse. A yellowish, transparent, viscid 
liquid, of agreeable, terebinthinate odor, and a bitterish and slightly acrid 
taste, slowly drying on exposure, forming a transparent mass \ completely 
soluble in ether, chloroform or benzol. Dose, gr. x-xxx. 

Pitch and its preparations are described under Pix. 

Official Preparations of Turpentine. 

Oleum Terebinthinae, Oil of Turpentine, commonly called " Spirit" or " Spirits of 
Turpentine," — is a volatile oil distilled from Turpentine. A thin, colorless liquid, of 
characteristic odor and taste ; soluble in 3 times its volume of alcohol ; mixes with 
other volatile and fixed oils, and dissolves resins, wax, sulphur, phosphorus and iodine. 
Bromine and powdered Iodine act violently on it, and when brought into contact with a 
mixture of Nitric and Sulphuric Acids it takes fire. It is isomeric with a number of 
volatile oils, has the formula C 10 H 16 — but constantly absorbs oxygen from the air when 
exposed, becoming thicker and less active, from formation of resin. It is a mixture of 
several hydrocarbons, each having the same formula as itself, viz. , C ]0 H 16 . 

Oleum Terebinthinae Rectificatum, Rectified Oil of Turpentine, — prepared by 
shaking Oil of Turpentine with 6 times its volume of Lime Water, distilling three -fourths, 
and separating. This preparation should always be dispensed when Oil of Turpentine is 
required for internal use. Dose, as a stimulant or diuretic, TTLv-xv, in emulsion, 3 to 6 
times daily ; — as a cathartic or anthelmintic ^ ss or more, combined with other cathartics. 
A little glycerin and Oil of Gaultheria will disguise the taste. 

Linimentum Terebinthinae, Turpentine Liniment, — has 35 parts of the oil with 65 
of Resin Cerate. 

Unofficial Turpentines. 
Chian Turpentine, — from the Pistaceoz Terebinthus, a small larch 
tree growing in the islands of Chio and Cyprus, a thick, tenacious, 
greenish-yellow liquid, concreting on exposure to the air into a translu- 
cent solid. Dose, gr.iij-v in emulsion. 

Venice Turpentine, — procured in Switzerland from the Larix 
Europoza or European Larch ; — a viscid liquid of the consistence of honey, 
30 



466 TEREBINTHINA. 

does not concrete on exposure, and is entirely soluble in alcohol. The 
Venice Turpentine of commerce is usually prepared by dissolving Resin in 
Oil of Turpentine. 

Thus Americanum, Common Franki?icense (B. P.), — the concrete 
turpentine which is scraped off the trunks of Pinus australis and Pinus 
Tozda, Southern States of N. America. An ingredient of the Emplastrum 
Picis of the B. P. 

Derivatives of Turpentine. 

Resina, Resin [Colophony) , — is the residue left after distilling off the volatile oil from 
turpentine ; the portion of turpentine which is fixed by oxidation ; consisting in greater 
part of Abielic anhydride (C 44 H 62 4 ). See ante, under its own title. 

Terebenum, Terebene, C 10 H 16 , — is a hydrocarbon obtained by the oxidation of Oil of 
Turpentine by strong Sulphuric Acid, and occurs as a colorless, or light yellow liquid, 
with the pleasant odor of newly cut pine wood ; practically insoluble in water, but may 
be emulsified, soluble in an equal volume of alcohol. It consists chiefly of Pinene, and 
should contain not more than very small proportions of Terpinene and Dipentene 
(U. S. P.); [consists of Camphene, Cymene, Borneol and Terpilene (Squibb)]. Dose, 
rr\v-xx on sugar, or suspended in £ ss of water by the aid of gr.xx of light magnesium 
carbonate. 

Terpini Hydras, Terpin Hydrate, C 10 H 18 (OH) 2 .H 2 O, — is the hydrate of the diatomic 
alcohol Terpin (Terebinthene), obtained by distilling oil of Turpentine with an alkali. 
Colorless, lustrous, rhombic prisms, nearly odorless, of slightly aromatic and somewhat 
bitter taste ; soluble in io of alcohol and in about 250 of water at 59 F. , in 32 of boil- 
ing water and in 2 of boiling alcohol. Dose, gr.v-x. 

Terpinol (Unofficial), — an oily body obtained from the preceding, by the action of an 
acid thereon. Dose, gr. ij-v. 

Sanitas Disinfecting Fluid (Unofficial), — is an aqueous solution of turpentine 
which has been oxidized by exposure to the air. It contains Hydrogen Dioxide, Thymol, 
Camphor and Camphoric Acid, the latter in such small proportion, however, that its 
action cannot be expected. This proprietary preparation has many combined advantages. 
It is a good oxidizing agent and antiseptic, is not poisonous, and' does not stain the linen, 
— qualities which strongly recommend it as an external disinfectant, and for use in 
surgical operations. 

Official Analogues of Turpejztine. 

These include Juniperus, Juniper, Sabina, Savine, Pix, Pitch, and Pix Liquida, 

Tar, which are described under their respective titles. 

Unofficial Analogues of Turpentine. 

Oleum Succini, Oil of Amber, — a volatile oil obtained by the destructive distillation 
of Amber (Succinum), a fossil resin, occuring in alluvial deposits in Bohemia, etc., and 
thought to be the exudation of Pinites succinifer, an extinct coniferous tree. Dose, gtt. 
v-x. (See ante, under SucciNUM.) 

Oleum Thujse, Oil of Thuja — a volatile oil which is given in doses of TT\J-v. A 
saturated tincture may be used in drachm doses. Obtained from Thuja occidentalis, the 
Arbor Vitae, a coniferous tree. (See under Thuja.) 

Oleum Pini Sylvestris, Oil of Scotch Fir ( B. P.), — a colorless liquid, obtained by 
distilling the fresh leaves of Pinus sylvestris, nat. ord. Coniferee, and used externally and 
by inhalation. 

Physiological Action. 

Turpentines are stimulant, diuretic, anthelmintic, and hemostatic ; 
in large doses laxative and irritant, and externally used are rubefacient 
and antiseptic. Their virtues depend entirely on the volatile oil. 

Oil of Turpentine in small doses causes a sense of heat at the epigas- 



TEREBINTHINA. 467 

trium, burning in the mouth, and salivation by reflex action. In mod- 
erate doses it at first stimulates the vaso-motor nervous system, after- 
wards paralyzing these centres, thus causing a rise and then a fall of the 
arterial tension. It lowers the functions of the brain, spinal cord and 
medulla in the order stated, causing diminution of voluntary movement 
and reflex action, dilatation of the vessels, lowered blood-pressure, and 
slowed respiration, the latter often becoming spasmodic. The pulse is 
sometimes slowed, sometimes quickened. Large doses produce gastro- 
enteritis, with vomiting and diarrhoea, suppression of urine, pain in the 
lumbar regions, burning in the urethra, hematuria and strangury. The 
muscular power is diminished, coordination impaired and a state of in- 
toxication induced. In toxic dose it acts as a narcotic poison and causes 
complete muscular relaxation, profound insensibility, with abolished re- 
flexes, dilated pupils, cyanosed face, labored and stertorous breathing 
and death by paralysis of respiration. It is excreted by the various or- 
gans of excretion, all of which are highly irritated, the kidneys suffering 
particularly. Its vapor inhaled produces nasal and renal irritation, 
frontal headache, and frequently strangury and hematuria. Locally to 
the skin it is rubefacient, and even vesicant if applied for any length of 
time or if evaporation be prevented. 

The Oil, when exposed to the air, readily absorbs oxygen in the form 
of ozone, which it retains tenaciously. This Ozonized Oil of Turpentine 
is an antidote to Phosphorus, preventing the formation of phosphoric acid, 
and converting the phosphorus into an insoluble substance resembling 
spermaceti. Worn about the neck in an open vial it is believed to prevent 
necrosis of the jaw and steatosis of the organs in workmen exposed to 
phosphorus-fumes. It is also supposed to dissolve gall-stones. 

Antidotes and Antagonists. 

In cases of poisoning the stomach should be emptied, anodynes and demulcents admin- 
istered, elimination favored, and special symptoms met as they arise. 

Therapeutic^. 

The Oil of Turpentine is employed externally as a rubefacient and coun- 
ter-irritant in many conditions producing pain and inflammation. Cloths 
wrung out of hot water and then sprinkled with the oil (turpentine stupes) 
are useful applications in sciatica and other neuralgiae, lumbago, chronic 
rheumatism, chronic bronchitis, peritonitis with tympanites, pleurisy, renal 
colic, etc. It is one of the most efficient agents in hospital gangrene, 
applied in full strength to the part affected. The liniment is in constant 
use for sprains, neuralgia, and other slight local affections. 

Internally it is best employed in ulceration and hemorrhage of the intes- 
tines and in hemorrhages of a passive character from other organs. Active 
bleeding with a plethoric condition and hematuria are states in which it is 



468 THEOBROMATIS OLEUM. 

contraindicated. It is often used with Ether (1 to 3) in biliary and flatu- 
lent colic, as an anodyne and antispasmodic. As a vermifuge against 
tape-worm it must be employed in large doses (gss-ij) with Castor oil to 
promote its rapid passage through the intestinal canal. The French acid 
oil, which is old and contains ozone, is used in phosphorus poisoning. It 
is well employed as a stimulant to the heart and vaso-motor system in 
puerperal fever, yellow fever, traumatic erysipelas, pneumonia, capillary 
bronchitis, etc. It is also useful in chronic bronchial catarrh, chronic 
cystitis, subacute gonorrhoea and similar affections of the mucous surfaces 
generally. Inhalations of the vapor or atomized oil are extremely bene- 
ficial in chronic affections of the larynx and bronchi. The pure vapor is 
too irritating for inhalation, but it may be diluted with steam from a steam 
atomizer. Chian Turpentine is one of the many remedies which have 
been used for cancer. 

Terebene has been extensively used by Dr. Murrell, with excellent re- 
sults, as a remedy for obstinate winter-cough and emphysema of the lungs, 
in flatulence, and flatulent dyspepsia, also in cystitis and in gleet, and as 
a spray in phthisis and post-nasal catarrh, also with Cocaine in solution as 
a spray for coryza and hay-fever. Other observers, of several years' ex- 
perience with this remedy in England, praise it highly as an inhalant 
remedy in phthisis, bronchiectasis, chronic bronchitis, and other pulmonary 
affections characterized by profuse, purulent expectoration. Dr. Rieu 
employs it extensively in bronchitis and bronchorrhcea, in doses internally 
of gr. xv— xxx per diem, — but says that it does not affect the muco-purulent 
expectoration of phthisis. It probably has no superior efficacy to Creo- 
sote, Venice Turpentine, etc., except that it is without much odor, and 
has no taste. 

Terpin Hydrate is praised very highly in chronic and recurrent 
bronchitis, night-cough from habit, cold, catarrhs and kindred affections. 
In fact, all acute and many chronic affections of the respiratory passages 
form the proper field for the therapeutical action of this preparation. 



THEOBROMATIS OLEUM, Oil of Theobroma, Cacao-butter,— is a fixed oil 
expressed from the seed of Theobroma Cacao, the Chocolate-tree, nat. ord. Sterculiaceee, 
growing in Mexico, the West Indies and South America. The oil is a yellowish-white 
solid, of faint odor, bland taste and neutral reaction, and melting at 86° to 95 F. 

The seeds are oval, about the size of almonds, and consist of shells and kernels, in 
both of which is found the alkaloid Theobromine C 7 H g N 4 2 , which closely resembles 
Caffeine, the latter being its methyl derivative. Chocolate is prepared by roasting the 
seeds, removing the shells, then crushing or grinding the kernels to a smooth paste, 
which is cast in molds. 

Oil of Theobroma consists chiefly of Stearin with a little Olein. Its action is demul- 
cent, and it does not become rancid on exposure to the air. Its chief use is as a basis 
for making suppositories. A Cerate is prepared by melting together Cacao-butter 35, 
White Wax 35, Oil of Almond 30, adding a drop of Oil of Rose and coloring with a 
minute quantity of Carmine previously triturated with a drop of Water of Ammonia. This 
is known as Red Lip-salve. 



THUJA THYMI OLEUM. 469 

Theobromine has the same action and uses as Caffeine. [See under Caffea, for 
this principle and for Diuretin.] 



THUJA, Arbor Vitae (Unofficial), — the fresh tops of Thuja occi- 
dentalism a tree of the nat. ord. Coniferas, commonly though incorrectly 
called White Cedar, and growing in swampy ground in Canada and the 
northern U. S. They contain a volatile oil, tannin, wax, resin, etc.; also 
Pinipicrin, C 22 H 18 O n , a bitter principle, and Thujin, C 20 H 22 O 12 , a yellow, 
astringent and crystallizable coloring principle, which is separable into 
glucose and Thujetin, C u H u 8 . 

Pi'eparations. 

The dose of a saturated, fresh tincture or fluid extract is £j, 3 to 6 times daily. The 
Volatile Oil may be given in doses of TT^j-v. 

Physiological Action and Therapeutics. 

Thuja resembles Savine in action very closely. It is stimulant, irritant, 
astringent, also aromatic, diuretic and emmenagogue. The oil is a 
gastro-intestinal irritant, and produces epileptiform convulsions in warm- 
blooded animals, and paralysis in cold-blooded ones. It causes rhythmi- 
cal contraction and dilatation of the vessels, lowers the temperature, and 
is anthelmintic. Thuja is indirectly an abortifacient when given in doses 
sufficient to cause violent gastro-enteritis, and is reported to have pro- 
duced an acute urethritis resembling gonorrhoea. 

Thuja in decoction has been usefully employed in coughs, rheumatic 
and arthritic pains, dropsy and amenorrhoea. It has also been given 
with benefit in intermittent fever and as an alterative blennorrhetic in 
chronic catarrh and bronchorrhcea. It is highly praised by Dr. Phillips 
for the cure of warts with narrow base and pendulous body, a strong 
tincture being applied locally and given internally at the same time in 
5-minim doses twice daily. Dr. PifTard speaks strongly in its favor as a 
valuable agent for non-syphilitic warts (condylomata acuminata) of the 
penis and vulva, for papillomatous growths in general, and for gleets 
dependent on granular urethritis. It has been used in chronic gonorrhoea 
and prostatitis with asserted success, and is said to have cured epithelioma. 
The oil has been employed as a vermifuge. 



THYMI OLEUM, Oil of Thyme,— is a volatile oil distilled 
from Thymus vulgaris, Garden Thyme, a common shrub of the nat. ord. 
Labiatge, indigenous in France but cultivated in our gardens. This oil is 
a pale yellow or colorless, thin liquid, having a strong odor of thyme, a 
warm, pungent and afterward cooling taste, and a neutral reaction ; readily 



470 THYMI OLEUM. 

soluble in alcohol. It consists of two portions, the more volatile being a 
mixture of the hydrocarbons Cymene and Thymene, the less volatile being 
chiefly Thymol, which is also official. 

Thymol, C 10 H u O, — is a phenol contained in Oil of Thyme and in 
the volatile oils of several other plants. It occurs in large, colorless, 
hexagonal crystals, of aromatic odor, pungent taste and neutral reaction ; 
soluble in 1200 of water, 900 of boiling water, and in 1 of alcohol at 59 
F., freely in fats and oils, solutions of chloral and alkalies, ether, chloro- 
form, etc. It liquefies when triturated with about equal quantities of 
camphor, menthol or chloral. Dose, gr. ss-ij. 

Unofficial Preparations. 

Thymol Solution, — for antiseptic spray, I in 1000. 

Thymol Gauze, — contains I per cent, of Thymol. 

Thymol Ointments, — vary from 5 to 30 grains to the ^ . 

Thymol Inhalation, — Thymol gr. xx, Alcoholis Sjiij, Magnesium Carbonate gr. x, 
"Water to ]|iij. A teaspoonful to a pint of water at 150 F. for each inhalation. 

Volkmann's Antiseptic Fluid, — has of Thymol I, Alcohol 10, Glycerin 20, and 
Water 100 parts. 

Physiological Action. 

Oil of Thyme has the same properties as the oils of other mints, and 
containing a large quantity of Thymol it is similar to the latter in action. 

Thymol in its action stands between Carbolic Acid and Oil of Tur- 
pentine. Like the former it is a powerful antiseptic and disinfectant. It 
is a local irritant and anaesthetic to the skin and mucous membranes, 
paralyzing the end-organs of the sensory nerves. When absorbed it para- 
lyzes the nerve-centres in the spinal cord and in the medulla, lessening 
reflex action, slowing respiration, lowering the temperature and the 
arterial tension, and in poisonous doses causing weakness, coma and 
death. Internally administered in doses of 20 to 30 grains per diem it 
produces a sensation of epigastric heat, sweating, singing in the ears, 
deafness, a sense of constriction in the forehead, and increase of the 
urinary discharge, which assumes a dark, greenish hue. It is eliminated 
by the respiratory and urinary organs, which it irritates considerably dur- 
ing the process of its excretion. As an antiseptic it is much more power- 
ful and permanent than Carbolic Acid, and much less poisonous. 

Therapeutics. 
Thymol is chiefly employed in lieu of Carbolic Acid as an antiseptic 
for dressing wounds; as a gargle, spray or inhalation in laryngitis and 
diphtheria; as an ointment in ringworm, eczema and psoriasis, and as an 
injection in ozsena. A solution of 1 part in 1000 is the strength usually 
employed. Internally it has been used with success in diphtheria, typhoid 
fever, and other intestinal affections, diabetes, phthisis, and vesical catarrh. 
Its fragrant odor renders it a very agreeable antiseptic application for 



TIGLII OLEUM. 47 I 

ulcerated conditions of the mouth and fauces, but makes it very attractive 
to flies; which fact, together with its high price, will prevent it becoming 
a favorite in hospital practice. A solution, used as a mouth-wash, is very 
efficient in removing the odor of tobacco from the breath. 



TIGLII OLEUM, Croton Oil,— is a fixed oil expressed from the 
seed of Croton Tiglium, a small tree of the nat. ord. Euphorbiaceae, and 
a native of India. The oil is of a pale or brownish-yellow color, some- 
what viscid and slightly fluorescent, of fatty odor, acrid taste and slightly 
acid reaction ; soluble in 60 of alcohol, freely in ether, chloroform, or 
carbon disulphide. Its composition is very complex and has not been 
thoroughly made out, but it is known to contain the glycerides of several 
fatty acids, also a peculiar acid named Tiglinic Acid, C 5 H 8 2 , which is iso- 
meric with Angelic Acid. Dose, ^ 1/3-ij, in pill, emulsion or tincture. 

Physiological Action and Therapeutics. 

Externally Croton Oil is highly irritant, producing a pustular eruption 
which heals by scabbing and may leave unsightly cicatrices. Internally 
it is a powerful drastic cathartic, producing in one or two hours copious 
watery stools, in overdoses causing great congestion of the intestinal canal 
and perhaps death from gastro-enteritis. Vomiting usually occurs after 
large doses, so that the irritant hyper-catharsis is not always observed. It 
is absorbed into the blood, and produces glandular hyperaemia as well as 
direct inflammation of the intestinal mucous membrane, together with 
increased peristaltic action. Its cathartic power is increased by the addi- 
tionjof an alkali, and is manifested, though in less degree, when applied 
to the integument. 

Croton Oil is used as a hydragogue cathartic when a speedy and com- 
plete evacuation of the bowels, diminution of arterial pressure and prompt 
derivative action are desired, as in apoplexy, impaction of the intestines, 
dropsy, lead constipation, paralysis, etc. It is contraindicated where 
there is debility, organic obstruction, and inflammatory conditions of the 
stomach and bowels. The smallness of the dose makes it a very easily 
administered and manageable purgative. A considerable fraction of a 
drop is absorbed by a pellet of sugar or bread, and may be given thus in 
repeated doses until the desired effect is obtained. It has been used as a 
vermifuge against tapeworm. 

Externally it is employed as a counter-irritant in ovaritis, bronchitis, 
pleurisy, rheumatism, neuralgia, glandular swellings and in laryngeal and 
pulmonary diseases. The Linimentum Crotonis of the British Pharma- 
copoeia contains 1 part of the oil in 3^ each of Alcohol and Oil of Caju- 
put, and is a useful pustulant preparation, being more manageable than 
the oil itself. 



47 2 TONGA — TOXINS. 

TONGA (Unofficial), — is a mixed drug said to be obtained from the Fiji Islands, con- 
sisting of thin barks, root-fibres and leaves, tied into long bundles. The fibrous material 
is believed to be derived from Rhaphidophora vitiensis, a creeping plant of the nat. ord. 
Araceae, containing starch, potassium chloride and a volatile alkaloid Toiigitie. The 
barky portion is referred to Premna tatiensis, a shrub or tree of the nat. ord. Verbena- 
ceae, and contains a little volatile oil, sugar, pectin, etc. A fluid extract is on the market, 
which may be given in doses of TT^xxx-^j thrice daily. 

Tonga was introduced by Drs. Ringer and Murrell as a remedy for neuralgia in 1880, 
stating that they had used it with gratifying results. Since then reports have differed con- 
siderably in regard to its efficacy, and from the fact that Dr. Ringer does not mention it 
in the later editions of his Handbook of Therapeutics, it may be inferred that his further 
experience with it has not borne out the claims first made. 



TOXINS (Unofficial). — The toxins are specific poisons produced by- 
bacterial metabolism in suitable media, and when circulating in the 
animal organism are the immediate causes of the acute infectious diseases. 
Many of their active principles are of albuminous nature, the so-called 
Toxalbumins. Toxins have been obtained from ripe cultures of the 
bacteria of tetanus, diphtheria, tuberculosis, cholera, typhoid fever, 
anthrax, pneumonia, glanders, and swine-plague, also from cultures of 
streptococcus erysipelatis, bacillus prodigiosus, etc. The treatment of 
diseases due to pathogenic microbes by the toxic products of their own 
particular bacteria is based upon the theory that these germs produce 
substances in their culture media which are inimical to their own life. 
The treatment of tuberculosis by Koch's tuberculin and the inoculations 
of Haffkine against cholera are examples of true toxin treatment. The 
vaccinations of Jenner for variola and Pasteur for rabies are of the same 
nature when employed as remedial methods, the material being obtained 
from a morbid product of the disease in the one case, and fron-^the 
diseased tissue itself in the other, the culture medium in both being the 
blood and tissues of the infected animal organism. 

It has been frequently observed that patients afflicted with malignant 
disease have been greatly benefited by an intercurrent attack of erysipelas, 
in consequence of which the tumors seemed to undergo retrogressive 
changes. This has suggested the employment of the toxins of streptococ- 
cus erysipelatis and bacillus prodigiosus in inoperable cancer, and may 
lead to the treatment of other diseases by the toxins of bacteria hitherto 
unassociated with them. 

The injection of a toxin in gradually increasing doses at proper inter- 
vals will confer immunity in many cases upon the animal so treated 
against the corresponding disease and its particular bacteria. This im- 
munity may be transferred to another animal by injecting into its cellular 
tissue the blood-serum of the immunized one ; and this serum will also 
act remedially on a subject of the disease if administered early in its 
course (Behring). The immunizing and curative action of the serum is 
believed to be due to the existence of an antitoxin in the blood of the 



toxins. 473 

inoculated animal, elaborated by the living cells of its tissues as a defence 
against the action of the toxins. These facts and hypothesis form the 
basis of the treatment of certain diseases by antitoxic serum (described 
under the title Antitoxins, ante, page 146 et seq.'), which now promises 
better results than any other system of bacterio-therapy. 

The toxins produced by any particular bacteria vary greatly in power 
through very slight circumstances. They may be weakened or increased 
in virulence by the cultivation of their bacteria on different culture media 
or on the same media with different surroundings as to oxygen, tempera- 
ture, etc. ; also by passing successive generations of these organisms 
through a definite series of animals, chosen for their natural insuscepti- 
bility or susceptibility thereto. The pathogenic microbes of several 
diseases are now cultivated in test-tubes, forced to acquire an increased 
or lessened degree of virulence or toxin-producing power as required, are 
separated from the poisonous products of their metabolic life-work, and 
by the inoculation of either their progeny or their chemical products 
(toxins) the corresponding diseases are reproduced upon healthy animals 
in almost any desired degree of intensity. 

Repeated efforts have been made in some cases to separate from these 
bacterial products a germicidal ingredient without its toxic associates, 
which might prove curative for the corresponding disease. The Tuber- 
culocidin and Antiphthisin of Klebs are claimed to be such substances, and 
are described in the following pages. 

Tuberculin, or KocK ' s Ly7?iph, announced as a secret and specific rem- 
edy for tuberculosis by Professor R. Koch, of Berlin, six years ago, was 
subsequently stated by him to be an extract of the products of pure cul- 
tures of the tubercle bacillus, made with glycerin and water. In Koch's 
preliminary statement to the Berlin meeting of the International Medical 
Congress in 1890, the chief point made was that guinea-pigs could be 
rendered immune to inoculated tuberculosis by means of this agent ; but 
even this has been denied by other observers. In the extended paper 
published in November, 1890, he stated that the remedy would not di- 
rectly kill the bacilli, but that it acted powerfully and specifically upon 
the living tuberculous tissue, caused a necrotic condition thereof and 
hastened its disintegration ; also that it might be expected to increase the 
resistant power of healthy tissue and thereby starve the bacilli, check 
their increase, and lead in many cases to the cure of the disease. The 
actual result, however, as Virchow and others soon pointed out, was to 
soften and disintegrate quiescent deposits and to disseminate the bacilli 
throughout the body, forming new foci of active infection in other situa- 
tions. The severe reactions, which followed the injections of the lymph 
in many instances, proved that serious risk must attend its general use ; 
and that, like most remedies for phthisis, it could do good only in a few 



474 toxins. 

carefully selected cases. A sense of profound disappointment succeeded 
to the enthusiasm at first excited, with the result that the remedial action 
of tuberculin became thoroughly discredited and its use almost universally 
abandoned. It has lately become of interest again by reason of the per- 
sistent efforts to extract from it a germicidal constituent free from toxins 
(see infra), as also the results obtained in tuberculosis with the blood 
serum of animals immunized by its repeated inoculation. (See the arti- 
cle on Tuberculosis Antitoxin, ante, page 153.) 

The violent action of tuberculin, together with its source, prove it to 
be a true bacterial toxin. Taken by the mouth it is inert, being proba- 
bly digested in the stomach. In small dose (0.001 cc. of the original 
lymph) injected hypodermically upon healthy subjects, it gives rise to 
slight pains in the limbs and a transient sense of fatigue ; but the same 
quantity injected upon tuberculous subjects produces a very powerful re- 
action both locally and generally, the constitutional effects being similar 
to those accompanying an acute exacerbation of the disease. About three 
hours after the injection a decided rigor occurs, which is followed by a 
rapid rise of temperature and pulse-rate, also pains in the limbs, a sense 
of great fatigue, drowsiness, nausea and loss of appetite, these effects 
lasting from 12 to 15 hours. In cases of advanced phthisis with cavities, 
after an injection of tuberculin the temperature has risen to 105. 8° F., 
which sinking suddenly collapse has occurred, and the patients have died. 
If the case presents a local tuberculous lesion, this swells and becomes 
tender to the touch, and the skin over it is inflamed. In pulmonary cases 
the reaction is greater than in those having surgical tuberculous lesions 
from a similar dose ; the cough increases, there is great distress and dysp- 
noea, the patient feels decidedly worse, and occasionally suffers from 
slight collapse. When the reaction has subsided the patient feels com- 
paratively well, and generally better than before. In cases of lupus, the 
effect of the injection is very marked. Within three hours there arises 
a feeling of tightness with heat and burning over the face and nose, and 
an eczematous exudation sets in which dries into crusts on the surface of 
the lesion, and continues about 48 hours. After two days these symp- 
toms begin to subside, and after nine days the crusts have fallen off, and 
the affected tissue appears shrunken, red and shiny, like the surface of a 
lupus patch which has been scraped with a Volkmann's spoon. 

The principal lessons taught by the history of Koch's tuberculin are 
pathological rather than therapeutical, and cannot be mentioned here. 
An important one is this — that any treatment in tuberculosis which pro- 
motes destructive changes instead of conservative ones, shown in this 
case by the breaking down of the lung tissue and its appearance on a 
large scale in the sputum, cannot be other than detrimental to the patient, 
as the area of infection, instead of being limited as it was, is thereby con- 



toxins. 475 

siderably widened. As a diagnostic agent it is certainly of value in 
showing the presence or absence of latent tuberculosis, but for this pur- 
pose it should only be used in veterinary practice, for the ordinary means 
of diagnosis are already so reliable as not to warrant such a risky proce- 
dure on human subjects. 

Professor Koch has acknowledged that tuberculin is only of service in 
the initial stage of phthisis and in cases of simple infection, and that 
when the case is complicated by the presence of other microbes it is not 
only of no service but often does harm. Professor Ewald has stated that 
so far as clinical and experimental testimony had gone it possesses no 
specific curative action, and that its use must finally be abandoned on 
account of the dangers attending its administration. The physicians of 
the Hospital for Consumption and Diseases of the Chest at Brompton, 
England, reported on its systematic employment in 30 cases of pulmo- 
nary tuberculosis and lupus, with the following conclusions : " That the 
tuberculin did not favorably influence the course of the disease in the ma- 
jority of cases; that in some the effects were detrimental ; and that even 
in the stationary and improved cases it was difficult to ascribe any distinct 
improvement to the injections which might not have been equally attained 
under the treatment ordinarily employed in the hospital." 

Koch' s Tuberculin was distributed in the form of a brown solution, which by evaporation 
and nitration had been concentrated to one-tenth the volume of the ripe culture fluid. One 
part of this original lymph, added to nine parts of distilled water containing y z to I per cent, 
of carbolic acid, made the so-called " mother solution," in which form, though too power- 
ful for use, it will keep a long time, being still further diluted as required. One part of 
this 10 per cent, solution added to nine parts of distilled water makes the dilute I per 
cent, solution used for injection. If, as Koch estimated, the original lymph contains but 
one per cent, of the dry, active substance, its proportion in the injection solution would 
be only one in ten thousand. The dose of the latter solution ranged from o. I cc. to 1.0 
cc. , corresponding to 0.001 cc. and 0.01 cc. of the original lymph ; and was administered 
by a sterilized hypodermic syringe of special form, under strict aseptic precautions, be- 
neath the skin of the back between the scapulas. As to the dose, Professor Koch says 
as follows: "An injection of 0.001 cc. [o. 1 cc. of the injection solution] was first given 
to the phthisical patient, and from this a rise of temperature followed ; the same dose being 
repeated once a day until no reaction could be observed. We then increased the dose to 
0.002 cc. [0.2 cc. of the injection solution] until this was borne without reaction, and so 
on, increasing by 0.001, at most 0.002 to 0.005 cc - This mild course seemed to be im- 
perative in cases in which there was great debility. By this mode of treatment the patient 
can be brought to take large doses [1.0 cc. of the injection solution] with scarcely a rise 
of temperature." In early lung cases a period of about four to six weeks completes the 
course of treatment. Koch's syringe contains 1.0 cc. and is graduated in tenths, each 
division representing one minimum dose (o. 1 cc.) of the I per cent, solution. When large 
doses are reached the stronger 10 per cent, solution may be used in appropriate quantity. 
For cases of lupus much heavier doses were employed at first, even ten times the quan- 
tities mentioned above, but necessarily at much longer intervals. These large doses, how- 
ever, gave rise to most formidable and dangerous symptoms, and caused fatal results in 
some cases. Dr. Whitla believes that better results would have been obtained by the use 
of much smaller doses, and suggests that the treatment be commenced by giving two 
daily doses of not more than ^^th of a grain of the original lymph, equal to )4 a minim 
of the I per cent, solution, for two or three weeks or longer. The ^nd of a grain (0.2 
cc. of the 1 per cent, solution) might then be given, and if marked reaction did not occur 
the dose should be rapidly increased. 



476 TOXINS. 

Tuberculocidin. After Koch's tuberculin became discredited, its 
composition became the subject of analytical research with the view of 
separating out it* toxic constituents and obtaining a remedial agent from 
it. These investigations were principally made by Dr. W. Hunter, Dr. 
Watson Cheyne and Professor E. Klebs of Zurich. The latter treated the 
crude tuberculin with platinum chloride, which precipitates the alkaloidal 
constituents or toxins, leaving a solution which he named Tuberculocidin, 
on account of its supposed antagonism to the tubercle bacillus. With 
this solution he treated 75 cases of phthisis, and reported 14 as cured, 45 
improved, 14 unimproved, and 2 died. During experiments on animals 
with it he claims to have observed the complete regression of an appa- 
rently advanced tuberculosis. Dr. Langermann used it in four cases of 
pulmonary tuberculosis with varied results. He admits that it does not 
cause either serious constitutional effects as tuberculin does or irritation 
at the site of injection, but as to its curative action he has great doubt. 
Klebs has apparently abandoned this agent in favor of Antiphthisin, his 
more recent but similar product. 

Antiphthisin is the latest result of Professor Klebs' long-continued 
efforts to extract a non-toxic and curative substance from tuberculin, 
which, according to his most recent analysis, contains (r) tox- albumins, 
precipitated by sodic iodide of bismuth, (2) alkaloids, (3) an albuminoid 
derived from the bodies of the dead bacilli, (4) a soz- albumin, precipitated 
by absolute alcohol after the removal of the toxic ingredients. It is 
claimed by Klebs that an aqueous solution of this soz-albumin, prepared 
by him and named Antiphthisin, possesses the germicidal and curative 
properties of tuberculin without any of its toxic effects. With this prod- 
uct he claims to have caused the complete cure of tuberculosis in guinea- 
pigs, and to have obtained 90 per cent, of good results (whatever that 
may mean) for all stages of phthisis in the human subject. He states, 
however, that it will produce its fullest benefits in the very early stages of 
the disease, for which stages alone it is recommended as a specific remedy; 
and that in advanced and complicated cases the prospects for its success- 
ful use are less certain. In asking physicians to give it a trial he requests 
that they will not try the remedy except in cases of pure tuberculosis, 
excluding for the present cases of mixed infection, septic cases, and all 
such as have amyloid degeneration or are so far reduced that they must 
die of the complications or exhaustion present. These requirements may 
be good for the reputation of the remedy, but are most difficult to observe 
in practice, as they confine it to a class of cases which seldom come to 
the physician in that stage and which are not easily diagnosed with accu- 
racy when seen. Dr. von Ruck, who is associated with Klebs, reports as 
his experience of nearly 100 cases of phthisis treated with this remedy, 
that it has an unmistakable influence over the fever, that under its use 



toxins. 477 

percussion dulness becomes perceptibly less, bronchial and harsh breath- 
ing give place to puerile and then vesicular respiration, the lung-capacity 
increases, the cough diminishes, the sputum loses its purulent character 
and lessens in quantity, while the bacilli therein diminish in number and 
show marked signs of degeneration. Dr. C. Denison, of Denver, reports 
that most of the cases treated by him with antiphthisin gave evidence of 
its germicidal and healing effects, " in the lessening of the number of 
germs to the field found, and their degenerative or incomplete forms 
thrown off when good sized doses were reached, as well as in the clearing 
up of consolidated or infiltrated tubercular lung tissue." 

Antiphthisin is prepared by Professor Klebs at the laboratory of the Winyah Sanitarium, 
Asheville, North Carolina, where he is now located. He explains the process of manu- 
facture as follows : " We take the ripe culture of the tubercle bacillus and reduce it to 
one-tenth of the original amount by evaporation in a vacuum and filter. This really is 
the tuberculin as prepared by Professor Koch. To the filtrate we now apply an acid 
solution of sodic iodide of bismuth and obtain a precipitate which is filtered out. This 
precipitate represents the toxic properties of tuberculin, as proved both in the animal 
experiment and in its application to the human being for diagnostic purposes. 
After the tox-albumins are filtered out, we precipitate further by the addition of absolute 
alcohol an organic substance resembling in its chemic reaction a peptone, and this 
organic substance redissolved in distilled water is antiphthisin. In the animal experi- 
ment we find that this alcoholic precipitate does not produce fever or toxic symptoms of 
any kind. . . . Antiphthisin cannot be given by the mouth, being an albuminoid 
substance it would be digested in the stomach. The remedy has no diagnostic proper- 
ties, there is no reaction to its use. I think my remarks will make it plain, that the 
diagnostic value lies in the toxins, and the curative substance separated from the toxins 
is antiphthisin." (From Professor Klebs' remarks in German, before the Section on Dis- 
eases of Children at the Baltimore meeting of the American Medical Association, May, 
1S95, translated by Dr. von Ruck.) 

The daily dose for an adult is 0.1 cc. at first, increased daily or every other day until 
0.5 cc. are reached. This dose may be repeated daily for a week, and is then gradually 
increased to 1.0 cc. which latter dose is again continued for a time, before being again 
increased. It is seldom necessary to go beyond 2.0 cc. , though a dose of 10 cc. has been 
given. The administration may be intermitted for a time after 50.0 cc. have been used. 
If, under a certain dose, the improvement is rapid and satisfactory, there is no reason 
to increase the quantity given ; and physical examination should constantly accompany 
and control the future course. The remedy may be administered hypodermically under 
aseptic precautions, or by rectal injection. It is put up in vials containing 15, 30, and 
50 cc. , and is sold at the rate of fifty cents per cubic centimeter. 

Erysipelas and Prodigiosus Toxins. Malignant tumors have 
occasionally been observed to disappear after the patient had suffered from 
an intercurrent attack of erysipelas. When the discovery was made that 
artificial erysipelas could be produced by the inoculation of pure cultures 
of the streptococcus erysipelatis, this inoculation was practised upon sub- 
jects of cancer, as a remedial measure. The results, though favorable, 
were not so complete as in the cases acted upon by accidental erysipelas, 
and the inoculated disease often proved fatal to the patient. Dr. Coley 
then employed the toxins of the streptococcus instead of the culture itself, 
and reported a number of apparent cures of malignant disease thereby. 
Later it was found by Roger that the bacillus prodigiosus has the power 
of intensifying the virulence of the streptococcus erysipelatis, and by using 



47 8 toxins. 

a mixture of the toxins of both these germs, Coley obtained a more bene- 
ficial effect than from the erysipelas toxin alone. The remedial action is 
much more efficient in sarcoma than in carcinoma, though some cases of 
the latter disease are reported as apparently cured by this treatment. In- 
cluding all the cases of sarcoma in which these mixed toxins have been 
employed by Coley, there are 43 such reported of which 11 were appa- 
rently cured. Professor Senn of Chicago has found negative results in 
his own experience of this treatment, and states that in all his cases these 
injections failed to effect even temporary improvement. 

Dr. Coley prepares these toxins in the usual manner, and avoids the 
danger of inoculating erysipelas itself by subjecting the cultures to a 
temperature (136. 4 F.) sufficient to destroy the germs. The commenc- 
ing dose is 1 or 2 minims, injected once daily into the tumor or sub- 
cutaneously in its vicinity, and gradually increased. This method should 
be employed only in cases which are manifestly unfit for operative inter- 
ference. 

Richet and Hericourt injected a serum obtained from animals inoculated with the fil- 
tered emulsion of an osteo-sarcoma into a recurrent sarcoma of the chest-wall and also 
into a supposed carcinoma of the stomach. The tumors were thereby reduced in size 
and general improvement followed, but in neither case was there any microscopical 
examination made, hence the diagnoses are uncertain. 

Emmerich and Scholl claim that excellent results were obtained by them in the treat- 
ment of both sarcoma and carcinoma by the injection into the growth of an antitoxic 
serum obtained from sheep inoculated with the toxins of virulent erysipelas streptococci. 
Other experimenters, including Bruns and Angerer, do not confirm their statements in 
this respect ; and as their observations were limited to a few weeks, it is impossible to 
regard their cases as presenting evidence of cure. 

Cholera Toxin. An extended series of inoculations against cholera 
was carried out in India during the past three years by Dr. HafTkine, 
whose procedure comprises the preparatory use of a weak virus followed 
by a second inoculation with a stronger one. He obtained the weak 
virus by passing air and oxygen over a culture of the comma bacillus on 
agar at a high temperature, which so modified the microbes that when 
injected they produced only slight local puffiness, followed by a mild reac- 
tion. The second inoculation was made five days after the first, and with 
a virus of such intensity that it killed a guinea-pig in eight hours. This 
virus, used on the human subject subsequent to the preparatory inoculation, 
caused only slight local and constitutional disturbance, thereby proving 
that the first inoculation had conferred a certain degree of immunity 
against its effects. The symptoms subside in another five days, and not 
until then can it be said that the operation of preventive inoculation 
against cholera is complete. Dr. HafTkine made 42,445 such inocula- 
tions, without a single instance of mishap or injury to health resulting 
therefrom. The results obtained were highly favorable, the statistics 
thereof demonstrating for this procedure a remarkably protective power 
against cholera in the country where that disease is endemic. The figures 



toxins. 479 

are furnished, not by Dr. Haffkine, but by responsible British medical 
officers assigned to the duty of verifying the result in each case. 

Rabies Toxin. Although no microbe has been yet found associated 
with rabies, there is abundant evidence to prove that the specific virus of 
this disease is a micro-organism, inasmuch as it behaves exactly like one. 
Pasteur found this virus most abundant in the spinal cord of the rabid 
animal, and showed that its inoculation upon a healthy animal will pro- 
duce the characteristic symptoms of the disease, and that the virus may 
be attenuated in virulence by drying the spinal cord containing it. 
He also found that by inoculating on each successive day the virus from 
a cord dried during a shorter period than that used on the previous day, 
the animal so treated may be gradually made almost certainly secure 
against rabies, either from the bite of a rabid animal or from any method 
of subcutaneous inoculation. Upon these facts he founded his preventive 
treatment of this disease, commenced by him in Paris in 1885; which 
consists in the daily inoculation of the bitten person with emulsions of 
gradually increasing virulence, made from the dried spinal cords of rab- 
bits that have died from inoculated rabies. By this procedure, chemical 
substances (toxins), produced during the life of some specific organism 
and known to be inhibitory of its growth, are introduced into the system 
of the patient (V. Horsley). 

During the eight years from 1886 to 1893 inclusive there were treated 
by this method at the Pasteur Institute in Paris 14,430 bitten persons 
from many countries, with 72 deaths resulting ; a mortality rate of ^ of 
1 per cent, for the entire number, the mortality for each year having 
steadily decreased from 0.94 per cent, in 1886 to 0.25 per cent, in 1891, 
0.22 per cent, in 1892, and 0.24 per cent, in 1893. During the four 
years from 1892 to 1895 inclusive, there were treated at the Pasteur Insti- 
tute in New York 424 bitten persons from all parts of the United States 
and Canada, among whom only 2 deaths occurred. 

The patient bitten by an animal supposed to be rabid should be sent 
at once for treatment to one of the Pasteur Institutes ; and should be 
accompanied, if possible, by a piece of the medulla oblongata of the 
biter animal, in order to determine by experimental methods whether the 
animal was rabid or not. The specimen should be removed with an 
aseptic knife, and be placed in a mixture of equal parts of pure glycerin 
and water, previously sterilized by boiling. The period of treatment is 
usually 15 days, during which from 2 to 6 inoculations are administered 
daily with viruses of gradually increasing intensity ; the number depend- 
ing on the time which has elapsed between the infliction of the bite and 
the commencement of the treatment. 

The Hydrophobia Co?)imittee, appointed by the British Parliament in 1887 to investi- 
gate M. Pasteur's treatment of rabies, consisted of Sir James Paget, chairman, Sir Joseph 



480 TRAGACANTHA TRITICUM. 

Lister, Dr. Lauder Brunton, Sir Richard Quain, Dr. Geo. Fleming, Sir Henry Roscoe 
and Dr. Burdon Sanderson, with Professor Victor Horsley as secretary. Their report 
to parliament, made after an extended investigation in Paris, and much experimental 
research, states as follows : " It may hence be deemed certain that M. Pasteur has dis- 
covered a method of protection from rabies comparable with that which vaccination 
affords against infection from small-pox. It would be difficult to overestimate the import- 
ance of the discovery, whether for its practical utility or for its application in general 
pathology. . . . From the evidence of all these facts we think it certain that the 
inoculations practiced by M. Pasteur on persons bitten by rabid animals have prevented 
the occurrence of hydrophobia in the large proportion of those who, if they had not been 
so inoculated would have died of that disease." Professor Victor Horsley, the secre- 
tary of the committee, said three years afterwards in Fowler's Dictionary of Medicine, 
that " its adoption has reduced the mortality among those bitten by indubitably rabid 
dogs from 15 per cent, to 1. 3 per cent." 

Tizzoni and Cantani have lately published reports of experiments on the cure of rabies 
after its actual outbreak. They found that an alcoholic precipitate from the serum of 
highly immunized animals not only caused protection against rabies but also cured it even 
after the first symptoms of the disease had made their appearance. It has also been 
announced that at the Pasteur Institute of Bologna a cure of rabies in the advanced 
stage was effected by a special mode of the Pasteur treatment. A man bitten by a rabid 
dog, who had subjected himself to the Pasteur inoculations, was seized with the phe- 
nomena of paralytic rabies. Paralysis having progressed from the lumbar region over 
the whole organism, bladder and rectum included, intravenous injections of the fixed 
virus were administered, whereupon the painful symptoms gradually diminished and 
finally a perfect cure was accomplished. 

Mallein is an extract in glycerin of the products of cultures of the 
bacillus mallei, the microbe associated with glanders. This toxin, when 
injected into animals affected with glanders, produces a strongly marked 
febrile reaction, similar to that caused by tuberculin in tuberculous sub- 
jects. It is now extensively employed in veterinary practice for the 
purpose of testing horses suspected of being infected with the disease. 
Recently, however, in London, a case occurred in which ten horses in 
one stable showed the typical reaction after the use of mallein, but sub- 
sequently developed none of the symptoms of glanders. 



TRAGACANTHA, Tragacanth, — is a gummy exudation from Astragalus gum- 
mifer and from other species of Astragalus, shrubs of the nat. ord. Leguminosae, growing 
chiefly in the mountainous regions of Asia Minor and Persia. It occurs in shell-like, 
curved or contorted bands, swelling with water to a gelatinous mass, which is tinged blue 
by test-solution of iodine, and consists of a mixture of Arabin, or gum-arabic, which is 
soluble in water, and Bassorin, a gum which is insoluble in water but swells up in it, 
also a little starch. 

Mucilago Tragacanthae, Mucilage of Tragacanth, — Tragacanth 6, Glycerin 18, 
Water to 100. Dose, ^j or more. 

Tragacanth is demulcent, but in large quantities it may cause indigestion. It is chiefly 
employed to suspend resins and heavy powders in emulsion. The mucilage may be used 
as a vehicle for active agents in gargles for pharyngitis, and to cause cohesion in the 
preparation of pills, ti-oches, etc. It is a constituent of 1 2 of the 15 official troches, and 
is a better agent than acacia for making emulsions of cod-liver oil. 



TRITICUM, Couch-grass, — is the rhizome, gathered in the spring and deprived of 
its roots, of Agropyrum repens, the Couch-grass, a perennial plant of the nat. ord. Gram- 
ineae, abounding in meadows and cultivated grounds, where it ranks as a weed, though 
of the same genus as wheat. It contains much sugar and a gum-like principle, Triticin. 
Dose, 3J-^j, in infusion or decoction. 



ULMUS UVA URSI VALERIANA. 48 I 

Extractum Tritici Fluidum, Fluid Extract of TriHcum. — Dose, 3J-^j, "well 
diluted. 

Couch-grass is demulcent, emollient and a feeble diuretic. It is chiefly used in cystitis 
and irritable bladder. The infusion is a popular fever-drink in Europe, and has had of 
old a considerable reputation in dysuria. 

ULMUS, Elm, Slippery Elm, — is the inner bark of Ulmus fulva, an indigenous 
tree of the nat. ord. Urticeie. It contains a large quantity of mucilage which it readily 
parts with to water. 

Mucilago Ulmi, Mucilage of Elm, — Elm 6, Water to 100, digested for an hour and 
strained. Dose, ad libitum. Should be freshly made, when wanted. 

Slippery-elm Bark is demulcent, slightly astringent and somewhat tonic. It is used 
internally in diarrhoea, dysentery and affections of the urinary passages, and externally in 
the form of poultice as an emollient application in cases of inflammation. It is also 
employed in the dilatation of fistulce, strictures and the os uteri. 

UVA URSI, Bearberry, — the leaves of Arctostaphylos Uva-ursi, a 
low, evergreen shrub, of the nat. ord. Ericaceae, inhabiting the northern 
latitudes and high mountains of Europe, Asia and America. They con- 
tain Tannic and Gallic Acids and 3 principles, viz., Arbutin, a bitter glu- 
coside, neutral, crystalline, soluble in warm water and resolvable into 
glucose and Hydroquinone ; Ericolin, bitter and amorphous; Ursone, 
resinous, neutral, crystalline and tasteless. The Californian Manzanita 
{Arctostaphylos glaucd) is an allied plant and also contains arbutin and 
tannin. Dose of the powdered leaves, gr. x-^j in infusion or decoction. 

Preparations. 
Extractum Uvae Ursi, Extract of Uva Ursi. — Dose, gr. ij-x. 
Extractum Uvae Ursi Fluidum, Fluid Extract of Uva Ursi. — Dose, mjc-^j. 
Infusum Uvae Ursi, Infusion of Uva Ursi (Unofficial), — ^j to Oj. Dose, ^j-ij. 
Arbutinum, Arbutin, C 24 H 32 O u (Unofficial). — Dose, gr. iij-v. 

Uva Ursi is astringent, tonic and feebly diuretic. Used in large quan- 
tity it produces vomiting and purging, and is alleged to have oxytocic 
power. Arbutin is an efficient diuretic, and is decomposed in the body 
yielding Hydroquinone, which is excreted by the kidneys as Hydroqui- 
none-Sulphuric Acid. This is non-toxic, imparts a brown color, with 
antiseptic and slightly irritant qualities, to the urine. 

Bearberry was formerly used in all calculous affections and chronic dis- 
orders of the urinary passages. It has some reputation as an antilithic, 
and is no doubt useful in gravel, chronic nephritis, cystitis, urethritis, and 
kindred diseases. It relieves incontinence of urine, dysuria and strang- 
ury, and has proved serviceable even in uterine hemorrhages. Arbutin 
has been successfully employed in cardiac dropsy as a diuretic, also in 
urethritis. 



VALERIANA, Valerian, — is the rhizome and roots of Valeriana 
officinalis, a large, herbaceous plant of the nat. ord. Valerianeae, having 



482 VALERIANA. 

small, white, or rose-colored flowers. The plant is a native of Europe, 
but is cultivated in Vermont and New York. It contains a complex 
Volatile Oil, from which are developed by oxidation Valerene, C 10 H 16 , 
which is a terpene, Valerol or Baldrian Camphor, C 12 H 20 O, and Vale- 
rianic Acid, C 5 H 10 O 2 , which occurs also in many other plants and in cod- 
liver oil. The Valerianic Acid of pharmacy is obtained as a product of 
the oxidation of Amylic Alcohol, and from it are formed the various 
Valerianates. It is not identical with the natural acid. Dose of the 
powdered root, gr. x-xxx. 

Preparations of Valerian. 

Extractum Valerianae Fluidum, Fluid Extract of Valerian. — Dose, TT^x-^j. 

Tinctura Valerianae, Tincture of Valerian, — strength 20 per cent. Dose, 3 ss— ij . 

Tinctura Valerianae Ammoniata, Ammoniated Tincture of Valerian, — has of 
Valerian 20, Aromatic Spirit of Ammonia to 100. Dose, 3 ss— ij . 

Oleum Valerianae, Oil of Valerian (Unofficial), — the volatile oil, sp. gr. about 0.950, 
a greenish or yellowish, thin liquid, having the odor of valerian, an aromatic taste and a 
slightly acid reaction, readily soluble in alcohol. Dose, TT^ij-v. 

The Oil is by far the best preparation for use, as the tinctures are extremely nauseous 
and the fluid extract is too bulky. The taste is best covered by Cinnamon. 

Preparations of Valerianic Acid. 

Ammonii Valerianas, Ammonium Valerianate, — see under Ammonium. Dose, 
gr. ij-x. 

Ferri Valerianas, Ferric Valerianate, — described under Ferrum. Dose, gr. j-iij. 

Quininae Valerianas, Quinine Valerianate, — described under Cinchona. Dose, 
gr- j-iij • 

Zinci Valerianas, Zinc Valerianate, — is described under Zincum. Dose, gr. ^-iij. 

The Valerianates are made with the acid produced from Amylic Alcohol, and do not 
represent the action of the plant, but rather that of the bases from which they are pre- 
pared. 

Physiological Action. 
Valerian is antispasmodic, and a gentle stimulant to the nervous and 
circulatory systems. It is sedative to reflex excitability, antagonizing the 
action of Strychnine, Brucine, Thebaine, etc., and is laxative, diaphoretic 
and anthelmintic. Its taste and odor are very disagreeable, but cats are 
extravagantly fond of it. In these animals it greatly excites the sexual 
appetite, probably from a resemblance between its odor and theirs when 
under venereal excitement. After a time it produces in them violent 
spasms and convulsions. In full doses it increases the action of the heart 
and raises the temperature, in most persons producing exhilaration (in 
some, slight mental disturbance), with formication of the hands and feet. 
Long used it induces a condition of low melancholy and hysterical de- 
pression. Large doses cause hiccough, diarrhoea, nausea and vomiting, 
frequent micturition with tenesmus of the bladder and lithates in the 
urine, mental disturbance even to delirium, reduced motility and sensi- 
bility, and lessened reflex excitability. The Oil in large doses is para- 



VANILLA VERATRUM VIRIDE. 483 

lyzant to the brain and the spinal cord, lowers the blood-pressure and 
slows the pulse. 

The Valerianates follow their bases in general action, but are supposed 
to combine therewith some of the sedative qualities of their acid con- 
stituent. 

Therapeutics. 

Valerian was formerly much employed in epilepsy, but it was probably 
useful only in the hysterical form of that disease (hystero-epilepsy). It is 
a valuable remedy in all forms of hysteria, especially when occurring in 
young and delicate women. It is also useful in flatulence of infants and 
in that of hypochondriacal and hysterical subjects, and in coughs of 
nervous type, whooping-cough, diabetes insipidus, convulsions due to 
worms and in delirium with vital depression. In the coma of typhus 
fever the oil proved remarkably efficient in a series of 135 cases out of 
172 cases treated by it. Ammonium Valerianate is used in the same 
class of disorders as is Valerian. It is often a good remedy for nervous 
headache, administered in io-grain doses and in an elixir. Zinc Val- 
erianate has been supposed to combine the antispasmodic power of valerian 
with the nerve-tonic effect of a zinc salt. It has been used in cholera, epi- 
lepsy and neuralgia, frequently with considerable success. The Ferric 
and Quinine Valerianates are used as are the other salts of their respective 
bases. 



VANILLA, — is the fruit of Vanilla planifolia, a perennial climbing plant of the 
nat. ord. Orchidese, native of the West Indies and tropical America, but cultivated in 
Java, etc. Its characteristic odorous principle is Vanillin, the Methyl-ether of Proto- 
catechuic Aldehyd, which oxidizes slowly in damp air to Vanillic Acid, and may be 
resolved into Methyl Chloride and Protocatechuic Acid. Vanillin may be made synthetic- 
ally from Coniferin or from Eugenol. Dose, indefinite. 

Tinctura Vanillae, Tincture of Vanilla, — 10 per cent. Dose, a few drops, according 
to the strength of flavor desired. 

Trochisci Ferri, Troches of Iron, — contain about -fa per cent, of Vanilla. 

Vanilla is an aromatic stimulant, with considerable influence on the nervous system. 
It is chiefly employed as a perfume and for flavoring purposes, but has been used in 
hysteria and low fevers. 



VERATRUM VIRIDE, American Hellebore,— is the rhizome 
and roots of Veratrum vii'ide, the Indian Poke (Poke-root, or Swamp 
Hellebore), an indigenous plant of the nat. ord. Liliacese. Veratrum 
Viride contains several alkaloids, Jervine, C 26 H 43 N0 2 , Pseudo-jervine, 
C 29 H 43 N0 7 , Cevadine, C 32 H 49 N0 9 , a very little Rubijervine, C 26 H 43 N0 2 , 
and traces of Veratrine, C 37 H5 3 NO u , and Veratralbine, C 28 H 43 N0 3 . Vera- 
troidine, formerly regarded as one of its alkaloids, is now thought to be 
a mixture of Rubijervine and a toxic Resin. The drug also contains gallic 
acid and sugar. 



484 VERATRUM VIRIDE. 

Allied Plants. 

Veratrum Album, White Hellebore, — is a native of the mountainous regions of con- 
tinental Europe, and so closely resembles V. Viride in appearance and characteristics 
that it may be considered a variety of the same plant. The rhizome was official in the 
U. S. P. 1870. It contains the alkaloids fervine, Psendo-jervine, Rubijervine, traces of 
Cevadine, and another powerful alkaloid Veratralbine, C 28 H 43 N0 5 . 

Veratrum Sabadilla, Cevadilla (Asagrcza officinalis), — is a bulbous plant of the nat. 
ord. Liliacece, indigenous in Mexico and Central America. It contains the alkaloids 
Cevadine (formerly called Veratrine), Cevadilline and Veratrine, with Veratric and 
Sabadillic or Cevadic Acids. It is the source of the official Veratrine (see below). The 
seeds are official in the Br. Phar. under the title Sabadilla. 

Preparations. 

Extractum Veratri Viridis Fluidum, Fl. Ext. of Veratrum Viride. — Dose, n\j-iv. 

Tinctura Veratri Viridis, Tinct. of Veratrum Viride, — 40 per cent. Dose, mjj-x. 

Norwood's Tincture of Veratrum Viride (Unofficial), — has a very high reputation 
for efficiency, — Dose, rr^v, increased by mj every 3 hours, until pulse is down to 65, when 
the original dose will hold it there. 

Veratrina, Veratrine, — is a mixture of alkaloids prepared from the seeds of Asagra-a 
officinalis (see above). A white, or grayish -white, amorphous powder, highly irritant to 
the nostrils, of very acrid taste, producing tingling and numbness of the tongue and 
constriction of the fauces ; slightly soluble in cold water, soluble in 3 of alcohol, in 6 of 
ether, 2 of chloroform, 96 of glycerin and in 56 of olive oil. Dose, gr. Jo - tV 

Unguentum Veratrinae, Veratrine Ointment, — Veratrine 4, Olive Oil 6, Benzoinated 
Lard 90. For local use. 

Oleatum Veratrinae, Oleate of Veratrine, — Veratrine 2, Oleic Acid 98. Local use. 

Physiological Action. 

Veratrum Viride is in action closely allied to Aconite, being a power- 
ful cardiac depressant and spinal paralyzant. It differs from Aconite in 
affecting the respiration to a much less degree, — in being a systemic 
emeto-cathartic — in paralyzing the motor system centrally, impairing the 
reflexes, but leaving sensation unimpaired, — and in having little or no 
diaphoretic or diuretic action. It causes great depression, but is seldom 
fatal ; when death does result from its use it usually occurs by paralysis 
of the heart. In small doses Veratrum reduces the force of the pulse, 
but does not at first affect its rate. If continued for some time, the pulse 
becomes very slow, soft and compressible; rising, on the least exertion, 
to be very rapid and feeble. At the same time there is great muscular 
weakness, and frequently nausea and vomiting. Large doses increase 
these symptoms very much, the pulse becoming very rapid and so small 
as to be almost imperceptible ; the skin is cold and clammy, and constant 
vomiting, extreme debility, giddiness, impaired vision, and partial un- 
consciousness ensue. 

Jervine represents in part the depressant action on the circulation and 
on the central nervous system. It does not, however, affect the vagus, 
and but very slightly the voluntary muscles or the motor nerves. It irri- 
tates the motor centres in the brain, causing convulsions ; and lowers the 
functions of the cord, of the centres in the medulla, especially the vaso- 



VERATRUM VIRIDE. 485 

motor, and those of the cardiac ganglia, — slowing the heart by direct 
depression either of the cardiac muscle or its motor apparatus. It always 
causes salivation, but never vomiting or purging; and kills by asphyxia, 
the heart beating after respiration has ceased. Veratroidine, on the con- 
trary, always causes emeto-catharsis, and produces less violent convul- 
sions. It stimulates the vagus centre and paralyzes the vagus ends, de- 
presses the cord, and paralyzes the respiratory centre, — but at the same 
time increases the excitability of the vaso-motor centre. The result is 
great slowing of the pulse-rate and of respiration, and lowering of blood- 
pressure, until the carbonized blood irritates the vaso-motor centre, when 
the blood-pressure rises greatly. It probably consists of Rubijervine and 
a toxic resin. 

Veratrum Album contains a very powerful alkaloid, Veratralbine , and 
also an irritant poisonous resin (?). Its general action is similar to that 
of its congener, but it is much more irritant to the gastro-intestinal 
mucous membrane, causing violent vomiting and purging, intense abdom- 
inal and oesophageal pain, greatly reduced temperature and pulse, col- 
lapse, and death from cardiac and respiratory paralysis. 

Veratrine is an acrid, intensely irritant powder, consisting of a mixture 
of alkaloids. It causes violent sneezing, a burning sensation, and free 
salivation. It affects the heart and circulation similarly to the other 
Veratrise, and in addition seems to be a direct poison to muscular tissue, 
and to cause violent convulsions before the muscular paralysis sets in. 
The alkaloids Jervine and Rubijervine both depress the circulation, while 
the latter produces the emeto-catharsis. 

Antagonists and Incompatibles . 

Alcohol, Opiiun, Belladonna and Ammonia counteract the cardiac depression. Mor- 
phine and Atropine should be administered hypodermically, or Laudanum internally with 
alcoholic stimulants; the recumbent position should be enforced, and dry heat applied to 
the body. Caustic alkalies are incompatible, as they decompose the alkaloids. 

Therapeutics. 
Veratrum Viride is inferior to Aconite in most of the fevers and 
imflammations, by reason of its lacking power over excretion. It renders 
good service, however, in the early stages of many parenchymatous and 
serous inflammations when occurring in sthenic subjects, especially in 
pneumonia. It is highly esteemed in puerperal fever and in many cardiac 
disorders, as simple hypertrophy, irritable heart, etc. It has been used 
with remarkably good results in many cases of acute mania and puerperal 
convulsions, and it is of service in aneurism to depress the circulation to 
the lowest point, but in this case the recumbent position must be strictly 
observed in order to secure safety. It should always be administered in 
small doses and its effects carefully watched. In puerperal eclampsia large 



486 VERBASCUM VIBURNUM. 

doses have been administered without danger and with decided benefit, 
as much as 20 drops of Norwood's tincture having been administered 
every hour for 5 consecutive days and nights in one case, the patient 
making a good recovery. The same preparation may be given hypoder- 
mically, in doses of ir^ ij-iv. 

Veratrum Album is the Hellebore of the ancient physicians, and was 
much used by them as a derivative in insanity. It is rarely used at pres- 
ent except by the homceopathists, who give it in the cold stage of cholera, 
in colic, in the vomiting and purging of summer diarrhoea, in whooping- 
cough and asthma. 

Veratrine is chiefly used externally. The ointment or oleate may be 
used with benefit in many cases of superficial neuralgia, myalgia and 
headaches, a small quantity being rubbed in over the seat of the pain. It 
may be absorbed through an abrasion of the cuticle and give rise to dan- 
gerous symptoms. Internally it has been employed as a cardiac sedative 
in fevers and inflammation, also in acute articular rheumatism, dropsies, 
dysmenorrhcea and various nervous affections, but its uncertainty of action 
and the dangerous depression which it may produce have caused it to lose 
favor as an internal remedy. 



VERBASCUM, Mullein (Unofficial),— is the leaves of Verbascum Th a spus, the 
Mullein-weed, a common plant of the nat. ord. Scrophulariaceee, having large woolly 
leaves and yellow flowers in dense spikes. Its chief constituent is mucilage, though the 
flowers contain an essential oil in very small proportion. An infusion of ^ iv of fresh 
leaves to the pint of milk is the form in which it has generally been given ; this quantity 
to be taken thrice daily. 

Mullein'is emollient and demulcent, perhaps also slightly anodyne. It has long been 
a popular Irish remedy in pulmonary affections, as under its use the weight steadily in- 
creases in phthisis and other wasting disorders, while expectoration is rendered more 
easy, cough is palliated and the general condition improved. It is also recommended in 
cystitis, irritable bladder, and diarrhoea, and is employed as an enema in dysentery and 
as a poultice for hemorrhoids. The dried leaves may be smoked with benefit in aphonia 
from laryngeal irritation. 

VIBURNUM OPULUS, Cramp Bark,— is the bark of Viburnum Opulus, a shrub 
of the nat. ord. Caprifoliacese. 

Extractum Viburni Opuli Fluidum, FL Extr. of Viburnum Opuhis. Dose, 3 ss-ij. 

Viburnum Opulus is highly valued by many practitioners as a remedy for uterine and 
abdominal pains. The so-called Viburnum Compound of Dr. Hayden is stated by its 
manufacturers to consist of "the active principles of the Viburnum Opulus, Dioscorea 
Villosa, Scutellaria Lateriflora, and a combination of aromatics, prepared by a process 
peculiar to ourselves." This they call publishing the formula of the preparation. 



VIBURNUM PRUNIFOLIUM, Black Haw,— is the bark of Viburnum pru- 
nifolium. an indigenous shrub of the nat. ord. Caprifoliacese. It contains tannic, oxalic, 
citric and malic acids, sulphates and chlorides ; also two resins, one of which is named 
Viburnin, and Viburnic Acid, which is identical with Valerianic Acid. 

Extractum Viburni Prunifolii Fluidum, Fl. Ext. of Viburnum Prim. Dose, 
3 ss-ij. 

Viburnum Prunifolium is considered to possess nervine, antispasmodic, astringent, 



VIOLA VISCUM VITELLUS XANTHOXYLUM. 48/ 

diuretic and tonic properties, and to be especially useful in preventing abortion, in the 
nervous diseases of pregnancy, and in spasmodic dysmenorrhcea. It may be administered 
with cannabis indica, morphine, nerve-sedatives or simple aromatics. No exact observa- 
tions have been made regarding its action,' and its therapeutical claims are denied by 
many who have used it. It often excites nausea and vomiting. 

VIOLA TRICOLOR, Pansy, (Unofficial),— is the wild-grown, flowering herb of 
Viola tricolor, the Heart's-ease Pansy, a plant of the nat. ord. Violaceae, native in Europe, 
but naturalized in the southern U. S. It contains an active alkaloid, Violine, allied in 
many respects to Emetine, and poisonous. Dose, gr. x-gj, in decoction. 

Viola is mucilaginous, emollient, expectorant and slightly laxative. Its active princi- 
ple is emeto-cathartic, but exists in very small quantity. A decoction of the fresh herb 
in milk, with a poultice of the same, was formerly recommended highly in crusta lactea 
and impetigo. It is used with benefit in some forms of eczema, especially in that of the 
head and face, and has had some reputation in bronchitis and constitutional syphilis. 

Viola Cucullata, the common Violet, is used in Pennsylvania with success as an in- 
ternal antidote against rattlesnake venom. The leaves are eaten, and a poultice of salt 
and indigo is applied to the wound. 

VISCUM, Mistletoe (Unofficial), — occurs in two species, (1) Viscum album, the 
European Mistletoe, a small, parasitic, evergreen shrub, of the nat. ord. Loranthacese, 
growing chiefly on deciduous-leaved trees, and (2) Viscum flavescens, the American 
species, growing on oaks, elms, etc. They contain mucilage, starch, fixed oil, resin, salts, 
etc., and Viscin, or Bird-lime, which occurs also in Ilex aquifolium, Gentiana lutea and 
other plants. Dose, gr. x-^j in decoction, or TTLv-xxx of a ten per cent, tincture. 

The berries of the mistletoes have produced emeto-catharsis, with great thirst, tenes- 
mus, bloody stools, convulsions and even death in young children. The leaves and 
twigs have been used in epilepsy, hysteria, chorea, asthma and other nervous affections. 
The American plant is asserted to possess qualities similar to those of Digitalis, and to 
incite uterine contractions. It has been used in cardiac affections, dropsies, uterine hem- 
orrhages and amenorrhcea, also as an abortifacient. 

VITELLUS, Yolk of Egg,— is the yolk of the egg of the domes- 
tic fowl, Gallus Bankiva, var. domestica. It is a viscid, reddish-yellow, 
opaque liquid, of bland taste, alkaline reaction, odorless, and may be 
regarded as a dense emulsion of oil suspended in water by means of 
albumen. It is coagulated by heat or by alcohol, and contains Vitellin, 
which is a proteid related to casein, also Cholesterin and Albit7nin, besides 
fat, inorganic salts, sugar, etc. 

Glyceritum Vitelli, Glycerite of Yolk of Egg, Glyconin, — consists of Vitellus 45, 
Glycerin 55, rubbed together until thoroughly mixed. 

Yolk of Egg is highly nutritive and forms a useful article of diet in 
exhausted conditions of the system, but its chief use in medicine is for 
emulsionizing oils and camphors. The Glycerite has the consistence of 
honey and forms an opaque emulsion with water. It is a very good 
vehicle for cod-liver oil. and an excellent protective application for burns, 
erysipelas, fissure of the nipples and many cutaneous disorders. It is also 
used as a cosmetic, and may be employed as an aliment. 

XANTHOXYLUM, Prickly Ash,— is the bark of Xanthoxylum 
americanum, the northern species, and of Xanthoxylum Clava-Herculis, 



488 ZEA MAYS. 

the southern species, of an indigenous shrub of the nat. ord. Rutaceae. 
It contains a volatile oil, a fixed oil, resin, gum, coloring matter and an 
alkaloid, Xanthoxyline, which is identical with Berberine. Dose, of the 
powdered bark, gr. x-xxx. 

Preparations. 
Extractum Xanthoxyli Fluidum, Fluid Extract of Xanthoxylum. — Dose, gss-j. 
Decoctum Xanthoxyli, Decoction of Xanthoxylum (Unofficial), — 5J to the quart. 
Dose, a pint during 24 hours in divided doses. 

Physiological Action and Therapeutics. 

Xanthoxylum is a stimulant and aromatic bitter, a local and systemic 
sialagogue, also diaphoretic, diuretic and emmenagogue. Its taste is 
aromatic, soon becoming acrid and bitter, and causing profuse salivation, 
tingling in the tongue and increased secretion from the stomach, intestines, 
liver and pancreas. It also increases the cardiac action and raises the 
arterial tension, and is classed among the vegetable alteratives, with 
Mezereum, Guaiac, Stillingia, etc. 

Xanthoxylum has a high reputation in chronic rheumatism, myalgia, 
lumbago and similar disorders, also in jaundice from catarrh of the bile- 
ducts, in dropsies, chronic pharyngitis and constitutional syphilis. In 
old cases of pharyngitis, the mucous membrane being glazed and dry, the 
decoction should be used as a gargle and r\ x-xxx of the fluid extract 
taken internally thrice daily. The bark, used as a masticatory, is a popu- 
lar remedy for toothache, and has been frequently successful in paralysis 
of the tongue. 



ZEA MAYS, Maize {Indian Corn), — This well-known species of 
the nat. ord. Gramineae, though itself unofficial, is the source of the offi- 
cial Starch (see Amylum), and of two drugs, one official, viz. : — 

Zea, Corn-Silk {Stigmata Maydis), — the styles and stigmas of Zea 
Mays, which should be gathered when the tassels have shed their pollen. 
Its active principle is thought to be Maizenic Acid. There are no official 
preparations. 

Extractum Zeae Fluidum, Fluid Extract of Zea (Unofficial), — is made by the 
general rule for fluid extracts. Dose, ^j-ij. 

Ustilago, Corn Smut (Unofficial), — is Ustilago Maydis, nat. ord. 
Fungi, a smut grown upon the stems, the pistils and the male inflorescence 
(tassel) of Zea Mays. Its odor and taste are unpleasant, and it contains 
fixed oil, resin, pectin, gluten, sugar, an acid resembling the Sclerotic 
Acid of Ergot, and a volatile principle called Secaline, which is supposed 
to be identical with Trimethylamine. 

Extractum Ustilaginis Fluidum, Fluid Extract of Ustilago (Unofficial), — may be 
prepared by the general rule for fluid extracts. Dose, Tl\x-gj. 



ZINCUM. 489 

Physiological Action and Therapeutics. 

Zea is a certain but mild diuretic when given in full doses at short 
intervals. It is by some observers considered demulcent and anodyne, 
and is generally believed to have a specific or alterative influence over 
many disorders of the genito-urinary passages and the urinary bladder. 
It has been used with success in incontinence of urine, uric and phos- 
phatic gravel, gout, rheumatism, urethritis, pyelitis, acute and chronic 
cystitis, cardiac dropsy and obstructive valvular disease of the heart. 

The properties of Ustilago, so far as examined, resemble those of 
Ergot and Nux Vomica combined. It is a spinal excitant and exalts 
sensibility and reflex action, producing tonic convulsions on the least 
irritation of the skin. It slows the heart by stimulation of the pneumo- 
gastric, dilates the pupils, causes muscular paresis, and death by tetanus 
of the respiratory muscles or by exhaustion. Experiments on its reputed 
oxytocic action have not substantiated the claims made for it in this re- 
spect, though it is said to have produced abortion in cows after they 
had eaten the diseased grain. As a therapeutic agent Ustilago has been 
very little used, but when employed it has been as a substitute for Ergot. 

ZINCUM, Zinc, Zn, — is metallic Zinc, in the form of thin sheets, or 
irregular, granulated pieces, and is a bluish-white metal, having the sp. 
gr. 6.9. It occurs native as a Sulphide {Blende), as a Carbonate and a 
Silicate {Calamine), as a Red Oxide (Zincite), and as a mixture of Zinc 
Oxide with Oxide of Iron and Manganese {Franklinite). Zinc is soluble 
in the weakest acids, and therefore should never be used for culinary ves- 
sels. Its salts are all more or less active poisons. Metallic Zinc is 
official, but is not employed as a medicine. 

Zinc Salts and their Preparations. 

Zinci Acetas, Zinc Acetate, Zn (C 2 H 3 2 ) 2 -f- 2H 2 0, — soft, white, micaceous or pearly, 
six-sided tablets or scales, somewhat efflorescent in dry air, of faintly acetous odor, sharp 
metallic taste and a slightly acid reaction ; soluble in 3 of water and in 36 of alcohol at 
59° F., in iy z of boiling water and in 3 of boiling alcohol. Used locally as an astringent 
in solution of gr. j or ij to the % , or internally in doses of gr. ^-ij. 

Zinci Carbonas Praecipitatus, Precipitated Zinc Carbonate, — a white, impalpable 
powder, permanent in the air, odorless and tasteless, insoluble in water or alcohol, but 
soluble in acids with copious effervescence. When strongly heated it loses water and 
carbonic acid gas, leaving a residue of oxide of zinc. Used locally as a protective. 

Zinci Chloridum, Zinc Chloride, ZnCl 2 , — a white, granular powder, or porcelain-like 
masses, or moulded into pencils, odorless, of such intensely caustic properties as to make 
tasting dangerous ; very soluble in water and in alcohol ; very deliquescent. Is tonic and 
escharotic. For internal use a solution in Spirit of Ether is the most convenient form, 
strength g j to the ^ , of which four to eight minims may be given twice daily in water. 
Strength of injections and collyria, gr. j-ij to the 5 . 

Liquor Zinci Chloridi, Solution of Zinc Chloride, — is an aqueous solution, contain- 
ing about 50 per cent, of the salt. A clear, colorless, odorless liquid, of a very astringent, 
sweetish taste and an acid reaction. A powerful disinfectant for sinks, drains, etc. Used 



49° ZINCUM. 

also as an injection in gonorrhoea, leucorrhcea, etc., in dilute solution, y z to I per cent. 
Burnett's Disinfecting Fluid is similar to the above but slightly stronger. 

Zinci Iodidum, Zinc Iodide, Znl 2 , — a white, granular powder, very deliquescent, of 
sharp, saline and metallic taste and acid reaction ; very soluble in water and in alcohol. 
Dose, gr. ss-ij in syrup. 

Zinci Oxidum, Zinc Oxide, ZnO, — an amorphous, white powder, without odor or 
taste ; insoluble in water or alcohol ; soluble, without effervescence, in dilute acids, also 
in ammonia water. Dose, gr. j-x, in pill. 

Unguentum Zinci Oxidi, Ointment of Zinc Oxide, — has of Zinc Oxide 20, Ben- 
zoinated Lard 80. 

Oleatum Zinci, Oleate of Zinc, — has of Zinc Oxide 5, in Oleic Acid 95. For ex- 
ternal use. 

Zinci Sulphas, Zinc Sulphate, ZnS0 4 -f- 7H 2 0, — small colorless prisms or acicular 
needles, slowly efflorescing in dry air, odorless, of sharp, saline, nauseous and metallic 
taste and acid reaction; soluble in 0.6 of water, insoluble in alcohol. Dose, as emetic, 
gr. x-xxx, — as a tonic and astringent, gr. yg-ij, in pill. For Villate's Solution, see 
under Cuprum. 

Zinci Valerianas, Zinc Valerianate, Zn (C 5 H 9 2 ) 2 + 2 H 2 — white, pearly scales, 
having the odor of valerianic acid, a sweetish and styptic taste and acid reaction ; soluble 
in about 100 of water and in 40 of alcohol. Dose, gr. T V-ij> m piU- 

The Bromide is described under Bromum, and the Phosphide under Phosphorus. 



Physiological Action and Therapeutics. 

Zinc Salts are astringents, but milder ones than the salts of Lead. Its 
soluble compounds (the Chloride, Iodide, Sulphate and Acetate) are cor- 
rosive poisons, causing violent gastro-enteritis, and in some cases pro- 
found nervous depression. The Chloride is a very powerful and painful 
escharotic or rather mummifier of the tissues, having great affinity for 
water, coagulating albumen and shrivelling the vessels. It is a very- 
active disinfectant. The Sulphate is also escharotic and a specific 
emetic, acting promptly by direct irritation of the stomach, and without 
much depression or after-nausea. In small doses it is tonic and astring- 
ent, in larger it would be a severe irritant but for its causing prompt 
emesis. The Acetate resembles the Sulphate in action. The Oxide 
used externally is a mild, soothing astringent ; used internally it enters 
the blood as a lactate or chloride, and acts as a mild astringent and as a 
nervous sedative. Being almost insoluble in the stomach, it has but 
feeble diffusive power and consequently but slight activity. The Car- 
bonate resembles the Oxide in action. The Iodide locally is a power- 
ful escharotic and has been supposed to possess some alterative powers 
when given internally in addition to its astringent qualities as a zinc salt. 
The Valerianate acts as a nervous sedative, but its properties are in all 
probability due to its base and not to the acid combined with it. 

The continued use of Zinc salts produces symptoms similar to those of 
chronic lead-poisoning, but of much less gravity. They manifest much 
less tendency to accumulate in the system than other metallic salts, and 
are excreted much more rapidly. Elimination takes place chiefly by the 
liver and intestinal glands. 



ZINCUM. 49I 

The action of the Bromide and Phosphide are described respectively 
under Bromum and Phosphorus. 

Antidotes and Incompatibles. 

Lime-water, mucilaginous drinks, soap, Tannic Acid, milk, Potassium and Sodium 
Carbonates, if given early, are the antidotes in poisoning by the salts of zinc. Incom- 
patibles are — Lime-water, Alkalies and their carbonates, Silver Nitrate and vegetable 
astringents. Lead Acetate produces double decomposition with zinc salts, but it is often 
used in solution with the Sulphate as an injection. 

Therapeutics. 
Zinc salts are chiefly employed in weak solution as mild astringent 
applications in catarrhs of mucous membranes, such as conjunctivitis, 
gonorrhoea, etc., and as unguents and lotions in skin diseases, particularly 
eczema, impetigo, herpes, and erythema. The Chloride is made into a 
paste with flour and glycerin for the destruction of lupus, epithelioma and 
other morbid growths, and for opening abscesses in locations where punc- 
ture or incision might be dangerous. The cuticle, if unbroken, should 
be removed by strong water of ammonia before the paste is applied, as it 
will not act through the epidermic tissue. It is a commonly used disinfec- 
tant and deodorant, and in weak solution (rrLiij-v of the Liquor to 3J 
of water) makes a good lotion for putrid ulcers, and still weaker (gr. j-ij 
to the pint), is an excellent injection for gonorrhoea. The Iodide is not em- 
ployed as an escharotic, nor has it ever been a favorite remedy for internal 
use. It is chiefly employed in solution as an application to enlarged tonsils, 
and as an ointment (1 part to 8 of lard) for the reduction of glandular 
enlargements. The Sulphate is used locally as an astringent to mucous 
surfaces generally, internally as an emetic in narcotic poisoning and 
croup, and in small doses as a tonic and antispasmodic in convulsive 
diseases, as chorea, hysteria, epilepsy, angina pectoris, asthma, etc. In 
diarrhoeas and dysentery it is a good astringent, and is frequently com- 
bined with Opium and Ipecac. The Acetate is used for the same pur- 
poses as the Sulphate, but is usually preferred for collyria. The Oxide 
may be used as a dusting powder in intertrigo, and as an ointment in 
eczema and excoriated surfaces generally. In combination with Bismuth 
and Pepsin it is an excellent remedy for the summer diarrhoea of child- 
ren, and with Aromatic Powder and Morphine it is very efficient in gas- 
tralgia. It is a good remedy in 3-grain doses for the night-sweats of 
phthisis, and has been successfully employed in epilepsy and neuralgia, in 
whooping-cough, hysteria and nervous headache, and in bronchorrhcea 
to check the profuse secretion. It is much employed as an ingredient of 
cosmetics. The Carbonate is by some preferred to the oxide for local 
use in skin diseases. Calamine Ointment, which is a mixture of the im- 
pure carbonate (calamine) with the oxide and an unguent basis, was until 
recently a favorite application as a soothing protective to abrasions and 



492 ZINGIBER. 

inflammations of the integument. The Valerianate has been used in 
chorea, epilepsy, neuralgia, and various anomalous nervous affections, 
such as the nervous headache of hysterical women, nervous coughs and 
aphonia due to uterine and ovarian irritation. 

The Bromide and Phosphide are used with reference to their respective 
non-metallic bases, under which titles their uses are described. 

ZINGIBER, Ginger, — is the rhizome of Zingiber officinale, a plant 
of the nat. ord. Scitamineae, having dingy-yellow flowers on a leafless 
flower-stalk, and long, lanceolate leaves on a separate stem. The plant 
is a native of Hindostan, but is cultivated in Jamaica, Sierra Leone, etc. 
It contains an aromatic volatile oil, and a resin. 

Preparations . 

Extractum Zingiberis Fluidum, Fl. Ext. of Ginger, — alcoholic. Dose, TTLx-3ss. 

Tinctura Zingiberis, Tincture of Ginger, — 20 per cent. Dose, rt\xx- 3 ij. 

Syrupus Zingiberis, Syrup of Ginger, — has of the Fluid Extract 3 per cent, in sugar 
and water. Dose, ^ss-ij. 

Trochisci Zingiberis, Troches of Ginger, — each troche contains of the Tincture 2 
minims, with Tragacanth, Sugar and Syrup of Ginger. 

Oleoresina Zingiberis, Oleoresin of Ginger, — contains all the virtues of the root, 
and is extracted by ether. Dose, tt\,)^-j, well diluted. 

Ginger is also a constituent of Pulvis Aromaticus and Pulvis Rhei Compositus. 

Ginger is sialagogue when chewed, sternutatory when inhaled, and ex- 
ternally a rubefacient. Internally it is a grateful stimulant and carmina- 
tive, produces a sensation of warmth at the epigastrium and promotes the 
expulsion of flatus. It is employed as a carminative in colic, as a masti- 
catory to increase the secretion of saliva and in relaxed conditions of the 
throat, also internally in atonic dyspepsia, to relieve flatulence, and as an 
adjunct to purgative agents to correct their griping properties. The 
syrup is in common use as a flavoring adjuvant in prescriptions. 

Ginger Beer is a favorite temperance beverage, but most of the preparations sold 
under its name are simply carbonated water flavored with ginger. The following recipe 
is furnished by Dr. William Hardman, of Blackpool, in whose family it has been used for 
over fifty years, and the excellence of which he guarantees. 

Take Ij^ oz. of the best ginger well bruised, I oz. of cream of tartar, and 1% lb- of 
cane loaf sugar. Put all the ingredients into an earthen vessel, and pour on a gallon of 
boiling water; when nearly cold add a gill of yeast, cover over with a blanket, and let it 
stand in a warm place until next morning. Then skim it, and run it through a filtering 
bag, bottle it, cork well with good corks, and tie down the corks with string. In three 
days it will be fit for use. The bottles must be clean and sweet. A little lemon juice 
is considered an improvement by some. [Lancet.) 



PART II. 



PHARMACY AND PRESCRIPTION WRITING. 



Pharmacy (Pharmahon, a medicament), — may be defined as the art 
of selecting and preserving medicines, and preparing them for adminis- 
tration. It may be divided into — 

Official or Galenical Pharmacy, — dealing with the processes and prepa- 
rations of the Pharmacopoeia ; and — 

Extemporaneous or Magistral Pharmacy, — which includes the opera- 
tions of compounding and dispensing remedies as directed by the extem- 
poraneous prescriptions of physicians. 

Pharmacopoeias and Dispensatories. 
A Pharmacopoeia is an official list of the drugs and their prepara- 
tions recognized by the medical profession of a certain country. In 
foreign countries the Pharmacopoeias are published under government 
auspices and have the force of a legal standard ; in the United States its 
publication is left to the medical and pharmaceutical professions and it is 
revised every ten years by a convention called for that purpose. The 
official Pharmacopoeias in the English language, with the dates of their 
latest revision or additions, are as follows, viz. — 

The Pharmacopoeia of the United States of America, 7th Decennial 

Revision, 1890; official from January 1, 1894. 
The British Pharmacopoeia, 1885 ; Additions, 1890. Is now in pro- 
cess of revision. 

Besides the above there are — The Pharmacopoea Germanica, 1882 ; the Pharamacopee 
Francaise (Codex Medicamentarius), 1884 ; the Austrian, Pharmacopoea Austriaca, 1889 ; 
Russian, Ph. Rossica, 1880 ; the Swedish, Ph. Suecica, 1869; the Norwegian, Ph. Nor- 
vegica, 1879; the Danish, Ph. Danica, 1868, 1874, 1876; the Belgian, Ph. Belgica, 
1885 ; the Swiss, Ph. Helvetica, 1872, 1876 ; the Spanish, Farmacqpea Espanola, 1884 ; 
the Portuguese, Ph. Portugueza, 1876 ; the Indian, Ph. of India, 1868 ; the Hungarian, 
Ph. Hungarica, 1888 ; The Netherlands', Ph. Neerlandica, 1889; the Roumanian, Ph. 
Romana, 1874; the Finnish, Ph. Finnica, 1885; the Chilian, Farmacopea Chilena, 

493 



494 WEIGHTS AND MEASURES. 

1886; the Greek, Ph. Hellenica, 1868 ; the Japanese, Ph. Japonica, 1886 ; the Mexican, 
Nueva Farmacopea Mexicana, 1884; the Croatia-Slavonian, Ph. Croatico-Slavonica, 
1888; and the Italian, Farmacopea Italiana, 1887. 

A Dispensatory is a commentary on one or more pharmacopoeias, 
giving in extenso the physical and medicinal history of the drugs and 
preparations, together with their doses, physiological action and thera- 
peutics, and includes similar information about many drugs which are not 
official in any pharmacopoeia, but are of occasional use or general interest. 
A dispensatory is a private publication, of authority according to the 
reputation of its author. The principal dispensatories are American pub- 
lications, and are veritable drug-encyclopaedias, so elaborately do they 
deal with every subject embraced therein. Those of acknowledged value 
are — 

The Dispensatory of the United States of America, by Dr. Geo. B. Wood and 
Dr. Franklin Bache. 17th edition, revised and largely rewritten, by Professors H. C. 
Wood, J. P. Remington and S. P. Sadtler. Philadelphia, J. B. Lippincott & Co. 1894. 

The National Dispensatory. 5th edition, revised by Professors Stille, Maisch and 
Caspari. Philadelphia, Lea Bros. & Co. 1894. 

The American Dispensatory, by King & Lloyd, Cincinnati, is the recognized au- 
thority of the "eclectic" practitioners. 

A Companion to the U. S. Pharmacopoeia, by Drs. Oldberg and Wall ; New- 
York, Wm. Wood & Co. — is an excellent book, but not so exhaustive as the others in its 
method of treating the subjects embraced in it. 

A Companion to the British Pharmacopoeia, by Peter Squire ; 16th edition, 
London, 1894; is the nearest English approach to the American dispensatories, and is 
the standard text-book on the general materia medica in Great Britain. Although a 
very good book it does not compare as a work of reference with either of the two great 
American Dispensatories first above named. 



WEIGHTS AND MEASURES. 



The working formulae of the U. S. Pharmacopoeia of 1880 were con- 
structed on the system of parts by weight for all articles, whether solids 
or fluids, except in the case of fluid extracts, for which the metric weights 
and measures were employed. On this system it really made no differ- 
ence what unit of weight was adopted in official pharmacy. The phar- 
macopoeia of 1890 has, however, in most cases employed definite weights 
for solids, and measures for liquids, in terms of the metric system. In 
certain cases, where weighing is decidedly more convenient, or where the 
product is adjusted to a percentage by weight which would be rendered 
uncertain if the ingredients were taken by measure, liquids are ordered 
to be weighed. And in some cases (Aqua Destillata, Aqua Aurantii 
Florum, etc.) the quantities are directed simply by volume. In most 



WEIGHTS AND MEASURES. 



495 



cases, therefore, solids are officially directed to be weighed by grammes, 
and liquids to be measured by cubic centimeters. At the same time, how- 
ever, the weights and measures generally used by physicians in prescrib- 
ing, and by pharmacists in dispensing medicines, are, and will doubtless 
continue to be, in the United States, those of the Apothecaries' or Troy 
System of weights, (having 480 grains to the ounce and 5760 grains to 
the pound) ; and the Wine Measure. The drachm (60 grains) and the 
scruple (20 grains), are intermediate units of weight which are still used, 
but are becoming obsolete. 

The units of the Wine Measure are the minim (t^), which in water at 
its maximum density equals gr. 0.95 ; the fluidrachm (60 minims), and 
the fluidounce (8 fluidrachms or 480 minims). The signs used to denote 
these units are n^ minim, 9 scruple, 3 drachm, ^ ounce, and in the case 
of liquids an f to denote fluid is often placed before the sign, thus f3 for 
fluidrachm, i% for fluidounce. The relations between these units of 
weight and measure are as follows : — 



Measure. 


Weight. 


Weight. 




Measure. 


TT\J, One minim = 0.95 grains, 
f^j, One fluidrachm == 56.96 " 
i%), One fluidounce = 455.69 " 


grain j = 

?> J == 

?i — 
oi — 


1 

63 
5o5 


.05 minims 
.20 " 
.60 






Table of Troy or Apothecaries' Weight. 




Pound. 




Ounce. Drachm. 


Scruple. 




Grain. 


Libra. 




Uncia. Drachma. 


Scrupulum. 




Granum. 


ft 

I 


= 


I 7> 
12 = 96 

1 = 8 


= 288 

= 24 

= 3 


= 


g r - 
5760 
480 
60 








1 


= 


20 






Table of Apothecaries' 


or Wine Measure. 




Gallon. 




Pint. Fluidounce. 


Fluidrachm. 




Minim. 


Congius. 




Octarius. Fluiduncia. 


Fluidrachma. 




Minimum. 


c. 

I 


= 


0. il 

8 = 128 
1 = 16 


{3 
= IO24 

= 128 

= 8 

1 


= 


"1 

61440 

7680 

480 

60 



The British Pharmacopoeia recognizes only the Imperial Standard 
(avoirdupois) weights, having 487^ grains to the ounce, 16 ounces to the 
pound (instead of 12), and 7000 grains to the pound; and the Imperial 
Measure, having 20 ounces to the pint (instead of 16, as with us). 



Pound. 
Libra. 

lb 

1 



Table of British Pharmacopceial Weight. 

Troy grain, Avoirdupois ounce and pound. 



Ounce. 
Uncia. 

oz. 

16 

I 



Grain. 
Granum. 

g r - 
7000 

437^ 



496 



WEIGHTS AND MEASURES. 



The Troy ounce contains 42^ grains more than the avoirdupois ounce, but the Troy 
pound contains 1 240 grains less than the avoirdupois pound. The grain is the only unit 
common to both. 

Table of British Imperial or Pharmacopceial Measure. 



Gallon. 


Pint. 


Fluidounce. 




Fl 


uidrachm. 




Minim. 


Congius. 


Octarius. 


Fluiduncia. 




Fluidrachma. 




Minimum, 


c. 


O. 


floz. 






fldr. 




min. 


I = 


8 


160 


= 




1280 


= 


76800 




1 = 


= 20 


— 




160 


= 


9600 






I 


= 




8 

1 





480 
60 



The Metric, or Decimal System of Weights and Measures, is now 
the official system in the United States, having been adopted throughout 
the last revision of the U. S. Pharmacopoeia. It is in general use on the 
continent of Europe, and is employed by French and German physicians 
in this country. Its three standard units are as follows, viz. : — 

A Meter, the standard unit of linear measure and also of the whole system, is the ten- 
millionth part of the quadrant of the earth, i. e , the forty-millionth part of the earth's 
circumference around the poles. One-tenth of the Meter is the Decimeter, one-hundredth 
is the Centimeter, and one thousandth is the Millimeter. 

A Liter, the unit of measure of capacity, is the volume of one kilogramme of pure 
water at the temperature of its maximum density, in vacuo. Theoretically, the Liter is 
equal to one cubic decimeter, or 1000 cubic centimeters. Per contra one-thousandth of 
a Liter is the Milliliter (or Cubic Centimeter), which measure of pure water at its maxi- 
mum density weighs one Gramme. 

A Gramme, the unit of weight, is the weight of the one-thousandth part of a liter of 
water at its maximum density. Its tenth is the Decigramme, its hundredth is the Centi- 
gramme, and its thousandth part is the Milligramme. 

The original and French spelling is metre, litre, gramme ; the Anglicized form is 
meter, liter, gram. The U. S. Ph. of 1890 sanctions a combination of both, thus — 
meter, liter, gramme. 

The metric terms used in pharmacy are few, and are generally confined 
to the Gramme, the Cubic Centimeter (or fluid-gramme) and the Milli- 
gramme ; but the system embraces many other terms of increase and de- 
crease, which are set forth in the following table, viz. — 







1 0000. 


Myrialiter. 




0000. 


Myriameter. 


1000. 


Kiloliter. 




1000. 


Kilometer. 


IOO. 


Hectoliter. 




IOO. 


Hectometer. 


10. 


Dekaliter. 


ioooo. Myriagramme. 


10. 


Dekameter. 


1. 


Liter. 


1000. Kilogramme. 


1. 


Meter. 


.1 


Deciliter. 


100. Hectogramme. 


.1 


Decimeter. 


.01 


Centiliter. 


10. Dekagramme. 


.01 


Centimeter. 


.001 


Milliliter (Cubic 


1. Gramme. 


.001 


Millimeter. 




Centimeter). 


.1 Decigramme. 
.01 Centigramme. 
.001 Milligramme. 



The relations between the Metric Weights and Measures and the 
Apothecaries' are as follows, viz. : — 



WEIGHTS AND MEASURES. 497 

I meter = 39.370432 inches. 

I liter = 2. 1 13433 pints. 

I gramme = 15.43234874 grains. 

I grain = 0.06479895 gramme. 

I minim = 0.061613 cubic centimeter. 

The Metric System is making way but slowly in this country although 
its progress is aided by every process of forcing which scientific bodies 
can bring into action, and it remains to be seen how much its adoption 
in the last edition of the U. S. Pharmacopoeia will influence the medical 
profession in its behalf. With all the influence brought to bear in its 
favor it certainly has not yet been adopted by any considerable propor- 
tion of native-born and home-educated physicians and pharmaceutists. 
One of its greatest difficulties for the physician is the absence of any 
correspondence or relation between the unit of weight (gramme) and the 
unit of measure (liter), and the consequent want of fluid denominations 
below the cubic centimeter, corresponding with the decigramme, centi- 
gramme and milligramme of the weight scale. Its chief disadvantage is 
one which is inherent to any decimal system, viz. — that the number ten 
cannot be divided more than once without producing a fraction. This is 
partly compensated for by the practice of dividing five into the three parts 
of 2, 2 and 1, and on this principle metric weights are usually constructed. 



Approximate or Domestic Measures become necessary in appor- 
tioning doses for a patient, when liquid medicines are used. Of these 
the measure most commonly employed is the teaspoonful, which is gener- 
ally taken as equivalent to a fluidrachm, though in most cases as now 
manufactured the teaspoon contains about 75 minims, or 25 per cent, 
more than the theoretical quantity. The dessertspoonful is about equal 
to 2 teaspoonfuls, and the tablespoonful to about 4 teaspoonfuls or f^ss, 
while the wineglass is supposed to contain about f^ij. The use of gradu- 
ated medicine glasses is strongly recommended instead of the above ap- 
proximate measures. They may be obtained at trifling cost in any well- 
stocked drug store. 

Drops (Guttae) are very variable in size, though popularly supposed to 
equal minims, the variations in their relative dimensions being due to the 
viscidity of the liquid, the shape and surface of the orifice from which 
they escape, and sundry other circumstances. The Syrups and Mucilages 
produce large drops, while Bromine, Chloroform and other heavy mo- 
bile liquids produce very small ones. These differences are well illus- 
trated in the following table, which gives the number of drops in a flui- 
drachm of several liquids of certain _classes. [See the Appendix for a 
fuller table.] 
32 



49$ WEIGHTS AND MEASURES. 



Syrupus Acacise, 44. 


Oleum Ricini, 77. 


Syrupus Scillee, 75. 


Oleum Copaibae, 123. 


Aqua, 60. 


Oleum Juniperi, 148. 


Liquor Potassse, 62. 


Spiritus Camphorce, 143. 


Liquor Hydrargyri Nitratis, 13 1. 


Spiritus Chloroformi, 150. 


Acetum Opii, 90. 


Ext. Digitalis Fluid., 134. 


Vinum Opii, 100. 


Ext. Ipecac. Fluid., 120. 


Tinctura Opii Deodorati, no. 


Ext. Cinchonge Fluid., 138. 


Tinctura Opii Camph., no. 


Ext. Zingiberis Fluid., 142. 


Tinctura Opii, 130. 


Ext. Buchu Fluid., 150. 


Tinctura Iodi, 148. 


Ext. Hyoscyami Fluid., 160, 


Tinctura Aconiti, 146. 


yEther, 176. 


Alcohol Dilutum, 137. 


Bromum, 250. 


Alcohol, 146. 


Chloroformum, 250. 



Specific Gravity is the relative weight of equal bulks of different 
bodies. The specific gravity of water at a certain temperature (generally 
59 F.) is taken as 1, and that of all other substances is expressed in terms 
of this unit. The Pharmacopoeia gives very complete tables of percent- 
ages and specific gravities of Alcohol, Ammonia Water, Acetic, Hydro- 
bromic, Hydrochloric, Nitric, Sulphuric and Phosphoric Acids, and aque- 
ous solutions of Potassa and Soda. The specific gravity of any substance 
is expressed by the quotient obtained by dividing the weight of a given 
measure of the substance by the weight of an equal measure of water. In 
pharmacy the specific gravity of solids is not of any importance, but that 
of liquids is a matter of constant value, and is determined in most cases 
by means of a specific gravity bottle or by a hydrometer, instruments 
which are described in any standard work on chemistry or physics. 
Modifications of the hydrometer with scales adapted to particular work 
are the urinometer, saccharometer, lactometer, etc. 

Specific Volume is the relative bulks of equal weights of different 
bodies. In pharmacy it means the volume of the weight of a liquid com- 
pared with the volume of an equal weight of water at 59 F. The specific 
volume of a body is therefore inversely as its specific gravity, and is ex- 
pressed by the quotient obtained by dividing unity by the specific gravity. 
^~- = sp. vol. and therefore sp. gr. X S P- vol. = 1 - 

A table of the specific gravity and specific volume of several liquids 
will be found in the Appendix. 



PRESCRIPTIONS. 499 

PRESCRIPTIONS. 



Extemporaneous Prescriptions are formulae written on the instant 
(ex tempore) to meet the requirements of individual cases. 

A prescription should begin with the name of the person for whom it 
is designed, and the date on which it is written. Then follows the Latin 
word Recipe, usually abbreviated to the sign R, and signifying " Take," 
or " Take thou;" next the names and quantities of the ingredients to be 
used, which are also expressed in Latin ; then the directions to the com- 
pounder, followed by the directions to the patient, the last being now 
usually expressed in English ; and finally the signature and address of the 
prescriber. 

A prescription then has four component parts, viz. — 

Superscription, — consisting of the name of the party for whom it is designed, the date, 

and the sign R — signifying " Take thou." 
Inscription, — the body of the prescription, consisting of one or more of the following 
subdivisions, viz. — the 

Basts, — or chief, active ingredient. 
Adjuvant, — to assist the action of the basis. 

Corrective, — to correct some injurious quality of the other ingredients. 
Vehicle or Excipient, — giving the prescription a suitable form. 
Subscription, — the directions for the compounder, usually expressed in contracted Latin. 
Signature, — the instructions for the guidance of the one administering the medicine, in 
English, followed by the signature of the prescriber. 

A prescription may, however, contain the base alone, or the base with 
the adjuvant, or the base with a simple vehicle or diluent. A single in- 
gredient may serve a double or treble office, as the Syrupus Rhei Aro- 
maticus with Quinine, in which case the syrup serves as an adjuvant to 
increase the action of the quinine, as an excipient to cover the taste, and 
as a vehicle to facilitate the administration of the dose directed. Again, 
the basis may need no aid in doing its work, and may require no correc- 
tive of its action, nor any special vehicle. On the other hand, there is 
no limit to the number of ingredients which may be used, provided that 
the prescriber has a clear idea of something to be accomplished by each 
one, and also provided that there is no chemical or medicinal incompati- 
bility between them. In olden times prescriptions were very complex, 
and contained a great many curious and incongruous ingredients. As 
Dr. Piffard well says, "the tendency of the present age is toward 
mono- rather than poly-pharmacy, and prescriptions with the orthodox 
adjuvans and corrigens are less frequently seen than formerly." There 
is danger, however, in carrying this simplicity too far, for there is no 
doubt but that proper combinations of medicines will often produce effects 
for the patient's good, which could not be obtained from the use of any 
one remedy. 



500 PRESCRIPTIONS. 

Procedure in Writing a Prescription. 

In writing an extemporaneous prescription, the first step is to write the 
patient's name and address, the date, and the sign R. Then the title of 
each ingredient should be written in Latin and in the genitive case, except 
that when a certain number only of an ingredient is ordered, the name 
of the ingredient should be in the accusative case, for example, " Vitel- 
lum unum, — one yolk-of-egg." Next, the quantity of each ingredient 
sufficient for one dose should be mentally determined and multiplied by 
the number of doses which the mixture is to contain, and the result set 
down in signs and Roman numerals. The directions to the pharmacist 
and patient being added, and the prescriber's name or initials affixed, 
the prescription is completed ; but when very active agents are used, it 
is a good plan to go over the calculations a second time before letting it 
leave the hands of the person most responsible for its action. For pills 
or powders the same process should be employed, slightly varied accord- 
ing to the requirements of each case. Frequently the ingredients and 
quantities for but one pill, powder or suppository are named, with instruc- 
tions to make a certain number after the formula. When an unusually 
large dose of any poisonous drug is prescribed, it is customary to under- 
line the quantity, so as to call the attention of the compounder to the fact 
that the prescriber is aware that the dose is above the average. 

An Example will perhaps make the foregoing more comprehensible, 
and at the same time serve to indicate the style of writing usually em- 
ployed. The following formula is that ordered in the U. S. Pharma- 
copoeia for the preparation known as Black Draught, but officially styled 
the Compound Infusion of Senna; approximate weights and measures 
being substituted for the pharmacopceial metric weights. 



For Mrs. Gray. fuly 7 th, , t 

Recipe, lake, — 

C Sennce, semiunciam, 
/-d • x J Of Senna, half an ounce, 
^ '' ~\ Magnesii Sulphatis, 

(^ Of Magnesium Sulphate, 
( ArT t ^ J Mannce, ana unciam unam, 
^ J * ' \ Of Manna, of each an ounce, 

/p . x J Funiculi, drachmani unam, 

v "' \ Of Fennel, one drachm, 

(\J v 1 \ / -Aqua Bidlientis , fluidnncias octo, 
(venicie.) ^ Qf BoiHng Water> eight fluid-ounces. 

Mac era per horam in vase clauso, deinde cola. 

Macerate for an hour in a closed .vessel, then strain. 
Signetur, Let it be entitled, — A wineglassful every four hours ~\ 

until it operates. V SIGNATURE. 

/. F. Wood, M. D. J 

Abbreviated in the style usual among physicians, the above prescription 
would read as follows, viz. — 



- Inscription. 



Subscription. 



PRESCRIPTIONS. 5OI 

For Mrs. Gray. July Jth, i8g4- 

R. Sennce, ^ss 

Magnesii Sulphat. , 

Manna, . aa ^j. 

Fceniculi, £j. 

Aqua: Bull. , f ^ viij. 

Mac. per hor. in vase clauso, deinde cola. 
Sig. — A wineglassful every four hours, till it operates. 

Wood. 

As the result of the above is nearly identical with the official prepara- 
tion, we might write the same prescription more simply, as follows, — 

R. Infusi Sennce Compos., ^ viij. 

with the proper superscription and signature ; this being the manner of 
prescribing the official preparations. 

It will be noticed that in the above analysis the term basis covers two 
ingredients ; but it is obvious that either of them might be considered the 
principal agent, and the other one classed as an adjuvant. 

"These four parts of a formula are intended to accomplish the object 
of Asclepiades, curare cito, tute et jucunde ; in other words, to enable the 
basis to cure quickly, safely and pleasantly.'" (Pareira.) 

Another Example will illustrate the mental operations which should 
always be followed by a prescriber ; for no matter how good a memory 
he may have, he will surely make a grievous mistake some day if he fol- 
lows the practice of writing prescriptions from memory. Furthermore, 
the unscientific character of the latter habit will, when appreciated, pre- 
vent any educated physician from indulging in it. Every prescription 
should be written with a definite purpose in view, consequently the mind 
of the prescriber should weigh each step carefully, and should avoid all 
slavish subjection to ready-made formulae. 

Suppose, then, that we wish to order for Miss Graham an emulsion of 
Castor Oil, flavored and sweetened so as to make it less disagreeable to 
the taste than it naturally is. If the ingredients were simply mixed to- 
gether, as in the previous example, the result would be an unsightly 
preparation, consisting of sweetened and flavored water with the oil float- 
ing on top. So we require that the process of emulsification be first 
accomplished, by which the oil is minutely subdivided and suspended in 
the water, by the aid of the emulsifier, which may be any viscid excipient, 
as gum, soap, or yolk-of-egg. Taking the last-named for the emulsifying 
agent, we would begin by writing down in order the following terms, as 
stated in italics, viz. : — 

For Miss Graham. June 10th, 1894. 

R . (Take thou—) 

Olei Ricini, (of Oil of Castor), 
Vitellum, (Yolk-of-egg), 
Tere bene sit/nil ; dein adde — (Rub well together; then add — ) 



502 PRESCRIPTIONS. 

Having gone so far, we begin to think of an agreeable vehicle, and 
choosing from the many Syrups at our disposal that of Ginger, and from 
the flavored Waters that of Cinnamon, we write further for these as the 
ingredients to be added, thus — 

Syrnpi Zingiberis , (of Syrup of Ginger), 
Aquce Cinjiamomi, (of Cinnamon Water). 

The ingredients are now all entered upon the prescription, but their 
respective quantities have not yet been decided on. We proceed, then, 
by first taking into consideration the total quantity of the medicament 
required, — which, in this case, as the preparation is intended to purge the 
patient, need not embrace more than one or two doses. As it is well to 
provide for a repetition of the dose, in case the medicine should not act 
sufficiently, we will decide upon two doses in all. Now, the average adult 
dose of Castor-oil is about a tablespoonful, or half-an-ounce, and as we 
want two such doses we insert the sign and numerals fgj, or simply ^j, 
opposite the title of the oil, which is written in the genitive case. But 
to emulsify it properly we need about one-half as much of the emulsify- 
ing agent, and we may express this by writing for half-an-ounce of yolk- 
of-egg, or for the yolk of one egg, or for one yolk-of-egg, which weighs 
about half-an-ounce. This would be expressed in Latin by either of the 
following methods, viz. : — 

Vitelli semi-unciam, (^ss). One half-ounce of Yolk-of-egg. 
Vitellum ovi unius, (j). The Yolk of one egg. 
Vitellum unum, (j). One Yolk-of-egg. 

As the word Vitellus means Yolk-of-egg, we may omit the word Ovi, 
and accepting the latter as the best style, insert the numeral j opposite 
the word Vitellum, which is properly in the accusative case. The whole 
quantity so far specified is one ounce and a half, and if we add two and 
a half ounces of diluent, we shall have a four-ounce mixture, or the full 
of a regular sized bottle, as found in the shops. There being consider- 
able viscidity already present in the emulsion we do not need much 
syrup, so we assign to the Syrup of Ginger the odd half-ounce, leaving 
two ounces of the Water to make up the total bulk of four fluid-ounces. 

The prescription now only requires for its completion that the subscrip- 
tion and signature be added. We proceed to admonish the dispenser by 
telling him to mix the ingredients together, and therefore write the word 
Misce, or the abbreviation M commonly used therefor; and to further 
point out the nature of the preparation we add-, Let be made an emulsion, 
or in Latin, Fiat emulsum, — the passive verb taking as predicate-nomina- 
tive the thing into which the making is to be. The final words Label — 
or Write thus — are expressed by the term Signelur, Let it be entitled, — 
followed by the directions for the patient or the person who is to admin- 



PRESCRIPTIONS. 503 

ister the medicine, which should be in English, though they may also be 
written in Latin. Our completed prescription will stand thus, — 

For Miss Graham. June 10th, 1894. 

R. Olei Ricini, %}. 

Vitelhim, j. 

Tere bene simul, dein adde — 

Syrupi Zingiberis, ^ ss. 

Aquce Cinnamomi, . . ^ij. 

M, Fiat emulsum. 

Sig. — " One-half at once, to be repeated next day if re- 
quired.' 1 '' Potter. 

The last entry of the inscription might also be written thus — Aquce. 
Cinnamo?ni, quantum sufficiat ad ^iv, meaning "of Cinnamon-Water as 
much as may be necessary to [bring the whole quantity to] four ounces," 
usually expressed in contracted style, thus — 

Aq. Cinnamomi, q. s. ad §iv. 

This style is preferred when any of the quantities are approximations, 
and the final item cannot be exactly stated to secure a certain total. In 
the foregoing case, the one yolk-of-egg might measure a little more than 
the half-ounce assigned to it; but by using the q. s. ad style at the end, 
we make sure of getting a total of exactly four fluid-ounces. 

The Use of Latin in Prescriptions. 

The use of the Latin language in writing prescriptions is a sore point 
with a certain class of patients who like to know what they are taking, or, 
in other words, like to exercise their critical judgment upon the pre- 
scription of a physician in whose learning, skill and judgment they pro- 
fessed to have confidence when they consulted him. This feeling crops 
out frequently in our State legislatures, where bills are periodically intro- 
duced making it a crime for a physician to write a prescription in any 
other than the vernacular language. It is well for the student to know 
the reasons for maintaining the use of a dead language in the ordinary 
affairs of life. These reasons are as follows : — 

The names of plants vary in every modern language, and even in the 
same language several different plants not infrequently receive the same 
common name. For example, — the name " Starwort " is given to Aletris 
farinosa and to Helonias dioica ; " Colic-root " is one of the names of 
Aletris farinosa, also of Dioscorea villosa and of Liatris spicata; " Man- 
drake " is applied to Podophyllum and to Mandragora ; " Winter-green " 
to Chimaphila and to Gaultheria ; and "Snake-root" to five different 
plants, viz. — Asarum, Cimicifuga, Eryngium, Senega and Serpentaria. 
There are many other instances of this diverse nomenclature in English ; 
and, as each plant has a different name in French, another in German, 



504 PRESCRIPTIONS. 

and still another in Italian, Spanish, Dutch, etc., the confusion, in such 
a polyglot country as this, would cause innumerable errors if any but a 
generally understood language were used in prescriptions. Latin is such 
a language, it is the accepted language of science throughout the world, 
the Latin names of plants are definite and cannot be confounded, and a 
prescription written in Latin by a physician of any nationality, in any 
part of the civilized world, can be readily understood and correctly com- 
pounded by a pharmacist in any other civilized country. 

Another reason, formerly more potent than at present, is the protec- 
tion to the patient which the secresy of a Latin prescription affords. A 
prescription ordering mercury and potassium iodide in plain language 
would be an awkward thing to send by one's child or servant to be put 
up, or to have ordered by telephone to be sent to Mrs. C. B. of a certain 
number and street. Again, there exists in many cases a strong prejudice 
against certain names of drugs, usually born of ignorance but none the 
less potent, and in such it becomes necessary for the patient's good to 
conceal from him the name of the medicine he is taking. In this age of 
free education in all branches and the consequent smattering of every- 
thing possessed by almost everybody, the use of Latin does not afford the 
necessary secresy, and the physician who does not dispense his medicines 
is often compelled to resort to private formulae deposited by him with a 
certain druggist. In France, it is a criminal offense to make known or 
expose the contents or nature of a prescription to any person other 
than the party for whom it was written ; the law of that country recog- 
nizing the fact that prescriptions may betray secrets which should be care- 
fully guarded. 

Opium, Morphine, Cocaine, and other agents likely to cause drug- 
habits, should never be ordered on written prescriptions for neurotic or hys- 
terical subjects. The physician should keep such drugs in his own hands, 
and retain the absolute control of their administration in every case in 
which he finds it necessary to use them. He should protect his patient 
from such a result as drug-slavery by every means in his power. Many 
of the worst cases of the cocaine-habit, known to the author, were ac- 
quired by the use of cocaine in nasal sprays prescribed by physicians ; 
and similar methods are responsible for many of the wrecks made by in- 
dulgence in opium and morphine. 

There is no royal road to prescription-writing; practice, care and knowl- 
edge of the whole subject is necessary to enable one to turn out habitually 
those elegant prescriptions which are properly termed " magistral," being 
the work of a magister, or master of his business. A fair knowledge of 
the Latin language is a sine qua non to every professional man, but espe- 
cially to the physician. It is pitiable to see a Doctor write ignorantly of 
even the genitive-case endings of the drug-names which he uses. The 



PRESCRIPTIONS. 505 

teaching of Latin is not within the scope of this work, and hence this 
part of the subject will be concluded with the advice to the physician who 
is ignorant of that language to write his prescriptions wholly in English 
if he cannot write them in decent Latin. A very full table of the Latin 
words, phrases and contractions used in prescription-writing, also a table 
of genitive case-endings, will be found in the Appendix; but for a com- 
plete treatment of the subject the reader should consult Dr. Pareira's 
Selecta e Prascriptis, in which every detail of prescription-writing is fully 
explained. 

Principles of Combination. 

The principles of combination are so well laid down by Dr. H. C. 
Wood, that his words are appended verbatim, as follows : — 

The art of combining medicines is not a difficult one; but in practice 
certain principles should not be lost sight of. Chief of these are, to pre- 
scribe as few remedies as possible, and to use no powerful drug without a 
very distinct idea of what it is intended to do. Whenever it is desired 
to give a powerful remedy in increasing doses until its physiological effect 
is produced, it should always be given by itself. Thus, it may be neces- 
sary to give Arsenic so as to impress the system, at the same time that 
Iron is indicated ; but the two remedies should be given separately, so 
that the dose of either can be increased or diminished independently of 
the other. 

The principles of combination formulated below were long ago enun- 
ciated by Dr. Paris, but are to-day as imperative as ever. Medicines are 
combined — 

First. To augment, correct, or modify the action of a medicine. Thus, 
purgatives act much more kindly when a number of them are united 
together. The chief reason of this probably is, that as different remedies 
affect different portions of the gut, the whole intestine is best reached by 
a union of the diverse substances. It may take an intense irritation of the 
mucous membrane to purge as actively as does a mild irritation of both 
the mucous membrane and the muscular coat. 

There are powerful medicines which act similarly upon some parts of the organism 
but dissimilarly upon other parts. By combining such remedies powerful effects can be 
obtained at the points where the two lines of action cross each other, without influencing 
to a great extent other portions of the system. Thus, Chloral produces sleep by its ac- 
tion upon the brain, and also has a distinct influence upon the heart, but none upon the 
intestinal tract. Morphine acts upon the brain, and does not influence the heart, but has 
a powerful effect upon the intestinal tract. By combining Chloral and Morphine we get 
an overwhelming conjoined influence upon the brain in producing sleep with the least 
possible disturbance of the heart and of the intestinal tract. 

Second. To obtain the joint action of two or more diverse remedies. 
Thus, in a cough mixture Morphine may be included to quiet the cough, 
whilst Ipecacuanha and Squill (in accordance with the first principle) are 



506 PRESCRIPTIONS. 

added to affect the mucous membrane. The application of this principle 
requires caution, or the practitioner will be led into that chief abomina- 
tion — polypharmacy. It is worse than futile to attempt to prescribe for 
every symptom. The underlying cause of the disorder or the understratum 
of bodily condition must be sought out and prescribed for simply. 

Third. To obtain a special combination, which is really a new remedy, 
or which experience has shown acts almost as a new remedy. Thus, when 
to Iodide of Potassium in solution Corrosive Sublimate is added, a new 
chemical compound is formed, which experience has shown to be of great 
value in syphilitic diseases. Griffith's antihectic mixture is another in- 
stance of the use of chemical changes, the Proto-carbonate of Iron being 
formed out of the Sulphate of the metal and the Carbonate of Potassium. 
In the famous Dover's powder no chemical change occurs, but the ordi- 
nary action of Opium upon the skin is so enhanced that the combination 
may be looked upon almost as a new remedy. 

Fourth. To afford a suitable form. Thus, Acacia is added to make 
an emulsion, or Confection of Rose to make a pill. In the choice of 
excipientscare should be exercised to select a substance free from medical 
properties, having no chemical incompatibility with the medicinal agent, 
and of suitable physical character. Bread crumbs often make a good 
basis for pills, but with Nitrate of Silver they are chemically incompati- 
ble, on account of the chlorides in them. 

When writing a prescription, the utmost care should be taken to use such excipients 
that the combination should not only be attractive to the eye, but also as little repulsive 
to the palate as may be. Whenever possible, the pill-form should be employed with 
bitter or disagreeable medicines. The pill may be readily coated with silver-foil ; tonic 
pills may be coated with Iron by shaking or rolling them in Ferri Pulvis while soft and 
sticky. Sugar-coated pills and " compressed pills" are apt to get so hard and insoluble 
that their use requires caution. In regard to mixtures, flavoring oils should be freely 
used, and the power of Glycerin to conceal the disagreeable taste of many substances 
should be remembered. {Therapeutics, jth edition, page io8, et sea.) 

Metric Prescriptions. 
Metric prescriptions are written or compounded with sufficient accu- 
racy by considering a Milligramme as equal to the -g^th of a Troy grain, a 
Gramme as equivalent to 15 Troy grains, and a Cubic Centimeter (fluid 
gramme, milliliter) as equal to 15 minims, or ^thofafiuidrachm. All other 
metric terms, units and prefixes may be wholly ignored by the physician 
and the pharmacist. In fact the terms centigramme and decigramme are 
rarely used at all, the former being generally expressed by 10 milli- 
grammes and the latter by 100 milligrammes. The term Gramme when 
abbreviated is printed and written Gm., the term Milligramme, Mg., and 
the term Cubic Centimeter, Cc. In expressing quantities by metric weight 
or measure in writing the common or Arabic numerals are used, and are 
always placed before the term or abbreviation designating the unit, thus — 



PRESCRIPTIONS. 507 

2.50 Gm.,30 Cc. When apothecaries' weight is employed the numerals 
are placed after the sign or symbol designating the unit, and in Roman 
characters, thus : gr. x, 9ij, ^jss, ^vj. The decimal point after the figure 
representing the number of grammes or cubic centimeters should be 
replaced by a line, in order to avoid such errors as might arise from the 
misplacement of a point, the dropping of ink, or the intrusion of a fly- 
speck, which might cause serious results in many cases. The simplest 
rule for writing a prescription in metric terms by one who is not prac- 
ticed in the use of the system, is the following, viz. — 

Write as though prescribing but one dose of each ingredient in grains or 
minims and decimals thereof ; then substitute the ter?n ' ' grammes ' ' or 
" cubic centimeters " for grains or minims, and the prescription is correct 
for 75 doses in metric terms. 

Of course, when writing for a mixture or solution, the proper quantity 
of vehicle must be added to complete the one dose, and must also be 
expressed first in grains or minims. For example, — 

One dose. 15 doses metric. 

R. Quininae Sulphatis, ...... gr. j, 1 

Strychnine Sulph. , gr. -^ or 0.016, 016 

Ext. Glycyrrhizae Fl., H1J V > 4 

Syrupi, . . . t TT\,lx, 60 

This gives a two-ounce mixture approximately, of which the dose would be a tea- 
spoonful. 

One dose. 15 doses metric. 

R . Quininae Sulphatis, gr. j, I 

Massae Ferri Carb., gr. ij, 2 

Ext. Nucis Vomicae, gr. ^ or 0.25, .... 25 

Ft. pil. no. xv. Sig. — One pill thrice daily after meals. 

The above rule will answer for all liquids except those which are very 
heavy (as Syrups and Chloroform), or very light (as Ether). Measures 
may be entirely discarded, and all fluid quantities expressed in grammes. 
The average drop of water may be considered equivalent to 0.05 cubic 
centimeter (or gramme), the average teaspoonful to 5 Cc, the table- 
spoonful to 20 Cc, the Troy ^ to 30 grammes, the fluidounce to 30 
Cc, and 8 fluidounces to 250 Cc. 

In prescribing Syrups or Chloroform, each Troy fluidounce should be 
reckoned at something more than 30 grammes — say 40 ; and if this be 
done, the difficulty of converting one scale into the other will be obviated. 
As to Syrups, Chloroform, etc, the following table shows the actual 
weight in grammes of each fluidounce of the substances named : — 







Water. 


Tinctures. 


Syrup. 


Chloroform. 


Ether. 


Fluid Oz. 




(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


(Grammes.) 


I!: 


= 


29.52 


28.OO 


38.OO 


43-70 


22.14 


s»- 


= 


59-04 


56.OO 


76.OO 


84.4O 


44.28 


liv- 


= 


IlS.oS 


# II2.00 


I52.OO 


I74.80 


88.56 


5V111. 


= 


236.16 


224.OO 


304.OO 


349.60 


177.12 



508 



PRESCRIPTIONS. 



A table of equivalents between Apothecaries' and Metric Weights and 
Measures will be found in the Appendix. 



Abbreviations. 
Abbreviations, though very commonly used by physicians in prescrib- 
ing, are a source of much annoyance to the compounder, and frequently 
one of great danger to the patient. Physicians who never knew anything 
of the Latin grammar, or those who have forgotten its rules, are very apt 
to use abbreviations to conceal their ignorance of case-endings. Many 
others use them through sheer laziness, and some from force of habit. The 
educated and conscientious man will take pride in turning out a full and 
clear prescription, free from cabalistic letters and all elements of uncer- 
tainty. In the Appendix will be found a list of the Latin terms used in 
prescriptions, with the abbreviations in vogue, and the English meanings. 
Ambiguous contractions may result fatally to the patient, as is readily 
seen by studying the following list, which gives a few examples of the 
dangers of careless abbreviation : — 



Aconit. . 
Amnion. 
Aq. Chlor. 
Aq. Fontis. 



Chlor 



Hyd. Chlor. 



Acid Hydroc. — may mean 

( Aconitine. 

\ Aconitum. 

f Ammonia. 

(_ Ammoniacum. 

f Aqua Chlori. 

\ Aqua Chloroformi. 

( Might easily be read 

\ Aqua Fortis. 

Chlorine. 

Chloral. 

Chloroform. 

Calomel. 

Corrosive Sublimate. 

Hydrate of Chloral. 



■ 



j Acidum Hydrochloricum. 
\ Acidum Hydrocyanicum. 

Hydrargyrum. 



Hydr. 



Sod. Salph. 



Sulph. 



Zinci Phos. 



Hydras. 

Hydriodas. 
| Hydrochloras. 
[_ Hydrocyanas. 

Sodium Sulphate. 

Sodium Sulphite. 

Sodium Sulphide. 

Sulphur. 

Sulphide. 

Sulphate. 

Sulphite. 

Zinc Phosphate. 

Zinc Phosphide. 



Renewals of Prescriptions. 

It would be advisable for physicians to always write the words Non 
Repetatur, or some similar direction, on all prescriptions which should 
not be repeated without their sanction. By so doing they would doubt- 
less cut off a good many renewal charges from the receipts of druggists 
who would fear the legal consequences of disobeying the mandate. This 
inconvenience to the drug-seller would be more than compensated for in 
the advantage resulting to the drug-taker, who too frequently carries in 
his pocket-book a stock of receipts for his various complaints ; and in 
protection to the physician, who by giving up the dispensing of his own 
medicines has placed it in the power of the druggist to connive at a direct 
robbery of the just reward of professional skill and knowledge. 

It is doubtless a fact familiar to every observer, that the old-time con- 



PRESCRIPTIONS. 5O9 

fidential relations between the professions of physician and pharmacist 
have almost passed into oblivion. In fact, the tendency of pharmacy 
now-a-days is towards the position of a mere money-making trade, instead 
of in the exalted direction of a profession. The indiscriminate renewing 
of prescriptions, the open sale of quack nostrums and homoeopathic pel- 
lets, the readiness with which counter-prescribing is indulged in, the in- 
sinuations too frequently made over the drug-counter in reflection on 
physicians, and many other similar practices, have caused the non-com- 
batant profession to regard the average druggist with suspicion. If phy- 
sicians boldly took the dispensing of medicines more into their own hands 
many of these evils would soon eliminate themselves from the drug-stores. 
Right here it may be said that there is nothing unprofessional or deroga- 
tory in the dispensing of his own medicines by the physician. In England 
it has been the universal practice for centuries in all places except the 
largest cities, and it has only been given up by a part of the medical pro- 
fession as a matter of convenience to themselves, not as a right belonging 
to the pharmacist. The homoeopaths fought for the reclamation of this 
practice as a right belonging to the medical profession, and succeeded in 
its legal establishment, but not from a worthy motive. They dispense 
their own medicines in order to cover up the many frauds of which they 
are daily guilty, and to give them the power of administering full doses 
of powerful drugs in a form which is apparently "homoeopathic," with 
no tell-tale prescription on file in a drug-store to give mute but danger- 
ous evidence against their honesty. In this way they administer several 
grains of Calomel or eighth-grain doses of Morphine, or correspondingly 
large quantities of active alkaloids, triturated with sugar of milk, or dis- 
solved, as many of the latter may be, in alcohol. Chemistry, by isolating 
the active principles of plants, and furnishing them to commerce in the 
form of soluble salts, has enabled the homoeopath to practice this fraudu- 
lent method of dispensing drugs, which the innocent and ignorant patient, 
who believes in the power of the minimum dose, supposes to be infinitesimal 
in amount. But the physician of the regular profession is too apt to think 
that if he adopts a practice which charlatans have appropriated to them- 
selves, he may be classed with them by his professional competitors. 
Hence, many regular physicians are absolutely afraid to use such drugs as 
Aconite, Belladonna, Gelsemium, Arnica, Rhus, etc., all of which are 
official, and most of which are older in medicine than homoeopathy ; and 
avoid pocket-cases, drachm-vials, and triturations, as badges of charlatan- 
ism. It is high time that we asserted our independence in all these mat- 
ters, and made use freely of those means which are recommended by our 
individual judgments as promotive of the best results to our patients and 
to ourselves. With a small stock of reliable fluid extracts, and an equally 
moderate supply of gelatin-coated pills and compressed tablet-triturates 



510 PRESCRIPTIONS. 

from the best houses, physicians could check-mate the unscrupulous prac- 
tices of many druggists to a great extent, save their patients many dol- 
lars, and retain many a dollar for their own pockets, which under the 
present system goes to their enemies. The homoeopaths understand the 
money part of the argument well. When their patients' medicine is 
exhausted, the doctor must be seen for a fresh supply, meaning of course 
another consultation about symptoms, a change perhaps from Mercurius 
Dulcis to Mercurius Vivus, and another fee. The expense is nothing, 
sugar of milk being cheap, and there is no prescription in the patient's 
pocket-book, to be renewed scores of times (paying toll however every 
time to the druggist), and finally to be copied by aunts, mothers, and 
friends, as a "sovereign remedy" for a cough, or a " really wonderful 
receipt " for a case of croup. 

Prescription Blanks. 

After many years' experience in prescribing on blanks furnished by 
druggists, the writer has come to the conclusion that it is much better, 
for many reasons, for the physician to have his own blanks, without the 
address of any drug-store thereon, These blanks should be furnished 
with stubs on which to write the prescription at first in rough, afterwards 
copying it out cleanly on the main blank. A careful prescriber always 
writes a formula twice before letting it go out of his hands. If he does 
the first writing on the stub of a book of blanks he will always have a copy 
of such prescription in his possession, for which he will often be thank- 
ful. The blank used by the writer measures 4^ inches by 3^, joined by 
a perforated edge to a stub 3^ inches by 2 Y / 2 inches. On the main 
blank the physician's name and address are printed, together with his 
office-hours, and a place for number and date, also the sign R., and aline 
for signature. On the stub there are printed the words, " Copy of Pre- 
scription No 189 . . For " 

These blanks are bound up in books of 100 each, with a flexible morocco 
cover, from which the book of stubs may be slipped and a fresh book 
inserted as required. The size is ample for all ordinary requirements, 
and permits of the book being carried in the breast-pocket. 



INCOMPATIBILITY. 5 I I 

INCOMPATIBILITY. 



Incompatibility may be Chemical, Pharmaceutical or Therapeutical, 
according as the prescribed combination results in chemical decomposi- 
tion, physical disassociation or antagonistic action. In the first case the 
incompatibility may be unintentional or intentional on the part of the 
prescriber, for in many cases the result of the chemical action affords the 
substance desired. 

Instances of intentional incompatibility are the mixtures of Calomel or Corrosive Sub- 
imate with Limewater, producing the Black and Yellow Oxides of Mercury respectively, 
and commonly known as "Black Wash" and " Yellow Wash." Such a combination 
should not be filtered (as a novice might suppose), but should be dispensed with a 
" Shake-label," that the precipitate may be uniformly distributed before using. 

Chemical Incompatibility generally results from neglect on the part 
of the prescriber of the most common chemical reactions, such as that — 

1. Acids tend to combine with bases and to form salts. 

2. Weak acids or bases are displaced from their combinations by 
stronger ones, so that salts in solution when brought together generally 
exchange their radicles, especially if by doing so an insoluble compound 
can be formed. 

3. A salt in solution is easily decomposed by a strong alkali if the salt 
is one having a weak or volatile base. 

4. A substance in solution may be decomposed by another without 
precipitation, the product being soluble in the solution. 

5. Alkaloidal salts are precipitated from their solutions by the addition 
of fixed alkalies, their salts, or salts which produce insoluble compounds. 
Oxides of the fixed alkalies decompose salts of the metals proper and 
those of the alkaloids, precipitating their bases ; but the base may be 
soluble in an excess of the alkali. 

6. Tannic and Gallic Acids and vegetable substances containing them 
precipitate albumen, alkaloids and most of the metallic oxides, and form 
inky solutions when brought into contact with the persalts of Iron. 
Tannic Acid precipitates gelatin. 

7. Glucosides are incompatible with free acids or Emulsin. 

Examples of the neglect of these principles are seen in the prescribing of Quinine Sul- 
phate in mixture with Potassium Acetate, resulting in a voluminous precipitate of Quinine 
Acetate which cannot be poured from the bottle ; — Vinegars or Syrups containing Acetic 
Acid (Syr. Allii, Syr. Scilke) added to a solution of alkaline carbonates, causing decom- 
position of the latter with evolution of C0 2 ; — the addition of Liquor Potassse to a solu- 
tion of Ammonia-alum, setting free gaseous ammonia; — the mixing of Strychnine Sul- 
phate and Potassium Bromide in solution, causing the decomposition of the alkaloid sul- 
phate and precipitation of strychnine ; — preparations of Cinchona with salts of Iron, 
forming an inky tannate of iron ; — Elixir of" Chloral with alkalies, causing the elimination 
of chloroform and its subsequent evaporation, etc., etc. 



512 



INCOMPATIBILITY. 



Insoluble Salts. — The following more or less Insoluble Salts will be 
formed whenever the materials of which they are composed are brought 
together in solutions : the Hydrates, Carbonates, Phosphates, Borates, 
Arsenates and Tannates of most earthy and heavy metals and alkaloids, 
and the metallic Sulphides ; the Sulphates of Calcium and of Lead, and 
the subsalts of Mercury ; the Chlorides, Iodides, and Bromides of Bis- 
muth, Silver, Lead, and subsalts of Mercury ; the Iodides of Quinine, of 
Morphine, and of most alkaloids. 

Instances are — Limewater or Aromatic Spirit of Ammonia with Tincture of Chloride 
of Iron, or solutions of Mercury salts, or neutral solutions of Quinine or Morphine salts. 

Ammonium, Potassium, and Sodium Carbonates or Bicarbonates with Limewater. 

Solutions of Magnesium Sulphate, Alum, Zinc Acetate or Sulphate, with solutions of 
salts of Iron, Manganese, Bismuth, Antimony, Lead, and most alkaloids. 

Ammonium or Sodium Phosphates with solutions of Iron salts, with Limewater, solu- 
tion of Magnesium Sulphate, of Alum, etc. 

Liquor Potassii Arsenitis with Limewater, with solutions of basic salts of Iron, and with 
solutions of neutral salts of Quinine and Morphine, etc. 

Solutions, Decoctions, Tinctures, and Extracts containing Tannic Acid with solutions 
of salts of Iron, Mercury, Antimony, Lead (as also with solutions containing albuminous 
substances and Gelatin). 

Limewater with solutions of Quinine or Morphine Sulphates. 

Solutions of Lead Acetate with Zinc Sulphate or Alum. 

Sodium Chloride with Silver Nitrate. 

Morphine Hydrochlorate with Lead Acetate. 

Alkaline Iodides or Bromides with Bismuth Carbonate or Subnitrate, with Lead Ace- 
tate, with Subchloride of Mercury, or with neutral solutions of Quinine, Morphine, and 
Strychnine salts. 



Table of Precipitant Solutions. 

The following table shows the most important instances of solutions which mutually 
precipitate each other, the letter P meaning " forms a precipitate with " — 



Solutions of — 


c 
o 

OS 

J s 

< 


.2 • 

'o'cs 
go £ 

2 c 

— V 

w 

S 


-a 

o <A 

oco 

"o 
CO 


5 
j> 

lo 

*o id 

.p 

"o 

CO 


3 

CJ . 

«*« i2 

°H 

"GO 

o 

"3 

CO 


So 

51 

ooo 

g s 

.2-2 

_3 
"3 
00 


a 

<u 

B 

< 
o 

c 
.2 

"o 

CO 


.2* 

O 
"o 

in 

a 
.2 

'o 

CO 




P 
P 
P 


P 
P 
P 


p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 


p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 
p 


P 


p 






Tannic Acid, 

Carbonic Acid and Carbonates, 


P 


p 


P 
P 
P 


p 






Phosphoric Acid and Phosphates, 


P 
P 


P 

P 


p 


































Hydriodic Acid and Iodides, 


P 


' P' 
P 

P 























































Explosive Compounds result from the admixture of powerful oxid- 
izing agents with substances which are readily oxidizable. The most 
important members of these two classes are as follows : — 



INCOMPATIBILITY. 5 I 3 

Oxidizers. Oxidizable or Combustible. 

Chlorine and its Oxides. Phosphorus. Hypophosphites. 

Free Hydrochloric Acid. Sulphur. Sulphides. 

Nitro-hydrochloric Acid. Glycerin. Sugar. Alcohols. 

Chlorates. Hypochlorites. Oils. Ethers. Tannin. 

Chromates. Chromic Acid. Cork. Charcoal. Creosote. 

Permanganates. Dry Organic Substances. 

Nitric Acid. Nitrates. Powdered Iron and Zinc. 

Bromine. Bromates. Arsenous Acid. 

Iodine. Iodates. Cyanides. 

Silver Oxide. Oxalates. 

Peroxides (Dioxides). Ferrous, Mercurous and Stannous salts. 

Explosions have resulted from mixing Fluid Extract of Uva Ursi with certain sam- 
ples of Spirit of Nitre, Chromic Acid with Glycerin, Potassium Permanganate with 
Glycerin, Nitric Acid with Glycerin, Silver Nitrate with Creosote, Silver Oxide in pill 
with Extract of Gentian, Potassium Chlorate with Glycerin and Tincture of Ferric Chlo- 
ride. Calcium Chloride triturated with Sulphur in a mortar has exploded, so also has 
Calcium or Sodium Hypophosphite when triturated alone. Tincture of Iodine with 
Ammonia forms the Iodide of Nitrogen, which is highly explosive, especially if triturated 
in the presence of water. Catechu and Potassium Chlorate in a dentifrice have exploded 
in the mouth from the friction produced by a dry tooth-brush. Lozenges of Potassium 
Chlorate, carried in the pocket with a box of safety matches, have exploded by rubbing 
on the composition on the outside of the box, causing an extensive burn of the thigh. 

Hydrogen Peroxide (Dioxide) is peculiar in that it acts both as an oxidizer and as an 
oxidizable agent. It reduces oxidizing agents and is itself reduced at the same time, 
hence it is incompatible with all the substances mentioned above. Nitrites may act in 
the same way under favorable circumstances. 

Poisonous Compounds may be formed by the admixture of many 
substances in solution, such as — 

Potassium Chlorate with Potassium Iodide, in solution together do not 
react at ordinary temperatures, but in the system they evolve a poisonous 
agent, probably Potassium Iodate. 

Potassium Chlorate with Syrup of Ferrous Iodide, liberates Iodine from 
the Iodide in the warm stomach, causing severe gastric irritation, perhaps 
gastritis of dangerous degree. 

Dilute Hydrocyanic Acid or Potassium Cyanide, with Calomel, forms 
the Bichloride and Bicyanide of Mercury, both virulent poisons ; — with 
metallic hydrates, carbonates, sub-nitrates, or sub-chlorides, cyanides of 
the metals are formed which are even more poisonous than the acid itself 
in its usual diluted form. 

Pharmaceutical Incompatibility differs from chemical incompati- 
bility in the absence of chemical action, and is generally produced by 
adding one substance to another which, through differences in solubility, 
causes a precipitation of solid matter or a separation of part of the liquid. 
The separated constituents may be active and hence important, or inert 
and therefore unimportant. 

Instances of this are — the addition of an acid to a Quinine and Licorice mixture, 
resulting in precipitation of the Glycyrrhizin (relied on to cover the taste of the Quinine) 
by the acid ; or the use of Quinine, Tincture of Ferric Chloride and Liquorice together ; 

33 



5 14 INCOMPATIBILITY. 

— or the prescribing of solutions of Chloral and Potassium Bromide with an alcoholic 
preparation, the Chloral separating to the top as an alcoholate, and therefore dangerously 
in excess for the first few doses ; — or the neglect to prescribe Acacia or some other emul- 
sifier in mixtures of an alcoholic fluid extract of a resinous body with an aqueous prepara- 
tion, which would result in the separation of the resin to the surface and an overdose with 
the first teaspoonful. 

When a fluid extract is diluted with a liquid differing in composition 
from those used in the fluid extracts, the gum, albumen, resin, and mucil- 
age are often separated. In such a case as Fluid Extract of Cannabis 
Indica the active resin would be thrown out of solution, and floating on 
top might cause serious symptoms ; but in many other instances the pre- 
cipitate would be inert and filtration would be in order. Water is the 
solvent for albuminous, gelatinous, gummy, and saccharine bodies and for 
a large number of inorganic salts ; while Alcohol is the solvent for vola- 
tile oils and resins, gum-resins, resinoids, balsams, and all drugs contain- 
ing these as their active principles. The solvent power of either Alcohol 
or Water for their particular substances decreases in proportion to the 
amount of the other added. 

Instances of Pharmaceutical Incompatibility. 

Resinous Tinctures or Fluid Extracts with aqueous solutions. 
Tincture of Guaiac with Spirit of Nitrous Ether. 
Compound Infusion of Gentian with Infusion of Wild Cherry. 
Compound Infusion of Cinchona with Compound Infusion of Gentian. 
Essential oils with aqueous liquids in quantities exceeding I drop to ^j. 
Fixed oils and Copaiba with aqueous liquids (except excipients). 
Tinctures made with Alcohol with those made with Diluted Alcohol. 
Alcoholic Tinctures and Fluid Extracts with aqueous preparations. 
Spirit of Nitrous Ether with strong mucilages. 
Infusions generally with metallic salts. 

Therapeutical Incompatibility arises when two agents are admin- 
istered together which oppose each other in their action on the human 
system, — as for instance Belladonna in any form with Physostigma. But 
in many cases physiological antagonists are designedly prescribed together, 
one as a guard against the action of the other, as in the hypodermic ad- 
ministration of Morphine guarded by Atropine. The antagonists to each 
of the active medicinal agents may be found in the section on Materia 
Medica under their various titles, and also in the Appendix, under the 
title The Treatment of Poisoning. They are summarized in the table 
on page 64, ante. 

The Dangers of Incompatibility may in great measure be avoided 
by the use of the utmost simplicity in prescribing. The subject can only 
be glanced at within these pages, but the following simple rules may help 
the burdened memory of the student and the practitioner. 

Never use more than one remedy at a time, if one will serve the purpose 
for which you are prescribing. 



INCOMPATIBILITY. 5 I 5 

Never use Strong Mineral Acids with other agents, unless you know ex- 
actly what reaction will ensue. They decompose salts of the weaker acids, 
and form ethers when combined with alcohol. Never combine Free Acids 
with hydrates or carbonates. 

Select the simplest solvent, diluent or excipient you know of, remem- 
bering that the solvent power of alcohol and of water for their respective 
substances decreases in proportion to the quantity of the other added. 

Generally do not combine two or more soluble salts; for such salts in 
solution, when brought together, usually exchange their radicles, thereby 
forming an insoluble compound. [See ante, page 512.] 

Never prescribe a drug with any of its Tests or Antidotes. 

Never prescribe a Glucoside (as Santonin, Colocynthin, etc.), in com- 
bination with free acids or with a substance containing Emulsin, as these 
agents will decompose it. 

Aconite should be ordered in water alone, Corrosive Mercuric Chloride 
by itself in water or in simple syrup. The latter drug is incompatible 
with almost everything, even the Compound Syrup of Sarsaparilla being 
said to decompose it. 

Potassium Iodide decomposes most of the metallic salts, and is one of 
the drugs which are best administered alone. 

The following-named substances are incompatible with so many others 
that it is best to always prescribe them alone; they are best given in sim- 
ple solution : — 

Alum. Morphine Acetate. 

Dilute Hydrocyanic Acid. Morphine Hydrochlorate. 

Dilute Nitro-hydrochloric Acid. Quinine Sulphate. 

Sulphuric Acid. Liquor Calcis. 

Mercuric Chloride (Corr. Sub.) Liquor Potassae. 

Iodine and Iodides. Liquor Potassii Arsenitis. 

Syrup of Ferrous Iodide. Liquor Ferri Nitratis. 

Potassium Permanganate. Tinct. Ferri Chloridi. 

Potassium Acetate. Zinc Acetate. 

Potassium Bromide. Iron and Quinine Citrate. 

Tartar Emetic. Free Chlorine in Solution. 

Tincture of Guaiac. Tannic and Gallic Acids. 

Silver Nitrate and Lead Acetate and Subacetate, though incompatible 
with almost everything, may be combined with Opium, the latter forming 
therewith a compound which though insoluble is therapeutically active as 
an astringent and anodyne lotion. Silver Nitrate with Creosote forms an 
explosive compound. 

Tannic and Gallic Acids, and substances containing them (as the 
Astringent Bitters), precipitate albumen, alkaloids and most soluble 
metallic salts. They may be prescribed with the proto-salts of Iron, but 
not with its per-salts. Calumba is the best vegetable tonic to use with 
ferric salts, as it contains neither tannic nor gallic acids. Tannic Acid 
precipitates gelatin. 



5l6 EXTEMPORANEOUS PHARMACY. 

Iodine and the soluble Iodides are incompatible with the alkaloids and 
substances containing them, also with most metallic salts. 

Alkalies neutralize free acids, and precipitate the alkaloids and the 
soluble non -alkaline metallic salts. Oxides of the Alkalies decompose 
salts of the metals proper and salts of the alkaloids, precipitating their 
bases ; but the base may be soluble in an excess of the alkali. 

Resinous Tinctures or Fluid Extracts, (e. g. } Tinct. Cannabis Indicae), 
when combined with aqueous solutions should always have Acacia or 
some other emulsifying agent added, to prevent the separation of the 
resin, which otherwise will be deposited on the sides of the bottle or will 
float on top of the mixture. 

Tincture of Digitalis should not be mixed with aqueous or syrupy solu- 
tions, for in such cases precipitation or decomposition of the active 
principles may occur. This tincture is injured by admixture, and is best 
administered on sugar or dropped on a piece of bread. 



EXTEMPORANEOUS PHARMACY. 



This is the most important division of the whole subject of Pharmacy, 
embracing as it does the preparation and dispensing of those medicines 
which are designed for immediate use and which are compounded on the 
prescriptions of physicians. Hence it comprises the chief portion of the 
daily work of the pharmacist, and can only be learned at the dispensing 
counter and under the personal supervision of a competent master. In 
the following pages are given the most important of the general directions 
pertaining to this subject, with the object of enabling the young medical 
practitioner to familiarize himself with the compounding and dispensing 
of drugs so far as the limits of the book will admit of. The drug-store of 
the present day has degenerated so much from its legitimate business that 
ere long physicians will be compelled in self-defence to dispense their own 
medicines, thereby protecting themselves and their patients from the 
patent-medicine vending, the counter-prescribing, and the many other 
nefarious methods which have degraded the pharmacist from his old pro- 
fessional position to that of a mere trader in drugs and nostrums. The 
first outfit of every young doctor should include a few pharmaceutical in- 
struments and a small stock of drugs. By the daily handling of these, 
the tools of his profession, he will insensibly become familiar with the 
technique of the art, and even if he does not continue to dispense his 
medicines in after years he will never regret the practical knowledge which 
such a course will give him. 



EXTEMPORANEOUS PHARMACY. 517 

Compounding means the mixing or preparing of the drugs ordered 
in a prescription, and comprises all the operations of official pharmacy 
together with many other manipulations which will be described in their 
appropriate places. 

Dispensing is the operation of putting up and issuing the drugs or- 
dered in a prescription, and may apply to the already compounded prepa- 
rations of official pharmacy as well as to those prepared extemporaneously. 

Filling a Prescription means a combination of operations which 
requires great care, undivided attention, and a special practical appren- 
ticeship at the dispensing desk. In the following discussion of extem- 
poraneous preparations such hints are incorporated as are particularly 
applicable to the compounding of each article under consideration ; and 
they may be prefaced by a few general suggestions which will serve to 
point out the most approved method of dealing with this important part 
of the druggist's work. 

The prescription should first be slowly read over in a critical spirit, but 
no word or action of unfavorable criticism should reach the ears or eyes 
of the messenger. To shrug the shoulders when scanning the items, to 
laugh or even smile at the phraseology, to question the person offering it 
as to whom it is for, or what complaint it is given for, are instances of 
such flagrant treason to the prescriber as would justify the most complete 
professional ostracism of the offender. The compounder has no business 
whatever with the propriety of the recipe for its purpose. It might have 
been given as a placebo for reasons eminently wise and judicious; or if 
not so constituted it has at least been ordered by one who is in possession 
of facts about which the druggist knows nothing, even if by education 
and experience he were competent to judge in the matter, which he sel- 
dom is. His criticism should be directed only to the dosage and the 
pharmaceutical compatibility of the ingredients. Even in the latter case 
he must remember that incompatibles are often prescribed with the view 
of forming another agent from the chemical reaction produced. If he 
thinks that there is any mistake, or that the quantities ordered are in any 
degree poisonous, it is his duty to make an excuse for delay to the mes- 
senger and at once communicate with the physician. This course, in 
these days of telephones, is nearly always practicable. 

After reading the prescription, it is well to number it and write the 
label. This gives time for the label to dry, and avoids the use of blotting 
paper, which often mars the writing and renders the directions all but 
illegible. 

A clearly defined method should next be decided on by which to com- 
pound the prescription. Directions for such plans of procedure will be 
found in the succeeding pages under the titles of the various preparations. 



5 l8 EXTEMPORANEOUS PHARMACY. 

Next, the ingredients should be carefully weighed or measured out, each 
one being checked off so as to avoid the danger of its being duplicated. 
In many cases the excipient is not specified, its choice being left to the 
druggist; but in all such a note should be made on the prescription to 
show the article used, in order that in the event of a renewal being or- 
dered there may be no difference perceptible. No alteration or addition 
should ever be made which would in any degree affect the medicinal ac- 
tion of the prescription, or interfere with the obvious intention of the 
prescriber. 

The labelling of the package and the numbering and filing of the pre- 
scriptions are matters of mechanical detail which are best learned at the 
counter. Various devices for simplifying these operations are in vogue 
and may be seen in any well-appointed drug-store. Poisonous articles 
sold by the druggists should always be labelled " Poison," and the trans- 
action entered in a book usually required by law to be kept for that pur- 
pose ; but in the case of prescriptions the word "Poison" should not 
appear on the package or label unless so directed by the prescriber. 

Stock Solutions of the salts most frequently prescribed are kept in 
many establishments for convenience in dispensing. Those most gener- 
ally used are the following: — 

Alum, — :f ijss in a quart of distilled water. Of this solution each fluidounce repre- 
sents 3 ss of the salt. 

Potassium Bicarbonate, — ^j in f^iv of distilled water; of which Jss contains ^j 
of the salt. 

Potassium Chlorate, — I in 24 of distilled water, will not crystallize as the tempera- 
ture changes. 

Potassium Bromide, — 1 in 3 of distilled water, makes a very convenient solution 
for dispensing purposes. 

Chloral Hydrate, — I in I of distilled water; of which each minim contains one grain 
of Chloral Hydrate. 

Morphine Sulphate, — gr. xyj in Jj of distilled water, with a grain of Salicylic acid 
or 3 drops of Carbolic Acid to prevent change. Of this solution, known as Magendie's, 
each minim contains gr. g 1 ^ of the salt, and TT\,x contain gr. 1/3. A safer solution for dis- 
pensing purposes, as it requires less mental calculation, is one of one-half the above 
strength, viz. — gr. viij in ^ j, of which each fluid-drachm contains gr. j of Morphine Sul- 
phate. 

Carbolic Acid, — ^j in f^iv of glycerin, makes a convenient solution which will mix 
with water in all proportions. TT^ivss represent gr. j of Carbolic Acid. 

Tannic Acid, — ^j in f !| iv of glycerin, dissolved by the aid of a gentle heat, rtyvss 
represent gr. j of Tannic Acid. 

Rules for the Pharmaceutical Student. The following are quoted 
from the Chemist's and Druggist's Diary for 1885, and are well worth 
remembering. 

Read through a prescription, rapidly and in a manner suggesting no suspicion or doubt. 
Write directions invariably before dispensing. Avoid thus the use of blotting-paper ; 
a good dispenser uses almost none. 



PHARMACEUTICAL OPERATIONS. 5 19 

If a mixture contains readily soluble ingredients, never use a mortar. 

Avoid effecting solution by heat, for fear of recrystallization. 

With' syrups and also ingredients not water, arrange in dispensing to rinse out the 
measure and leave it clean ; a skilled dispenser shows very little traces of his work. 

Carefully clean and put away weights and scales after each operation. 

Hold the scales firmly by the left hand, never lift them high above the counter, and 
judge of the weight as much by the indicator as by the position of the scale. 

Select glass pans for scales, preferably of heavy make, and discard flimsy brass material, 
which corrodes speedily and becomes inaccurate. 

Learn to judge of the quantity to be weighed with tolerable accuracy ; train the eye as 
well as the hand. 

If in doubt, always begin with that about which you have no doubt. 

Be rapid in manipulation. Finish wrapping, tying, or sealing quickly. Slow dispens- 
ing is bad dispensing, and arises either from deficient practice or want of knowledge. 

Never, when in a shadow of doubt, hesitate to ask advice from a fear of compromising 
vour own dignitv. 



OFFICIAL PHARMACY. 

Official Operations are those processes which are directed in the 
pharmacopoeia to be used in the preparation of medicines. Many of them 
are processes which are common to both chemistry and pharmacy, as pre- 
cipitation and crystallization, — while others are peculiar to pharmacy, as 
percolation, trituration, etc. The most important of the pharmaceutical 
operations are briefly described below ; for full details of the various 
apparatus used the patient is referred to the more exhaustive treatises on 
Pharmacy. 

PHARMACEUTICAL OPERATIONS. 
Carbonization is the heating of organic substances without exposure 
to the air until the volatile constituents are driven off, and the residue 
assumes the characteristic appearance of carbon. 

Clarification is the separation from liquids of solid matter, which 
prevents their being transparent, without using filters or strainers. It may 
be effected by heat (as in the case of Mel Despumatum), by adding a 
lighter liquid, by adding albumen, gelatin, milk, or paper-pulp, by fer- 
mentation, or by subsidence of the particles in the form of a sediment 
through long standing. 

Colation, or Straining is usually a very simple operation, so familiar 
to every one of ordinary experience as to be scarcely worth describing. 
The strainers are made of cotton flannel, fine muslin, gauze, woolen felt 
and other fabrics. 

Comminution is the process by which the aggregation of the particles 
of a solid body is overcome, and the body is reduced to pieces of varying 
sizes. Its object is to increase the surface exposed to the action of sol- 



520 PHARMACEUTICAL OPERATIONS. 

vents, and it includes the mechanical operations of cutting, rasping, grat- 
ing, crushing, stamping, grinding, pulverizing, triturating, levigating, 
elutriating, granulating, etc. Apparatus of various kinds, as cutters, 
mortars and pestles, mills, etc., are used for the comminution, while 
spatulas are employed to loosen the particles, and sieves to sift the coarser 
from the finer. These last-named contrivances are of five sizes, desig- 
nated by the number of their meshes to the inch, 80, 60, 50, 40, and 
20, respectively permitting the passage of powders termed very fine, fine, 
moderately fine, moderately coarse and coarse. 

Crystallization is the process which bodies undergo in passing from 
the liquid or the gaseous state to the geometrical forms called crystals. 
Six systems of crystals are recognized by crystallography, which has 
assumed the dignity of a separate science. Bodies which are not capable 
of crystallization are termed amorphous. Every crystallizable body 
assumes its own peculiar form, or some other form directly derived from 
or related to it. The process of crystallization is effected (1) by fusion 
and partial cooling, as in the cases of some metals and Sulphur ; (2) by 
sublimation, as Benzoic Acid, Mercuric Chloride, etc. ; (3) by deposition 
from hot saturated solutions while cooling ; (4) by deposition from a 
solution during evaporation ; (5) by deposition caused by passing a gal- 
vanic current through the solution ; (6) by precipitation, as in the case 
of the Mercuric Iodide ; (7) by the addition to the solution of a sub- 
stance having a strong affinity for water, as the adding of Calcium Chlo- 
ride to an aqueous solution of Sodium Chloride, or Alcohol to a solution 
of Potassium Nitrate, or to an aqueous syrup. In a few cases amorphous 
solids may crystallize without undergoing liquefaction, as Sulphur, Bar- 
ley-sugar, Iron or Brass wire. The methods most frequently employed 
are those by deposition from supersaturated solutions, and by deposition 
during evaporation. The more slowly the process is carried on the 
larger and more regular will be the crystals. The process is facilitated 
by use of foreign bodies as nuclei around which the crystals are depos- 
ited ; a familiar instance being the thread in the centre of a mass of 
rock-candy. 

The Water of Crystallization is the H 2 with which most substances combine in 
the act of crystallization , and the number of molecules thereof differs for each body and for 
the same body frequently under different conditions. ExsiccatioJi is the driving off of 
this combined water by heat, the crystals assuming thereby the form of a dry powder. 
Efflorescence is a similar process occurring spontaneously on exposure of the crystals to 
the air, the effloresced portion appearing as a dry powder on the surface of the crystals. 
Deliquescence, on the other hand, is the act of absorbing water from the atmosphere, a 
property possessed by some substances, which are therefore said to be hygroscopic. 

Decantation is the pouring or drawing off a supernatant liquid into 
another vessel. If done by pouring, a guiding-rod for the liquid to run 



PHARMACEUTICAL OPERATIONS. 521 

on is an effective adjuvant ; if by drawing, the siphon in some form is 
usually employed. 

Decoloration, or the removal of coloring-matter from liquids or from 
solids in solution, is effected by the use of animal charcoal, which in small 
operations may be arranged in a funnel or a percolator, and the liquid 
placed thereon. It should not be forgotten that charcoal absorbs many 
other principles besides coloring-matter, especially alkaloids, bitters, and 
astringents, so that the process of decoloration may be one of serious 
injury to the efficiency of the preparation. 

Deflagration is the heating of an inorganic substance with another 
which yields oxygen (usually a nitrate or a chlorate), the result being 
the decomposition of the body, with violent and sudden combustion. 

Desiccation is the process of removing moisture from solids, and has 
for its object either the preservation of the substance, the reduction of 
its bulk or the facilitation of its comminution. The operation should be 
conducted at as low a temperature as possible. Roots, leaves and seeds 
are generally dried by being placed in trays of wire network and exposed 
to a uniform temperature in a room heated by steam. A better method 
is to suspend organic substances from the ceiling of an attic during warm 
weather ; a slow process, but one which does not result in much loss of 
the active volatile principles. Crystals and precipitates require a higher 
temperature and are usually dried on a water-bath. When the water of 
crystallization is to be expelled, as in desiccating Alum and Ferrous Sul- 
phate, a temperature of about 400 F. is required. In absorbing water 
from alcohol Potassium Carbonate and slaked Lime heated are employed, 
and in several instances Sulphuric Acid is the desiccator used. 

Dialysis is a process by which crystallizable substances are separated 
from non-crystallizable ones, by suspending a solution containing both 
upon a porous diaphragm having its under surface in contact with water. 
The crystalloids pass through the diaphragm, while the non-crystalline 
remain above it, and are termed colloids. Examples of the latter class 
are gelatin, gum, glue, starch, dextrin, albumen and extractive matters 
which are generally the inert and valueless constituents of vegetable 
drugs. Parchment-paper and bladders are used for the diaphragm ; the 
whole apparatus being termed the dialyzer, while the water into which the 
crystalloids pass is called the diffusate. 

The unofficial preparation known as Dialyzed Iron {Ferrum Dialysatuvi) is a colloi- 
dal substance obtained by treating Ferric Chloride in solution with Ammonia, whereby 
Ferric Hydrate is precipitated and then dissolved by agitation. The mixture being placed 
on a dialyzer, the crystalloids formed (Ammonium Chloride and Ferric Chloride), together 
with any free acid present, pass into the diffusate, leaving the neutral colloidal liquid 
(solution of Ferric Oxychloride) above on the septum. 



522 PHARMACEUTICAL OPERATIONS. 

Distillation consists of two processes, (i) the evaporation of a liquid, 
(2) the condensation of the vapor into a liquid in a separate vessel. The 
agent used in the first part of the operation is heat, in the second part 
cold. Its object is to separate mixed volatile and fixed substances, or to 
combine volatile substances which cannot otherwise be mixed, as in the 
preparation of some of the official Waters. The apparatus used is of great 
variety, from the simple retort and receiver to the elaborate and costly 
stills. 

Destructive or Dry Distillation is a process of decomposing an organic substance 
by heat into volatile products, which are collected in a separate vessel, the residue being 
said to be carbonized. It is only employed by large manufacturers, for the preparation 
of Acetic and Succinic Acids, Oil of Amber, Wood Tar, etc. 

Fractional Distillation is the separation by distillation of substances which are 
volatile at different temperatures, each being separately driven over and received in a ves- 
sel by itself. Different degrees of heat are successively employed in accordance with the 
volatilizing points of the substances to be obtained. 

Expression is the forcible separation of liquids from solids, by sub- 
jecting them to pressure. Hand-pressure through straining-cloths may be 
employed, but mechanical presses are more efficient and are coming into 
general use. Oils obtained in this manner are called expressed ox fixed 
oils, to distinguish them from the volatile oils obtained by distillation. 

Exsiccation or Calcination is the process of depriving a solid of its 
moisture or other volatile constituents by the application of heat without 
fusion. The term Exsiccation is usually applied to the vaporization of 
the water of crystallization from a crystalline body ; Calcination to such 
operations as the expulsion of carbonic acid and water from carbonates, 
as in the manufacture of Lime, Magnesia, etc. 

Filtration is a process of straining through a medium so fine as to 
deliver the filtrate in transparent condition. The filters are made of paper 
usually, though charcoal, asbestos, sand and other articles are sometimes 
employed, and are supported in a funnel of glass or other material held by 
the ring of a retort-stand. The best filtering-paper is made in Sweden by 
Munktell, and is white ; but a good paper for ordinary use is the " Prat 
Dumas White," which should always be employed for filtering alkaline or 
alkaloidal solutions. The gray French papers answer well enough for 
fluid extracts, tinctures or colored liquids, but should never be used for 
solutions containing free alkali. 

Filtering-paper is folded by doubling a sheet upon itself, and then folding it again 
directly in the middle. When opened four distinct sections appear, one of which is 
separated from the other three, and the filter thus formed is placed in a funnel. This 
arrangement is known as a plain filter, which by repeated creasing is converted into the 
plaited filter ; the latter being the form generally used in pharmaceutical operations of 
small extent. In large laboratories special processes of filtration are employed with ap- 
paratus of more or less complexity for hot filtration, rapid filtration, etc. 



PHARMACEUTICAL OPERATIONS. 523 

Fusion is the process of liquefying solids by the application of high 
heat without the use of a solvent. It is employed in making ointments, 
plasters, etc., in purifying resins, and for the purpose of decomposition. 
The degree of heat required varies from a temperature of 90 F., sufficient 
to melt lard in an open vessel, to one of 8oo° F., employed in fusing Zinc 
in an earthen crucible ; and may be regulated by the aid of the water-, 
steam- or sand-bath. The two former appliances limit the degree of heat 
applied, while the sand-bath prevents sudden changes in the temperature. 
Oil- baths and glycerin-baths are employed in fractional distillation on a 
large scale. 

Granulation is a process of reducing a coarsely crystalline substance 
to a granular powder, by dissolving it in water and evaporating the solu- 
tion with constant stirring until the product becomes perfectly dry. Many 
salts are thus treated for convenience in dispensing, as the Bromide, the 
Iodide, the Carbonate and the Citrate of Potassium. Ferrous Sulphate, 
though generally dispensed in the exsiccated powder, may be granulated 
into minute crystals by filtering an aqueous solution of it into alcohol. 

Ignition in pharmacy means the process of strongly heating solids or 
semi-solid substances, the residue left being the product desired. It is 
used in the official quantitative tests for Phosphoric Acid, Ammonium 
Phosphate and purified Antimony Sulphide. 

Incineration is the heating of organic substances with access of air 
until the carbon is consumed, the ashes remaining being the product 
desired. 

Maceration is one of the processes of extracting the soluble princi- 
ples from drugs, and consists in steeping or soaking the comminuted sub- 
stance in a suitable liquid called the menstruum, generally alcohol, for a 
period varying from 2 to 14 days, during which it is occasionally agitated. 
The liquid is then poured off, the residue is expressed, and the mixed 
liquors are filtered. Several of the official tinctures are prepared by this 
method, and many others are subjected to maceration first and percola- 
tion afterwards. 

Percolation or Displacement is a process of obtaining the soluble 
constituents of a substance in powder by the descent of a solvent through 
it. Though an ancient process for the making of lye from wood-ashes 
(lixiviation), it has only within the last forty years been adopted as an 
official process in pharmacy, and it is gradually taking the place of macera- 
tion as a means of extracting the soluble principles of drugs. The vessel 
used to hold the powdered drug is called the percolator, of which there 
are many forms employed by the manufacturers. The liquid used as a 



524 PHARMACEUTICAL OPERATIONS. 

solvent is called the menstruum, and when coming from the percolator it 
is termed the percolate. The U. S. Pharmacopoeia gives very full direc- 
tions concerning this process. 

Precipitation is the process of separating solids from their solutions, 
and is usually effected by chemical reaction, though it may be accom- 
plished by other methods, as by adding a second liquid in which the sub- 
stance is insoluble, by heating albuminous solutions, or by exposing solu- 
tions of silver salts to the action of light. The most familiar example of 
chemical precipitation is the addition of a solution of Mercuric Chloride 
to one of Potassium Iodide, the result being a double decomposition of 
the salts and the formation of Mercuric Iodide, which falls to the bottom 
of the vessel as a brilliant, red, insoluble and crystalline powder. The 
Precipitate is the separated substance, which is usually thrown down, but 
it remains suspended in some cases, and in others it rises to the top. The 
Precipitant is the substance which is added to produce the precipitation. 
A Magma is a thick, tenacious precipitant remaining behind after the 
supernatant liquid is removed by decantation or otherwise. Precipitates 
are termed flocculent, gelatinous, curdy, granular, crystalline, etc., accord- 
ing to the forms assumed. In small operations they are usually collected 
on plain filters, and washed by the repeated addition of water. 

Separation of liquids which do not mix with each other is a simple 
mechanical process performed with pipettes of various forms, or with fun- 
nels having stop-cocks in their necks. Special forms of receivers are 
used for the separation of volatile oils from the water which may accom- 
pany them during distillation. 

Solution is the dissolving of a solid or a gaseous substance in a liquid, 
and may be Simple when the substance undergoes no alteration, being 
recovered unchanged on evaporation ; or Chemical when the dissolved 
body is chemically altered by the solvent of some other substance present, 
and cannot be recovered on evaporation. Simple Syrup is an instance of 
simple solution, the Syrup of Lime one of chemical solution. The liquid 
employed is termed a Solvent before the substance is added to it, after 
the operation is completed the combined preparation is called a Solution. 
If fully charged with the dissolved substance so that it will retain no 
more, it is known as a Saturated Solution. One liquid may be dissolved 
in another, or a gas may be dissolved in a liquid. The solution of 
solids is greatly facilitated by pulverization and by stirring the men- 
struum. .Heat generally aids solution, most substances being more solu- 
ble in hot liquids than in cold ones. A saturated solution of one sub- 
stance may still be capable of dissolving others. Rapid solution of solids 
without chemical change causes reduction of temperature, while chemi- 



PHARMACEUTICAL OPERATIONS. 525 

cal solution produces elevated temperature. Circulatory Solution is per- 
formed by suspending the substance to be dissolved near the surface of 
the solvent in a gauze bag or on a porous shelf. The portion first acted 
on descends and produces a circulatory movement in the fluid, facilitat- 
ing the solution of the whole. 

Solvents employed are chiefly Water, Alcohol, Glycerin, Acids and Oils. Others less 
frequently used are Ether, Chloroform, Benzin and Carbon Disulphide. 

Sublimation is the distillation of a volatile solid, the product being 
termed a Sublimate. Its objects are to purify volatile solids from im- 
purities, and to collect such as result from chemical action at high tem- 
peratures. The operation is carried on in iron, glass or stoneware retorts, 
and results in Cake Sublimates or Powder Sublimates according as the 
temperature of the condensing surface is high or low. 

Testing and Assay are directed by the Pharmacopoeia in certain 
cases, for the purpose of determining the identity and purity of its drugs 
and their preparations. In the main portion of the book such Tests are 
frequently directed, according to a specified method in each case ; but 
processes of Assay are confined to Cinchona, Nux Vomica, Opium, and 
such of their preparations as are considered to require it. The Pharma- 
copoeia contains also a very complete section on Reagents, in which 
full directions are given for the preparation and use of Test-solutions and 
Volumetric solutions ; also instructions for Gasometric estimations, and 
for the determination of the Optical Rotation of organic substances. 

Pharmacopceial testing and the volumetric method of determination 
are necessary to the work of the practical pharmacist, and as the appar- 
atus used is simple and the operations are those in the line of his daily 
work, he should be familiar therewith. On the other hand the proximate 
analysis of organic substances for their principles, and the ultimate analy- 
sis of the same bodies for their elements, require a high degree of skill 
and long experience, and should be left to the professional chemist. 

The apparatus used in testing consists of graduated flasks and jars, 
burettes, pipettes, funnels, beakers, test-tubes, capsules, crucibles, reagent- 
bottles, etc. The metric system is directed for all work, and the appar- 
atus employed should be graduated accordingly. 

Torrefaction or Roasting is the application of heat, in a less 
degree than for carbonization, to an organic substance for the purpose of 
modifying some of its constituents, as in the roasting of coffee and 
rhubarb. The latter substance when subjected to this process, loses its 
cathartic properties but retains its astringency, and is known as Torrefied 
Rhubarb. 



526 PHARMACEUTICAL OPERATIONS. 

Trituration is the comminution of a solid to an extremely fine pow- 
der by continued rubbing in a wedgewood mortar with an inert and gritty 
powder, Sugar of Milk being the substance directed to be used. The 
product is called a Trituration (see that title under Official Prepara- 
tions). The surfaces of the mortar and pestle-head should coincide closely, 
and the thorough comminution of the trituration is best accomplished by 
a circular motion of the pestle in gradually increasing circles, until the 
side of the mortar is reached, then reversing the motion, and gradually 
lessening the circles until the pestle reaches the centre again. The pro- 
cess is greatly facilitated by having the pestle attached to a long handle 
playing in an opening made in a piece of wood which is nailed at a con- 
venient height. A weight may be fixed on top of the handle if a greater 
degree of friction is desired. 

Pulverization by Intervention is only another name for trituration when performed 
in a mortar and with solid bodies, the foreign substance used being subsequently removed. 
Potassium Sulphate may be employed as the medium for the pulverization of Gold, and 
. is then dissolved out with water. Alcohol or Chloroform may be added to Camphor to 
aid its pulverization, and then removed by evaporation. Phosphorus may be pulverized 
by placing it in water, gently heating the latter until the phosphorus is melted, and agi- 
tating the whole while cooling. 

Levigation is trituration of a substance made into paste with water or some other 
liquid, and resembles the old process of grinding oil paints by hand on a slab of stone. 
The process is used for coarse materials, as chalk, etc., where the refuse is rejected, or for 
such substances as Red Mercuric Oxide, Zinc Oxide, etc. When performed with a por- 
phyry slab and muller it is termed Porphyrization. 

Elutriation is a water-sifting process for separating the coarser particles of insoluble 
substances from the finer. The substance is mixed with water and after the larger par- 
ticles have fallen to the bottom, the liquid is decanted into another vessel, in which the 
light and powdery particles are collected. 

Vaporization includes the various operations by which volatile mat- 
ters are separated from fixed substances or from other matters which are 
less volatile, heat at varying temperatures being the agent used. The 
operations under this head are — Evaporation, Distillation, Desiccation, 
and Sublimation. 

Evaporation in Pharmacy is the process by which the more volatile 
constituents of a liquid are driven off by heat for the purpose of reducing 
its volume or of purifying it, as in the preparation of extracts and fluid 
extracts, the crystallization of salts, etc. The vessels used should be shal- 
low so as to expose a large surface of the liquid to the atmosphere. The 
heat used may be regulated by a water-bath, a steam-bath or sand-bath, 
and ordinarily should be kept below but near to the boiling point of the 
liquid treated. As organic substances are usually injured by long heating, 
small portions only of vegetable preparations should be subjected to this 
process, and the liquid should be frequently stirred in order to hasten the 
operation. In large laboratories vacuum-pans are employed to remove 
the atmospheric pressure, enabling the evaporation to be accomplished at 



PHARMACEUTICAL PREPARATIONS. 527 

a much less degree of heat than if the liquid were exposed to the air. 
Ebullition or Boiling is a form of evaporation. 

Spontaneous Evaporation is the evaporation of a liquid without the direct applica- 
tion of strong heat, but at the temperature of the room or closet used for the purpose. It 
is especially applicable to cases in which the residue is liable to injury or loss from much 
heat, or in order to secure finer crystals than can be obtained by quick evaporation of 
their solution. 

Washing is a simple mechanical process for separating soluble from 
insoluble matter, by pouring upon it a liquid which will dissolve the solu- 
ble portion. Various methods of doing this are in vogue and are often 
dignified with very high-sounding terms, as Lotion, Affusion, Ablution, 
etc. An ordinary wash-bottle, with the two glass tubes perforating the 
cork, is a convenient implement for directing a continuous stream upon a 
precipitate, while for continuous washing a combination of bottles with a 
funnel may be used. 



PREPARATIONS. 



The Official Preparations may be presented under various methods 
of classification, otie of the simplest being that which divides them into 
liquids and solids, the former being subdivided into groups named after 
their principal bases, viz. — 

Liquid Preparations. 

Aqueous, — Waters, Solutions, Infusions, Decoctions, Syrups, Honeys, Mucilages, 
Emulsions, Mixtures ; the last five containing sweet or viscid substances. 
Alcoholic, — Fluid Extracts, Tinctures, Wines, Spirits, Elixirs. 
Ethereal, — Oleoresins, Collodions. 
Oleaginous, — Liniments, Oleates. 
Acetous, — Vinegars. Glycerines, — Glycerites. 

Solid Preparations. 

Extracts. Pills. Powders. Ointments. 

Resins. Troches. Triturations. Cerates. 

Masses. Confections. Suppositories. Plasters. 



Pap 



ers. 



In the following descriptions of the pharmaceutical groups the composi- 
tion and dosage of the various preparations are omitted, as they are fully 
detailed in the section on Materia Medica, under the title in each case of 
the principal constituent. 

PHARMACEUTICAL PREPARATIONS. 
The Pharmaceutical Preparations include the pharmacopceial (official) 
as also those of extemporaneous pharmacy (unofficial). Both classes are 
described together in alphabetical order, for the sake of easy reference. 



528 



PHARMACEUTICAL PREPARATIONS. 



Aceta, Vinegars, — are solutions of the active principles of certain 
drugs in Diluted Acetic Acid. They are made by percolation and each 
contains the soluble principles from 10 per cent, of drug. Acidulous 
menstrua form soluble salts with the alkaloids and possess antiseptic quali- 
ties. The official Vinegars number 2, viz. : — 



Acetum Opii. 



Acetum Scillas. 



Aquae, Waters, — are aqueous solutions of volatile substances, which 
may be either solids, liquids, or gases, dissolved either by solution in 
cold or hot water, by nitration through an absorbent powder, by percola- 
tion through cotton saturated with the substance, or by distillation. The 
official waters number 19, including the two forms of Aqua itself, as 
follows, viz. : — 



Aqua. 

Aqua Destillata. 

Aqua Ammonias. 

Aqua Ammonise Fortior. 

Aqua Amygdalae Amarae. 

Aqua Anisi. 

Aqua Aurantii Florum. 

Aqua Aurantii Florum Fortior. 

Aqua Camphorae. 

Aqua Chlori. 



Aqua Chloroformi. 

Aqua Cinnamomi. 

Aqua Creosoti. 

Aqua Foeniculi. 

Aqua Hydrogenii Dioxidi. 

Aqua Menthae Piperitae. 

Aqua Menthae Viridis. 

Aqua Rosse. 

Aqua Rosas Fortior. 



Of the above 5 are prepared by simple solution, 4 by passing gases through water, 3 
by distillation, and 6 by trituration of the medicament with precipitated calcium phos- 
phate, addition of water and filtration. 

All waters deteriorate when long kept, microscopic plants being propa- 
gated in them from spores derived from the atmosphere. They should 
be prepared only in such quantities as are needed for use within a reason- 
able time. 



Balnea, Baths (Unofficial). Baths are often medicated, and then 
become medicinal preparations. The ingredients only are ordered in a 
prescription, as per the following examples, each of which is intended for 
a bath of 25 to 30 gallons : — 



Balneum Acidi Nitrohydrochlorici. 

R . Acidi Nitrici, 

Acidi Hydrochlorici, . aa^j. 
M. Sig. — Use with 30 gallons of hot 
water, as a bath. 



Balneum Sulphuris Compositum. 

R . Sulphuris Praecip., . . . Sij. 
Sodii Hyposulphitis, . . 3J. 
Acidi Sulphurici Dil., . gss. 

Aquae, Oj. 

M. Sig. — For a 30 gallon bath. 



Capsulse, Capsules, (Unofficial). Gelatin Capsules are to be obtained 
from the drug stores, of various sizes from o to 10. They are a conve- 
nient means of administering oils or nauseous solids, and when filled may 
be swallowed as easily as a large pill. By some of the manufacturers 



PHARMACEUTICAL PREPARATIONS. 529 

Soluble Elastic Capsules are prepared, each containing an ordinary dose 
of such medicines as Castor Oil, Cod-liver Oil, etc. The largest of these 
capsules makes a bolus which may be swallowed with a little effort, as it 
is quite compressible and changes its shape to suit the calibre of the pas- 
sage. The ordinary capsules are easily filled by the aid of a paper funnel, 
and the end of a pen-holder as a packer ; but simple devices (capsule- 
fillers) tor facilitating the operation may be purchased. 

R. Pulv. Opii, gr. x. , R • Copaibse, giss. 

Pulv. Camphorae, . . . gr. xx. Oleoresinae Cubebse, . . £ss. 

Sacch. Alb., q. s. M., et fiant capsulae xij. 

Triturat., et fiant capsulae x. Sig. — Two capsules three times daily, 

Sig. — One at bedtime for chordee ; re- \ soon after meals, for gonorrhoea, 
peat in two hours if necessary. 

Cataplasm at a, Poultices ', — are usually prepared at the residence of 
the patient, the ingredients only being ordered from the druggist. They 
are generally employed as a means of applying heat and moisture to a 
certain portion of the body, but are sometimes medicated with anodyne, 
counter-irritant or disinfectant agents. Poultices are not official in the 
U. S. Pharmacopoeia, but are in the British, the following list including 
all so recognized : — 

Cataplasma Carbonis, Charcoal Poultice, — Wood Charcoal I, Crumb of Bread 4, 
Linseed Meal 3, Boiling Water 20 parts. 

Cataplasma Conii, Hemlock Poultice, — Hemlock -juice 1, evaporated to half its vol- 
ume, Linseed Meal 4, Boiling Water 10 parts. 

Cataplasma Fermenti, Yeast Poultice, — Beer Yeast 3, Wheaten Flour 7, Water at 
loo° F. , 3 parts. 

Cataplasma Lini, Linseed Poultice, — Linseed Meal 2, Boiling Water 5 parts, mixed 
with constant stirring. 

Cataplasma Sinapis, Mustard Poultice, — Mustard, Linseed Meal, Boiling Water and 
Water, of each a sufficiency. 

Cataplasma Sodae Chlorinatae, Chlorine Poultice, — Solution- of Chlorinated Soda I, 
Linseed Meal 2, Boiling Water 4 parts. 

Cerata, Cerates, — are unctuous preparations similar to ointments but 
of a much firmer consistence. They all contain Wax (Cera), and do not 
melt at temperatures below 104 F. They are intended for external use, 
and are generally spread on lint before being applied. There are 6 official 
Cerates, including Ceratum itself, which is made by fusing together 30 of 
White Wax and 70 of Lard. The composition of the others may be 
found in the section on Materia Medica under the appropriate titles, but 
the figures in parentheses below give the percentage of drug to basis in each. 

Ceratum. Ceratum Cetacei (10). 

Ceratum Camphorce (2). Ceratum Plumbi Subacetatis (5). 

Ceratum Cantharidis (32). Ceratum Resinre (35). 

Chartae, Papers, — consist of strips of paper medicated by impregna- 
tion of its fibers with medicinal substances, or by being coated therewith. 

34 



530 PHARMACEUTICAL PREPARATIONS. 

Of the 2 official Papers i is made with sized paper, and intended for ex- 
ternal application as a vesicant or counter-irritant ; the other (Charta 
Potassii Nitratis) is unsized paper impregnated with Nitre and intended 
for the inhalation of its fumes while burning. Those officially recognized 
are — 

Charta Sinapis. Charta Potassii Nitratis. 

Collodia, Collodions, — are liquid preparations having for their base a 
solution of Pyroxylin in a mixture of Ether and Alcohol. They are in- 
tended for external use, being applied to the skin by means of a brush, 
and producing a film on the surface after the evaporation of the men- 
struum. There are 4 official Collodions, viz. : — 

Collodium. Collodium Flexile. 

Collodium Cantharidatum. Collodium Stypticum. 

The Flexible Collodion contains 5 per cent, of Canada Turpentine, and 3 per cent, of 
Castor Oil. Styptic Collodion contains 20 per cent, of Tannic Acid. 

Confectiones, Confections, — consist of medicinal substances formed 
into a mass with Sugar, Honey, Water, etc., with the object of rendering 
them palatable and of preserving them from change. Electuaries are 
similar preparations, but this term is now obsolete. There are only two 
official Confections, viz. : — 

Confectio Rosae. Confectio Sennse. 

Confections and Electuaries are very seldom prescribed, and therefore 
can have but little place in extemporaneous pharmacy. A few old for- 
mulae for such preparations are given below as pharmaceutical curios. 
The first is a meritorious prescription. 



Electuary for Piles. 
R . Potassii Bitartratis, 
Potassii Nitratis, 

Pulv. Jalapse, aa^ss. 

Confectionis Sennae, ... Jj. 
Syrupi Zingiberis, q. s. 
M. Fiat electuarium. 
Sig. — A piece the size of a marble to be 
taken thrice daily. 



The Chelsea Pensioner. 

Bi • Sulphuris Loti, 2ij. 

Potassii Bitart. , Jj. 

Pulv. Rhei, gij. 

Guaiaci Resinae, .... gj. 

Mellis Despum., Ibj. 

Myristicam Pulv., . . . . j. 
M. Fiat electuarium. 
Sig. — A dessertspoonful twice daily, as 
a laxative in chronic rheumatism. 



Confectio Damocratis. 
[An ingredient of Warburg's Tincture.] 
This preparation was official in the London Pharmacopceia of 1745. It contained I 
grain of Opium in Jss, and consisted of 45 ingredients, as follows, viz. : Cinnamon, 14 
parts; Myrrh, II parts; — White Agaric, Spikenard, Ginger, Spanish Saffron, Treacle, 
Mustard Seed, Frankincense and Chian Turpentine of each 10 parts ; — Camel's Hay, 
Costus Arabacus, Zedoary, Indian leaf, Mace, French Lavender, Long Pepper, Seeds of 
Harwort, Juice of ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam of 
Gilead, Oil of Nutmeg, Russian Castor, of each 8 parts ; — Water Germunder, Balsam-tree 
Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, strained Bdellium, of 



PHARMACEUTICAL PREPARATIONS. 53 I 

each 7 parts ; — Gentian-root, Celtic Hard, Leaves of Dittany of Crete, Red Rose, Seeds 
of Macedonium, Parsley, Sweet Fennel Seeds, Seeds of Lesser Cardamom, Gum Arabic, 
Opium, of each 5 parts; — Sweet Flag, Wild Valerian, Anise-seed, Sagapenum, of each 3 
parts ; — Spigrul, St. John's Wort, Juice of Acacia, Catechu, Dried Bellies of Skunk, of 
each 2)/ 2 parts; — the roots finely powdered and the whole mixed thoroughly into a paste 
with Clarified Honey. 

Decocta, Decoctions, — are made by boiling vegetable substances with 
water. As very few drugs contain active ingredients which are not in- 
jured by heat, these preparations have never obtained favor with scientific 
physicians. There are only 2 official Decoctions, viz. : — 

Decoctum Cetrariae. Decoctum Sarsaparillae Compositum. 

The official general formula for Decoctions prescribes that when the strength is not 
directed by the physician, nor specified by the Pharmacopoeia, they shall be prepared in 
the proportion of 5 grammes of the substance with 100 Cc. of water ; but that the strength 
of decoctions of energetic or powerful substances should be specially prescribed by the 
physician. Decoctum Cetrariae has the aforesaid official strength, while Decoctum Sar- 
saparillae Compositum has the strength of 10 per cent, as regards its principal ingredient. 

Elixiria, Elixirs, — are sweetened, aromatic and spirituous preparations, 
containing active medicinal substances in small quantities. There are 
but 2 official Elixirs, viz. : — 

Elixir Aromaticum. Elixir Phosphori. 

The first-named is intended to represent a type of the large class of 
unofficial elixirs employed in manufacturing and extemporaneous phar- 
macy. It is practically an alcoholized syrup, flavored with Orange, and 
is designed for use as an excipient for extracts, tinctures, salts, etc. The 
Elixir of Phosphorus has about % milligramme of Phosphorus to each cubic 
centimeter. The manufacturers have put on the market a great variety of 
elixirs, and most druggists keep a stock of them on hand prepared in the 
shop ; but they may be ordered by prescription just as any other mixture 
would be. The substances generally used in this form are as follows : — 

Arsenic. Guarana. 

Bismuth. Iron, Tincture of the Chloride. 

Ammonium Bromide. Iron, Phosphate. 

Lithium Bromide. Iron, Pyrophosphate. 

Potassium Bromide. Liquorice. 

Calisaya Bark, Pepsin. 

Chloral Hydrate. Quinine. 

Coca. Strychnine. 

Gentian. Taraxacum. 
Ammonium Valerianate. 

Many of these agents are combined with each other, as in the Elixir of Bismuth and 
Strychnine ; Elixir of Calisaya, Iron and Strychnine ; Elixir of Gentian with Tincture of 
Chloride of Iron; Elixir of Iron, Quinine and Strychnine, etc., etc. 

Emplastra, Plasters, — are solid compounds, insoluble in water, of a 
tenacious but pliable consistence and intended for external application to 
limited areas of the body surface. They are prepared by incorporating 



532 PHARMACEUTICAL PREPARATIONS. 

medicinal substances with certain bases, which are usually Lead Plaster 
(Oleate of Lead), a Gum-resin, or Burgundy Pitch. The heat employed 
should be low so as to avoid decomposing the active agents, and should 
not be continued long enough to drive off any volatile constituents. The 
plaster mass is then spread evenly on chamois skin, kid skin or muslin. 
The constituents of the following named 13 official Plasters may be found 
in the section on Materia Medica, under their appropriate headings. 

Emp. Ammoniaci cum Hydrargyro. Emplastrum Ichthyocollae. 

Emplastrum Arnicae. Emplastrum Opii. 

Emplastrum Belladonnas. Emp. Picis Burgundicae. 

Emplastrum Capsici. Emp. Picis Cantharidatum. 

Emplastrum Ferri. Emplastrum Plumbi. 

Emplastrum Hydrargyria Emplastrum Resinae. 

Emplastrum Saponis. 

Of the foregoing only two are directed to be spread, viz. — Emp. Capsici upon muslin, 
and Emp. Ichthyocollae upon taffeta, the others having no pharmacopceial prescription for 
the material to be used. Plasters after being spread should remain soft, pliable and ad- 
hesive, without melting at the heat of the body. To soften the surface, if old, it should 
be brushed with a small portion of Tincture of Camphor. 

Plasters are rarely prepared extemporaneously, the official and many 
other ones being produced on a large scale by the manufacturers, and 
kept in stock by all druggists. As a consequence the compounding and 
spreading of a plaster by the pharmaceutist has become a lost art. The 
official plasters may be ordered by prescription in the manner illustrated 
below. Blisters may be produced by the application of any preparation 
of Cantharides sufficiently strong for the purpose. The official Cerate of 
Cantharides may be spread on Adhesive Plaster (Emplastrum Resinse), 
making a blistering plaster ; or Cantharidal Collodion may be painted 
over the surface. Plasters are usually ordered by the square inch, but a 
model of the shape and size may be drawn on paper, and the plaster be 
directed to conform thereto, as in the first of the following prescriptions. 

Emplastrum Vesicatorium. Counter-irritant and Anodyne. 



R . Cerati Cantharidis, q. s. 

Extende supra Emplastrum Resinae hujus 
formae et magnitudinis. 

Sig. — Blistering Plaster, to be applied 
over the region of the heart. 



R . Chartae Sinapis, 

Emplas. Belladonnas, aa 3 // x 6 // . 
Sig. — Apply the mustard paper first, to 
be followed by the plaster when the surface 
has been well reddened. 



Emulsa, Emulsions, — are aqueous, liquid preparations containing an 
insoluble medicinal substance (as an oil or resin) in a state of minute 
subdivision and suspended by the aid of some viscid excipient, as gum, 
which may be contained in the medicinal ingredient itself (Ammoniac, 
Asafetida), or may be added by the pharmaceutist. The official Emul- 
sions are 4 in number, all of which were classed as Mixtures in the phar- 
macopoeia of 1880, viz. — 



PHARMACEUTICAL PREPARATIONS. 533 

Emulsum Ammoniaci. Emulsum Asafcetidae. 

Emulsum Amygdalae. Emulsum Chloroformi. 

Natural Emulsions comprise two classes of substances, — (i | those 
emulsions which exist ready formed in nature, as milk, yolk of egg, the 
milky juices of plants, etc. ; and (2) the mixtures formed by rubbing up 
gum-resins (as Ammoniacum, Myrrh, Asafetida) with water. Each of 
the latter substances contains, together with its resin, enough gum to make 
a perfect emulsion when triturated with water. The manufactured emul- 
sions are simply imitations of the natural ones, sufficient gum being added in 
case of a resinous substance to cause its suspension in the aqueous diluent. 

Emulsification consists in the division of the oily or resinous substance 
into very minute globules, and the surrounding of each globule with a thin 
envelope of the excipient. If properly done the gobules will remain 
mechanically suspended in the water, without any tendency towards re- 
combination. Milk is the best illustration of a natural emulsion, its 
butter existing in the aqueous portion as very minute globules, each sur- 
rounded by a thin film of casein. Yolk of Egg is a dense emulsion, con- 
sisting of oil suspended in water by means of albumen. 

The Excipients which may be used for emulsification are the following, 
arranged in the order of their most frequent employment, viz. : — 

Mucilage of Acacia. — used for oils and resins. Powdered Acacia is even better, 
being made into a mucilage by the process of emulsification ; such a mucilage having the 
advantage of being perfectly fresh when incorporated with the other ingredients. To 
give uniformly good results the following proportions in parts by weight should be used, 
viz. : — 

Gum Acacia. Water. 

I pari of Fixed Oils or Copaiba requires, l 2 % 

I " •• Balsam of Peru " 2 1 : 2 

I " " Oil of Turpentine " I I 

Mucilage of Tragacanth, — may also be used for oils and resins, but it has not 
proved so satisfactory as the preceding. The same maybe said of powdered Tragacanth. 

Vitellus, Yolk of Egg, — is an excellent agent for emulsifying oils, but mixtures made 
with it must be used within a few days, as they will not keep long. One yolk will emul- 
sionize an ounce of fixed oil, and is about equal to half an ounce of Acacia. It :- sst 
suited to emulsions of cod-liver oil intended for immediate administration. The official 
Emulsum Chloroformi is an emulsion made with yolk of egg. Glyceritum Vitt 
Glyconi7i is an official preparation consisting of glycerin and yolk of egg. One ounce of 
it will emulsify three ounces of fixed oil. 

Liquor Potassae. — may be used for oils, the resulting compound being however a soap 
rather than an emulsion. Copaiba is usually emulsified by using both a gum and an 
alkali ; a similar process being employed for many of the fixed oils. 

Tincture of Senega. — will emulsify fats and oils very efficiently, and even in very 
small quantities, rt^x emulsifying an ounce of fixed oil. 

Tincture of Quillaja (Soap-bark), — is a good emulsifier for oils, and is much used in 
Europe for this purpose. 

Milk, — is used to emulsify Scammony in the Mistura Scammonii, which is official in 
the British Pharmacopoeia. 

Syrups, Confections and Extracts,— may be used in making emulsions, but are 
rarely so employed. 

Soap, — is occasionally used for emulsifying Oil of Turpentine. 



534 



PHARMACEUTICAL PREPARATIONS. 



The method of preparing an emulsion which experience has shown to 
be the best, is as follows: — Add the oil, resin, etc., to a proper quantity 
of the excipient, and mix both thoroughly in a wedgewood mortar. Then 
add enough water to equal one-half the weight of the previous mixture, 
and triturate the whole rapidly and unceasingly until the emulsion is homo- 
geneous and of a whitish color. Next, add the remainder of the water 
slowly, with continual stirring ; finally incorporating the other ingredi- 
ents, if any. 

Emulsions are sometimes flavored and at the same time colored, with 
such a preparation as the Compound Tincture of Cardamom ; but they 
present a better appearance when perfectly white. Alcoholic preparations 
should not be added in large quantity to emulsions made with Acacia or 
Yolk of Egg, as alcohol will precipitate the emulsifying agent. Volatile 
Oils require admixture with a fixed oil before being made into an emul- 
sion. Soluble salts should never be prescribed with emulsions of oils. 
Acids are incompatible with mixtures which have been emulsified by an 
alkali. Mucilage used for emulsions should always be freshly prepared. 

The following examples of prescriptions for emulsions will represent 
those generally met with : — 



Cod- Liver Oil Emulsion. 

R . Olei Morrhuae, t ^ij. 

Vini Albi, \ iss. 

Acidi Phosphorici Dil., . . 3 iij. 

Syrupi, 3 v. 

Vitellum, j. 

Aq. Amygd. Amar., q. s. ad . £ viij. 
Misce, et fiat emulsum. 
Sig. — Tablespoonful doses. 



Alkaline Emulsion of Copaiba. 
R . Copaibae, 

Liq. Potassae, aa ^ij. 

Misce, et adde — 
Pulv. Acaciae, 

Pulv. Sacchari, . . . . aa 3 ij. 
Aq. Menth. Viridis, q. s. 

ad ^ iv. 

Misce, et fiat emulsum. 
Sig. — Tablespoonful doses. 



Extracta, Extracts, — are solid or semi-solid preparations obtained by 
evaporating solutions of vegetable principles. The drug is first powdered, 
then percolated with the appropriate menstruum to exhaustion. The first 
third of the percolate is reserved, the remainder is evaporated at a tem- 
perature not above 122 F., until its weight is ten per cent, of that of the 
drug used, then mixed with the reserved portion, and both are evaporated 
to a pilular consistence. The above is the general rule, but in several 
instances maceration is directed for 1 to 4 days before percolation ; and 
in other cases, instead of reserving a portion of the percolate, the whole 
quantity is distilled until the alcohol is removed, and the residue is evapo- 
rated to a pilular consistence. The menstrua used are, — in 6 cases Alco- 
hol, in 13 cases Diluted Alcohol of varying strength, in 7 Water, in 1 
Water with Aqua Ammoniac, in 1 a diluted Acetic Acid, and in 2 Acetic 
Acid and Diluted Alcohol. One extract is an inspissated juice (Ext. 
Taraxaci) ; one is made by evaporating a fluid extract (Ext. Ergotae), one 



PHARMACEUTICAL PREPARATIONS. 535 

by mixing an extractwith other ingredients (Ext. Colocynthidis Comp.), 

and one (Ext. Glycyrrhizse) is an ordinary commercial product. 

The official Extracts number 32, and are named as follows, the letters 

in parentheses indicating the ingredients of the menstruum used in 

extraction in each case, viz. — 

Extractum Aconiti (A). Ext. Glycyrrhizse. 

Ext. Aloes (W). Ext. Glycyrrhizse Purum (W). 

Ext. Arnicas Radicis (DA). Ext. Hyoscyami (AjWj). 
Ext. Belladonnas Foliorum Alcoholicum Ext. Iridis (A). 

(A 2 W X ). Ext. Jalapae (A). 

Ext. Cannabis Indicae (A). Ext. Juglandis (DA). 

Ext. Cimicifugae (A). Ext. Krameriae (W). 

Ext. Cinchonae (AgWj). Ext. Leptandrae (AgWj). 

Ext. Colchici Radicis (WAc). Ext. Nucis Vomicae (AgWj). 

Ext. Colocynthidis (DA). Ext. Opii (W). 

Ext. Colocynthidis Compositum. Ext. Physostigmatis (A). 

Ext. Conii (DA, Ac). Ext. Podophylli (A 4 Wj). 

Ext. Digitalis (A^). Ext. Quassiae (W). 

Ext. Ergotae (DA,Ac). Ext. Rhei (A^W,). 

Ext. Euonymi (A 2 W 2 ). Ext. Stramonii Seminis (DA). 

Ext. Gentianae (W). Ext. Taraxaci (W). 

Ext. Uvae-ursi (A 2 W 5 ). 

The Proximate Principles generally present in extracts, besides the 
peculiar principles of plants, are Sugar, Tannin, Extractive, Chlorophyll, 
Coloring-matter, and Salts. When an alcoholic solvent is used there are 
also present Resins, Fats, and often a Volatile Oil, and when the men- 
struum is not purely alcohol there is more or less gum and starch. One 
of these ingredients, named Extractive or Apotheme, is a deposit, soluble 
in water and alcohol, which has the singular property of passing into an 
insoluble substance under the influence of the atmospheric air with heat. 
It also has a tendency, when precipitated from solutions, to unite with 
other principles, carrying them down with it. It is frequently present in 
extracts, hence its name. 

Extracta Fluida, Fluid Extracts, — are permanent and concentrated 
solutions of vegetable drugs, of uniformly definite strength if the crude 
drugs are so, a cubic centimeter (rr^ 16.23) m eacn case representing the 
medicinal powers of one gramme (gr. 15.43) of the drug, or approxi- 
mately a minim of the finished preparation representing the active con- 
stituents of a grain of the drug. They are officially directed to be pre- 
pared by percolation and partial evaporation, the menstrua employed 
being usually Alcohol, diluted Alcohol, or Alcohol and Water in various 
proportions, though a few are percolated with water, the alcohol being 
afterward added. In several instances Glycerin in different proportions 
is added to the first menstruum ; and in the menstrua used for the fluid 
extracts of Conium, Ergot, Nux Vomica and Sanguinaria, Acetic Acid is 
an ingredient. In the preparation of the fluid extract of Prunus Virgin- 
iana, the extraction is preceded by maceration with water and glycerin, 



53^ 



PHARMACEUTICAL PREPARATIONS. 



in order to permit of the formation of Hydrocyanic Acid by the reaction 
of the amygdalin and emulsin of the bark upon each other, which takes 
place only in the presence of water. The glycerin aids to keep the dis- 
solved matters in perfect solution, and also to better retain the acid and 
volatile oil formed during the process. The fluid extract of Glycyrrhiza 
is prepared by maceration for 48 hours in a menstruum containing Am- 
monia-water, then by percolation, using a mixture of alcohol and water. 
The menstruum directed to be used in each case is intended to be that 
which will thoroughly extract all the active constituents of the drug and 
at the same time leave the inert soluble matters behind in the rejected 
portion, known as the marc. In manufacturing fluid extracts on a large 
scale, modifications of the official processes are necessary, and the 
methods used are generally percolation and maceration with hydraulic 
pressure, vacuum maceration followed by percolation, percolation with 
incomplete exhaustion, or repercolation. 

The official Fluid Extracts number 88, and are named in the following 
list ; the letters and figures following in parentheses showing the ingre- 
dients of their respective menstrua, by the initials of Alcohol, Diluted 
Alcohol, Water, Glycerin and Ammonia-water. The interrogation sign 
(?) signifies that the several proportions cannot be represented by figures. 



Extractum Aconiti Fl. (A,W[). 

Ext. Apocyni Fl. (A 65 W 2 ,G 10 ). 

Ext. Arnicse Radicis Fl. (AgW^. 

Ext. Aromaticum Fluidum (A). 

Ext. Asclepiadis Fluidum (DA). 

Ext. Aspidospermatis Fl. (AgYV.GJ. 

Ext. Aurantii Amari Fl. (A 2 W,). 

Ext. Belladonna Radicis Fl. (A 4 W^ 

Ext. Buchu Fluidum (A). 

Ext. Calami Fluidum (A). 

Ext. Calumbae Fluidum (A 3 W X ). 

Ext. Cannabis Indicae Fl. (A). 

Ext. Capsici Fl. (A). 

Ext. Castanet Fl. (A^GA. 

Ext. Chimaphilae Fl. (DA). 

Ext. Chiratse Fl. (A./^). 

Ext. Cimicifugae Fl. (A). 

Ext. Cinchona Fl. (AWG?). 

Ext. Cocae Fluidum (DA). 

Ext. Colchici Radicis Fl. (A 2 WA. 

Ext. Colchici Seminis Fl. (A 2 W 1 ). 

Ext. Conii Fl. (DA). 

Ext. Convallariae Fl. (DA). 

Ext. Cubebae Fluidum (A). 

Ext. Cusso Fluidum (A). 

Ext. Cypripedii Fluidum (DA). 

Ext. Digitalis Fluidum (A 2 W/). 

Ext. Dulcamara; Fluidum (DA). 

Ext. Ergotae Fluidum (DA). 

Ext. Eriodyctii Fluidum (A 4 W,). 

Ext. Eucalypti Fluidum (A 3 WA. 

Ext. Eupatorii Fluidum (DA). 



Ext. Frangulae Fluidum (A 5 W 8 ). 

Ext. Gelsemii Fluidum (A). 

Ext. Gentianas Fluidum (DA). 

Ext. Geranii Fluidum ^DAgGA. 

Ext. Glycyrrhizae Fl. (A 3c W 65 Am 5 ). 

Ext. Gossypii Radicis Fl. (A 3 Gj). 

Ext. Grindeliae Fluidum (A). 

Ext. Guaranae Fluidum (A 3 WA. 

Ext. Hamamelidis Fl. (A 5 W 8 GA. 

Ext. Hydrastis Fluidum (AgWgGJ. 

Ext. Hyoscyami Fluidum (A^VA. 

Ext. Ipecacuanha; Fluidum (AgWjJ. 

Extractum Iridis Fluidum (A). 

Ext. Krameriae Fluidum (DA 9 Gj). 

Ext. Lappae Fluidum (DA). 

Ext. Leptandrae Fluidum (A 3 W 1 ). 

Ext. Lobeliae Fluidum (DA). 

Ext. Lupulini Fluidum (A). 

Ext. Matico Fluidum (AgW^. 

Ext. Menispermi Fluidum (AgWJ. 

Ext. Mezerei Fluidum (A). 

Ext. Nucis Vomica; Fluidum (A 3 WA. 

Ext. Pareirse Fluidum (AWG?). 

Ext. Phytolaccae Radicis Fl. (A 2 WA. 

Ext. Pilocarpi Fluidum (DA). 

Ext. Podophylli Fluidum (A^VVj). 

Ext. Pruni Virginianae Fl. (AWG?). 

Ext. Quassiae Fluidum (A X W 2 ). 

Ext. Rhamni Purshi anas Fluidum (DA). 

Ext. Rhei Fluidum fA 4 W,). 

Ext. Rhois Glabrae Fluidum (DA 9 Gj). 

Ext. Rosae Fluidum (DA 9 G,) 



PHARMACEUTICAL PREPARATIONS. 537 

Ext. Rubi Fluidum (A^G^. Ext. Spigelian Fluidum (DA). 

Ext. Rumicis Fluidum (DA). Ext. Stillingiae Fluidum (DA). 

Ext. Sabinae Fluidum (A). Ext. Stramonii Seminis Fl. (AgW^). 

Ext. Sanguinariae Fluidum (A 3 Wj). Ext. Taraxaci Fluidum (DA). 

Ext. Sarsaparillae Fluidum (AjWg). Ext. Tritici Fluidum (AjW 3 ). 

Ext. Sarsaparillae Fl. Co. (AgWgGj). Ext. Uvse Ursi Fluidum (A 2 \Y 5 G 3 ). 

Ext. Scillae Fluidum (A 3 Wj). Ext. Valerianae Fluidum (A 3 W 1 ). 

Ext. Scoparii Fluidum (DA). Ext. Veratri Viridis Fluidum (A). 

Ext. Scutellariae Fluidum (DA). Ext. Viburni Opuli Fluidum (AgWA. 

Ext. Senegx Fluidum ( A- 5 W 20 Am 5 ) . Ext. Viburni Prunifolii Fl. (AgWj). 

Ext. Sennae Fluidum (DA). Ext. Xanthoxyli Fluidum (A). 

Ext. Serpentarioe Fluidum (A^Wj). Ext. Zingiberis Fluidum (A). 

In 14 instances only does the Pharmacopoeia direct the making of 
other preparations from corresponding fluid extracts, these being the 
Syrups of Ipecac, Krameria, Rhubarb, Rose, Rubus, Senega and Ginger ; 
the Compound Syrups of Sarsaparilla and Squill ; the Tincture of Ipecac 
and Opium, the Wine of Ipecac, the Extract of Ergot, the Liniment of 
Belladonna, and the Mixture of Rhubarb and Soda. Notwithstanding 
this fact it is a common practice for dispensing pharmaceutists to make 
tinctures, syrups, infusions, etc., from fluid extracts; and some manufac- 
turers put a label on the bottles containing their fluid extracts, giving the 
formulas for so preparing other preparations. This practice is illegitimate, 
and tends to still further degrade the profession of pharmacy into a mere 
trade, so far as dispensing is concerned. 

A large number of unofficial fluid extracts are manufactured and for sale, one house 
alone carrying over 400 such on their catalogue. Normal Liquids are a class of superior 
fluid extracts introduced by Parke, Davis & Co. , which are claimed to be adjusted to a 
maximum strength by accurate assays for alkaloidal strength made at each stage of their 
manipulation, irrespective of the amount of material required, which in the case of official 
fluid extracts is prescribed by the Pharmacopoeia, regardless of the varying quality of drugs 
in the market. This firm prepares Normal Liquids of Aconite, Veratrum Viride, Bella- 
donna (root or leaves), Cannabis Indica, Cinchona, Calisaya, Cinchona Rubra, Colchicum 
(root or seed), Conium, Ergot, Digitalis, Gelsemium, Hyoscyamus, Ipecacuanha, Podo- 
phyllum, Nux Vomica. Rhubarb, and Stramonium (seed or leaves). Of these prepara- 
tions one cubic centimeter is equivalent to one gramme of the corresponding drug of 
standard alkaloidal strength. A fluid extract of Belladonna leaves may contain .25 or 
.45 per cent, of Atropine, according to the quality of the drug employed ; a Normal 
Liquid will contain invariably .4 per cent, of the alkaloid, so that in a given dose it may 
be relied upon to produce a certain effect. 

Gargarysma, A Gargle (Unofficial), — is a mixture or solution for 
application to the pharynx or the mouth (mouth-wash). It should never 
contain any very active drug, which would produce dangerous symptoms 
if swallowed ; nor any agent which would injure the teeth or the mucous 
membrane. Gargles are ordered and compounded in the same manner 
as mixtures. They usually contain astringent or disinfecting salts (Alum, 
Borax, Zinc Sulphate, Potassium Chlorate), with a vegetable astringent, 
and often honey. The following formulae will illustrate prescriptions of 
this class: — 



538 



PHARMACEUTICAL PREPARATIONS. 



R . Tr. Guaiaci Ammoniatae, 

Tr. Cinchonae Comp. , aa ^ ss. 

Mellis Despumat., . . ^jss. 
Bene simul agita, et adde — 

Potassii Chloratis, . . . .^ijss. 

Aquae, q. s. , ad . , . . ^fviij. 
Fiat gargarysma. Sig. — Gargle. 



R 



M. 



Aluminis, . . . . 
Granati Corticis, 
Petal. Rosae Rubr., 
Mellis Despumat. , 
Aquae Bullientis, . 
Sig. — Gargle. 



Sfj- 

ki- 
th 

(Goddard.) 



Glycerita, Glycerites, — are mixtures of medicinal substances with 
Glycerin, in which some of them are dissolved. They are very useful 
preparations for dispensing purposes, as they can be readily diluted with 
water or alcohol without precipitation. There are 6 official Glycerites, 
the figures following their names in the list below indicating the percent- 
age of drug in each. The Glycerite of Starch contains 10 per cent, of 
water, and that of Hydrastis has for its menstruum a mixture of glycerin, 
alcohol and water. 



Glyceritum Acidi Carbolici, 20. 
Glyceritum Acidi Tannici, 20. 
Glyceritum Amyli, 10. 



Glyceritum Boroglycerini, 31. 
Glyceritum Hydrastis, 100. 
Glyceritum Vitelli, 45. 



Haustus, A Draught (Unofficial), — is an extemporaneous mixture 
consisting of a single dose, and usually ordered in a vial containing from 
one to two fluidounces. 

Effervescing Draught is one of the best known. It is prepared by neutralizing a 
watery solution of Potassium Bicarbonate with Lemon-juice or Citric Acid, and may be 
drunk during effervescence. When the C0 2 has escaped it is a solution of Potassium 
Citrate in water, and corresponds to the official Liquor Potassii Citratis, or Neutral 
Mixture. 

Black Draught is another well-known preparation of this class. It is official as In- 
fusum Sennas Compositum. 



Infusa, Infusions, — are prepared by treating vegetable substances with 
hot or cold water without boiling. Cold water is preferred when the drug 
contains a desirable volatile principle, or when its active ingredient is 
injured by heat. The drug should be coarsely comminuted, sliced or 
bruised, and treated by maceration or percolation with the proper quan- 
tity of water, which in the absence of specific directions to the contrary 
should be 5 parts by weight of the drug to 100 of water, or 5 grammes in 
100 Cc. Infusions should be freshly made as required, for they are very 
prone to decomposition. Those official number 4, and are named in the 
following list, the figure after each representing the percentage of drug 
to menstruum, viz. — 



Infusum Cinchonae, 6. 
Infusum Digitalis, \]/ z . 



Infusum Pruni Virginianae, 4. 
Infusum Sennae Compositum, 6. 



The last named infusion contains also 12 per cent, each of Manna and Magnesium 
Sulphate and 2 of Fennel. The infusion of Cinchona has of Aromatic Sulphuric Acid 
I per cent. Alcohol, in the proportion of 10 per cent, is an ingredient of the Infusion 
of Digitalis to prevent decomposition. 



PHARMACEUTICAL PREPARATIONS. 



539 



Many dispensing pharmaceutists are in the habit of making infusions 
from concentrated alcoholic tinctures or from fluid extracts. It is a very- 
reprehensible practice, especially in those cases where the active ingre- 
dients are of a resinous nature and therefore precipitate when the alco- 
holic solution is added to water. 

Inhalationes, Inhalations, and Vapores, Vapors (both Unofficial), 
— are medicines in the form of a vapor, a gas or an atomized spray, to be 
inhaled by the patient for their local action on the respiratory tract. 
The well-known steam-atomizer is the agent by which most of these 
preparations are administered, though many substances may be inhaled 
from the surface of hot water, from a sponge in a bottle surrounded by 
a hot cloth, or from a heated shovel. They are prescribed in the usual 
manner, as follows : — 



Stimulant Inhalation. 

R . Olei Cubebae, 3 ij. 

Magnesii Carbonat. , . . £j. 

Aquae, j| iij. 

M. Sig. — A teaspoonful in a pint of 
water at 150 F., for each inhalation. 

Oil of Pine. 

R. 01. Pini Sylvestris, . . 3 ij. 

Magnesii Carb. , . . . . gj. 

Aquae, ^iij. 

M. Sig. — A teaspoonful on a pint of 
hot water for each inhalation. 



R 



Carbolized Inhalation . 
Acidi Carbolici, . 



. . Tr^xlviij. 
Aquae, q. s. ad . . . . ,:f ij. 
M. Sig. — Use one-half in the cup of 
steam-atomizer for each inhalation. 



Tar and Turpentine. 



R. 



01. Picis Liquidae, 

01. Terebinth, . . . aa ^ ij. 
M. Sig. — Pour slowly on a hot shovel 
in the sick-room, keeping the vapor con- 
fined therein. 



The official Charta Potassii Nitratis (Nitre-paper), is a preparation intended for use as 
an inhalation, its vapors while burning being taken into the lungs. 



Injectiones, Injections (Unofficial), — are liquid preparations intended 
for introduction into the cavities of the body by means of a syringe. 
When thrown into the rectum they are termed Enemas (Enemata), or 
Clysters, and are usually prepared at the bedside. Enemata may be de- 
mulcent, laxative, nutritive, stimulant, or vermifuge in character ; and 
always have warm or tepid water as their diluent, with which are incor- 
porated such medicaments as may be desired. They may consist simply 
of water to act as a wash for the cleansing of the bowel. Injections are 
termed vaginal, urethral, vesical, nasal, hypodermic, etc., according to 
the locality in which they are employed. A special form of syringe is 
employed in each case, the discussion of which belongs rather to the 
domain of surgery than that of medicine. Those used for the nasal cav- 
ities are often arranged with small holes or an atomizing attachment, so 
as to deliver the injection in the form of a fine spray. A Collunarium is 
a nasal douche or wash. In the Appendix will be found a list of formulae 



540 



PHARMACEUTICAL PREPARATIONS. 



for hypodermic injections ; a few prescriptions for other forms are ap- 
pended below. 



Enema for Stricture of the Rectum. 

R. Bismuthi Subcarb. , . . f ) ). 
ExtractiOpii, gx. ij. 

Glycerini, Aquae, . .aa t ^ij. 
M. Fiat enema. Sig. — Two table- 
spoonfuls to be injected thrice weekly. 



Demulcent Enema. 



& . Tincturae Opii, 
Decocti Amyli, 
M. Fiat enema. 



. TTlxx. 



K 



Vermifuge Enema. 

Extr. Quassias FL, . . . j?jss. 

Aquae, ^ij ss - 

M. Sig. — A tablespoonful with an equal 
quantity of warm water, as an enema, to 
be retained as long as possible. 



Nasal Injection {DobeW s). 

R. Acidi Carbolici, .... 3Jss. 

Sodii Bicarb., 

Sodii Boratis, .... aa^iv. 

Glycerini, gxivss. 

Aquae q. s. ad ,l v iij- 

M. Sig. — A tablespoonful diluted with 
an equal quantity of tepid water to be used 
thrice daily with a nasal sprayer. 



M 



Injection for Gonorrhoea 
(Injection Brou.) 
Zinci Sulphatis, . 
Plumbi Acetatis, 
Tincturae Opii, . 
Tinct. Catechu, . . 
Aquae Rosae, q. s. ad 
Fiat injectio. Sig 



gr. vnj. 
gr. xv. 

3vj. 

Use 



with a 



urethral syringe. 



Injection for Chronic Urethritis. 

& . Hydrarg. Chi. Corrosivi, gr. )£. 

Zinci Chloridi, . . . . gr. ss. 

Aquae Destillatae, . . Sjviij. 
M. Sig. — A teaspoonful to be injected 
well down into the urethra thrice daily, 
through a gum-catheter. 



Vaginal Injections for Lettcorrhcea. 

R. Aluminis, gj. 

Zinci Sulphatis, . . . . s^ss. 

Sodii Boratis, gr. iv. 

M. Sig. — Dissolve in half-a-pint 



of 



warm water, and use with a vaginal sy- 
ringe. 

R. Acidi Tannici, . . . . t ^j. 

Glycerini, ^ iv. 

M. Sig. — One-half with an equal 
quantity of water to be injected twice 
daily. 



Linimenta, Liniments, — are very thin ointments for external applica- 
tion, intended to be applied with friction to the skin. They are solutions 
of various substances in oily liquids or in alcoholic liquids containing 
fatty oils. Of the following 9 official Liniments 2 have as their basis 
Cotton-seed Oil, 1 Linseed Oil, 1 Oil of Turpentine, 1 Alcohol, and 
3 Alcohol and Water. 



Linimentum Ammoniae. 
Linimentum Belladonnae. 
Linimentum Calcis. 
Linimentum Camphorae. 



Linimentum Chloroformi. 
Linimentum Saponis. 
Linimentum Saponis Mollis. 
Linimentum Sinapis Compositum. 
Linimentum Terebinthinae. 



Besides the above, (except Lin. Saponis Mollis), the Br. Phar. contains Lin. Aconiti, 
Lin. Camphorae Comp., Lin. Crotonis, Lin. Hydrargyri, Lin. Iodi, Lin. Opii, Lin. 
Potassii Iodidi cum Sapone, and Lin. Terebinthinae Aceticum. 

Extemporaneous Liniments may correspond to the official ones or they 
may be simple mixtures of fluids without either fat or soap. A prescrip- 
tion for each kind is appended. The official Linimentum Saponis (Soap 
Liniment) is a good basis for extemporaneous preparations of this class. 



PHARMACEUTICAL PREPARATIONS. 



541 



Compound Chloroform Liniment. 

R. Ext. Belladon. Rad. FL, . ^ss. 
Extracti Aconiti Fl. , 
Chloroformi Venalis, . . aa^ij. 
Spiritus Camphorae, . . . ^j. 
Alcoholis Diluti, q. s. ad . 3 viij. 
M. Fiat linimentum. 
Sig. — Poison. To be rubbed on 
painful part. 



the 



». 



Anodyne Liniment. 

Tinct. Aconiti, 55 ij. 

Tinct. Opii, ^iv. 

Tinct. Arnicae, 3J. 

Chloroformi, gij. 

Linim. Saponis, q. s. ad . ^iv. 
M. Fiat linimentum. 
Sig. — Poison. Liniment. 



Stokes'' Liniment. 

R. Olei Terebinthinae, . . . ^iij. 

Acidi Acetici, £ ss. 

Olei Limonis, £j. 

Vitellum, j. 

Aquae Rosoe, % ^iij. 

M. Fiat linimentum. 
Sig. — Liniment. 



Army Medical Wagon Liniment. 

R . Liq. Ammonige, 
Ol. Terebinthinse, 
01. Olivse, 

aa, partes sequales. 
M. Fiat linimentum. 
Sig. — Liniment. 



An Embrocation is a similar preparation, but of thinner consistence. The term is 
almost obsolete. 



Liquores, Solutions, — comprise all aqueous solutions of non-volatile 
substances, except the syrups, infusions and decoctions, which naturally 
form distinctive classes. There are 24 official solutions, 7 of which are 
simple aqueous solutions of the medicament, the rest being chemical 
aqueous solutions, in which the dissolved substances are altered by 
chemical action, and new ones formed. They are named as follows, viz. — 



Liquor Acidi Arsenosi. 


Liquor Iodi Compositus. 


Liquor Ammonii Acetatis. 


Liquor Magnesii Citratis. 


Liquor Arseni et Ffydrargyri Iodidi. 


Liquor Plumbi Subacetatis. 


Liquor Calcis. 


Liquor Plumbi Subacetatis Dilutus 


Liquor Ferri Acetatis. 


Liquor Potassse. 


Liquor Ferri Chloridi. 


Liquor Potassii Arsenitis. 


Liquor Ferri Citratis. 


Liquor Potassii Citratis. 


Liquor Ferri et Ammonii Acetatis. 


Liquor Sodse. 


Liquor Ferri Nitratis. 


Liquor Sodae Chloratae. 


Liquor Ferri Subsulphatis. 


Liquor Sodii Arsenatis. 


Liquor Ferri Tersulpbatis. 


Liquor Sodii Silicatis. 


Liquor Hydrargyri Nitratis. 


Liquor Zinci Chloridi. 



Lotio, A Lotion or Wash (Unofficial), — is a solution or mixture of 
medicinal agents, intended for external application ; and usually consists 
of some soluble, astringent salt, dissolved in water, with perhaps some 
glycerin or alcohol. A Fomentation (Fotus) is a similar preparation 
used hot. A Collyrium is an eye-wash, and generally contains a soluble 
astringent salt dissolved in rose-water or distilled water, in the proportion 
of gr. j-iv to the 3. The only official preparation suitable for a lotion is 
the Liquor Plumbi Subacetatis Dilutus, or Lead-water. A well-known 
anodyne, refrigerant and astringent lotion is that represented by the 
upper two of the following prescriptions. 



542 



PHARMACEUTICAL PREPARATIONS. 



R 



M 



Lead-water and Laudanum. 

Liq. Plumbi Subacetatis, . gj. 

Tinct. Opii, !§j. 

Aquae, q. s. ad ^ v "j- 

Fiat lotio. Sig. — Lotion. 

( Gross. ) 



Colly rium. 



R. 






Sodii Boratis, . . . 

Aquae Camphorae, . 

Mucil. Cydonii, 

Aquae Destil., . . . . aa^ss. 
M. Fiat collyrium. Sig. — Eye-water; 
a few drops to be put into the eye three or 
four times daily. 



Lead and Opium Wash. 

R . Liq. Plumbi Subacetatis, 

Tinct. Opii, aa .lJ- 

Aquae, q. s. , ad ! vu j- 

M. Fiat lotio. Sig. — Lotion. 

{Sturgis.} 



Collyrium of Four Sulphates. 



R 



Zinci Sulphatis, 

Ferri Sulphatis, 

Cupri Sulphatis, 

Aluminis, aa gr. j. 

Aquae Destillatae, . . . . Jj. 
M. Fiat collyrium. Sig. — For use with 
brush to palpebral conjunctivae, and to be 
washed off with clean water. 



Massse, Masses, — are Pill-masses prepared as described under the 
subtitle Pilulse. The official Masses number 3, viz. : — 

Massa Copaibae. Massa Hydrargyri. Massa Ferri Carbonatis. 



Mellita, Honeys, — differ from syrups merely in their being prepared 
with honey as a base. The Oxymel and Oxymel Scillce of the B. P. are 
similar preparations, containing also Acetic Acid. There are 3 official 
Honeys, including two forms of honey itself, viz. : — 



Mel. 



Mel Despumatum. 



Mel Rosae. 



Misturse, Mixtures, — in official pharmacy are aqueous preparations of 
insoluble substances held in suspension by a suitable vehicle. In extem- 
poraneous pharmacy the term mixture has a wider signification, as 
explained below. Mixtures are generally prepared extemporaneously 
upon prescriptions, as few of them are of the stability necessary to insure 
their preservation beyond a few days. The official mixtures are 4 in 
number, and are named as follows, viz. : — 



Mistura Cretae. 

Mistura Ferri Composita. 



Mistura Glycyrrhizae Composita. 
Mistura Rhei et Sodae. 



In extemporaneous pharmacy the term Mixture is applied to every 
fluid compound intended for internal use, except a few which bear dis- 
tinctive titles, such as Emulsions, Draughts, Enemas, Elixirs and Drinks. 
The simplest form of mixture in this extended sense is that in which two 
or more liquids are mixed together ; but a great variety of substances 
may be prescribed in this form, chief among which are most of the solu- 
ble salts, light insoluble powders, salts which may be diffused by agita- 
tion, extracts, gum-resins, and the fixed essential oils. They are generally 
ordered in 2, 3, 4, 6, 8, 10 and 12-ounce vials. 



PHARMACEUTICAL PREPARATIONS. 



543 



Substances suitable to the mixture-form, properly so called, are 
those which, though more or less insoluble in water, will mix with it by 
agitation, trituration, etc. Those most frequently ordered are as 
follows : — 



Diffused by Agitation : — 

Calcii Phosphas Praecipitatus. 
Cinchona (powdered). 
Ipecacuanha (powdered). 
Magnesia. 
Quininae Sulphas. 
Sulphur Praecipitatum. 

Suspended by Viscid Excipients :— 
Essential Oils. 
Oleum Amygdalae. 
Oleum Morrhuae. 
Oleum Olivaa. 
Oleum Ricini. 
Copaiba. 
Ferri Carbonas Saccharatus. 



Miscible only by Trituration : — 
Ammoniacum. 
Asafcetida. 
Confectio Rosae. 
Confectio Sennae. 
Extractum Aconiti. 
Ext. Belladonnae Fol. Alcohol. 
Ext. Conii. 
Ext. Hyoscyami. 
Ext. Stramonii. 
Ext. Glycyrrhizae. 
Ext. Krameriae. 
Ext. Taraxaci. 
Guaiacum. 
Scammonium. 
Myrrha. 



Best Suspended by the aid of a Fixed Oil or Yolk of Egg : — 

Ext. Cannabis Indicae. Oleum Terebinthinae. 

Camphora. Chloroformum. 

Solutions intended for internal administration are classed as Mixtures 
in extemporaneous pharmacy, for the reason stated above. The follow- 
ing list of acids and salts comprises most of the solids which are best 
adapted for use in liquid form, by reason of their solubility in water. 



Acidum Citricum. 

Acidum Tannicum. 

Acidum Tartaricum. 

Alumen. 

Ammonii Chloridum. 

Antimonii et Potassii Tartras. 

Barii Chloridum. 

Calcii Chloridum. 

Calcii Hypophosphis. 

Ferri Pyrophosphas. 

Ferri Sulphas. 

Ferri et Ammonii Citras. 

Ferri et Potassii Tartras. 

Ferri et Quininae Citras. 

Magnesii Sulphas. 

Mangani Sulphas. 

Potassii Acetas. 

Potassii Bicarbonas. 



Potassii Bromidum. 
Potassii Carbonas. 
Potassii Citras. 
Potassii Chloras. 
Potassii Hypophosphis. 
Potassii Iodidum. 
Potassii Tartras. 
Potassii et Sodii Tartras. 
Morphinae Acetas. 
Morphinae Hydrochloras. 
Morphinae Sulphas. 
Sodii Bicarbonas. 
Sodii Boras. 
Sodii Carbonas. 
Sodii Chloridum. 
Sodii Hypophosphis. 
Sodii Phosphas. 
Sodii Sulphas. 



A few require the use of viscid substances as vehicles or correctives. 
They are as follows : — 



Ammonii Carbonas. 
Plumbi Acetas. 



Potassa. 

Potassii Cyanidum. 



Hydrargyri Chloridum Corrosivum. 

Certain salts are best ordered by prescribing such agents as will when 
in solution together react upon each other and produce the desired salt. 



544 PHARMACEUTICAL PREPARATIONS. 

Instances of this may be found in the pharmacopoeial processes for most 
of the official Liquores ; some of the salts so produced being the follow- 
ing:— 

Ammonii Acetas. Ferri Acetas. Potassii Arsenis. 

Magnesii Citras. Ferri Chloridum. Potassii Hydras. 

Potassii Citras. Ferri Nitras. Sodii Hydras. 

Ferri Citras. Hydrargyri Nitras. Soda Chlorata. 



Zinci Chlorid 



am. 



Certain other substances require the addition of other agents in order 
to form eligible solutions. Such are the following : — 

Quininae Sulphas, — requires acidulated water for its solution, the acid used being gen- 
erally Diluted Sulphuric, or the Aromatic Sulphuric. This method of prescribing the salt 
develops its bitter taste to the utmost, and is often avoided by ordering the drug to be sus- 
pended in a viscid liquid, such as Pulv. Acaciae in Syrup of Ginger. In such a case an 
officious dispenser anxious to show his smartness by adding some dilute Sulphuric Acid to 
dissolve the Quinine would thereby defeat the object of the prescriber. 

Quinine Sulphate may be prescribed with Aromatic Spirit of Ammonia, Spirit of 
Nitrous Ether, Tinctures or other alcoholic preparations together with Glycerin or Syrup 
and Water. In such cases the salt should be first dissolved in the alcoholic portion of the 
prescription ; then the glycerin or syrup and finally the aqueous portions should be added 
gradually. It may also be ordered with Diluted Sulphuric Acid and some vegetable in- 
fusion containing Tannin, in which case a precipitate of Quinine Tannate will be produced. 
This of course should not be filtered, but should be dispensed with a " Shake-label." 

For the use of " Velatine " as a vehicle for the use of Quinine Salts, see ante under 
the title Cinchona. 

Chinoidin, Cinchonine Sulphate and Quinidine Sulphate, — also require the addi- 
tion of a dilute mineral acid for their solution in aqueous mixtures. 

Iodine, — requires the addition of Potassium Iodide for its solution in a convenient 
quantity of water, as in the case of the official Liquor Iodi Compositus. 

Hydrargyri Iodidum Rubrum, Red Mercuric Iodide, — requires the addition of 
Potassium Iodide or Mercuric Chloride for its aqueous solution. 

Potassii Bitartras, Cream of Tartar, — requires the addition of Borax or Boric Acid 
for its solution in water. 

Benzoic Acid, — requires the addition of Borax to aid its solubility in water, an equal 
part of the latter making it 5 times more soluble than when alone. 

Lime, — is more soluble in sweetened water than in plain water, the sugar aiding its 
solution. 



Excipients are substances which give form and consistence to prescrip- 
tions, and serve as vehicles for the exhibition of the other ingredients. 
Some of the excipients are Diluents, or agents which effect the dilution or 
division of the active ingredients ; while others act in the double capacity 
of diluents and Flavoring agents. The Excipients most generally used in 
mixtures may be tabulated as follows, viz. : — 

Diluents. True Excipients. 

Water (Aqua). . Acacia (in powder or mucilage). 

Medicated Waters (Aquae). Tragacanth (in powder or mucilage). 

Syrups. Sugars. 

Mel Rosse. Confections. 

Elixir Aromaticum. Some Extracts. 

Yolk of Egg (Vitellus). 



PHARMACEUTICAL PREPARATIONS. 



545 



Flavoring Agents. 



Oleum Amygdalae Amarae. 
Oleum Cari. 
Oleum Caryophylli. 
Oleum Cinnamomi. 
Oleum Gaultheriae. 
Oleum Sassafras. 
Tinctura Aurantii Dulcis. 
Tinct. Cardamomi. 
Tinct. Cardamomi Comp. 
Tinct. Cinnamomi. 
Tinct. Gentianse Comp. 



Syrupus Zingiberis. 



Tinct. Tolutana. 
Tinct. Vanillae. 
Tinct. Zingiberis. 
Spiritus Anisi. 
Spiritus Lavandulae. 
Spiritus Limonis. 
Spiritus Myristicae. 
Spiritus Menthse Piperitae. 
Spiritus Menthae Viridis. 
Syrupus Limonis. 
Syrupus Tolutanus. 



Compounding the Mixture is a matter of no slight importance, and 
one which is best learned at the dispensing counter, though a few directions 
may not be out of place. In the case of the simplest form of mixture, 
where two or more fluid preparations are prescribed together, the only 
operations required are the measuring of the several ingredients and 
pouring them into the designed vial. In doing this the compounder should 
pursue a regular and definite order of procedure. Taking in his left hand 
a graduate of sufficient capacity to hold the whole quantity prescribed, 
he should walk along the shelves, and with the right hand pour from 
the stock-bottles the requisite quantity of each ingredient in the order 
in which they are entered on the prescription. A skillful druggist will 
hold the graduate between the thumb and first finger, the prescription 
between the second and third fingers, and the stopper of the stock-bottle 
between the little finger and the hand, leaving his right hand free for the 
manipulation of the bottles containing the ingredients. 

When an actively poisonous agent is ordered it should always be the 
last thing put into the mixture. Attention to this rule will prevent the 
danger of the toxic substance being put in twice. 

The order in which the ingredients are put together is not of so much 
importance in compounding a simple mixture as in the case of an emul- 
sion, and the order of the prescription can usually be followed, with the 
exception noted in the preceding paragraph. Still, when several alcoholic 
preparations, syrups and waters are ordered together, it is good practice 
to first mix the alcoholic fluids, then to add the syrups and finally the 
water, so as to avoid the precipitation of resinous principles which would 
occur if the alcoholic solutions were added to the water. Distilled water 
should always be used, in order to insure uniformity in taste and appear- 
ance, and also as a matter of purity and cleanliness. All mixtures should 
be well shaken before being labelled. 

Solids which are comparatively insoluble or only slowly soluble require 

to be rubbed up in a mortar with one or more of the fluid ingredients. 

Glass mortars are much employed for this purpose, and many compounders 

mix all the ingredients in such a mortar before transferring them to their 

35 



546 



PHARMACEUTICAL PREPARATIONS. 



vial. Vegetable powders (as Rhubarb, Ipecac, etc.), or finely pulverized 
inorganic substances, are often ordered in intimate mixture with water, 
thickened with mucilage or syrup. In such cases the mixture should be 
made in a porcelain or wedgewood mortar, enough mucilage or syrup 
being added at first to make a thick paste, and after this is rubbed smooth 
the water may be gradually added during the continued process of mix- 
ing. This process will answer for all inorganic substances in powder, 
except Magnesia, which is best mixed by being thrown on the surface of 
the water, and after it has sunk to the bottom as a uniform sediment the 
other ingredients may be added, and the whole well shaken. Froth upon 
the surface of the liquid, which often arises after agitation, and may pre- 
vent the corking of the bottle, will quickly subside on the addition of a 
few drops of alcohol. 

The following are samples of prescriptions for medicines to be admin- 
istered in mixture form : — 



R. 



Bismuth Mixture for Children. 
Bismuthi Subcarbonatis, . . gij. 



Syrupi Acaciae, .... 
Aquae Cinnamomi, . . . . aa^ij. 
Misce. Signa — A teaspoonful every 
hour in choleraic diarrhoea. 



Quinine Mixture for Children. 

R. Quininae Sulphatis (pulv.), . £ss. 

Acaciae (pulv.), 3 SS « 

Syrupi Zingiberis, :§ iv. 

Fiat mistura. Signa — A teaspoonful 

thrice daily. 



Mucilagines, Mucilages, — are thick, viscid liquids prepared by dis- 
solving gum in water, or by extracting with water the mucilaginous prin- 
ciples from certain plants. They are easily spoiled and should be kept 
only in small quantities. The official Mucilages number 4, as follows, 
the two first-named being prepared without heat, the two last-named with 
heat, viz. — 



Mucilago Acaciae. 

Mucilago Sassafras Medullae. 



Mucilago Tragacanthae. 
Mucilago Ulmi. 



Oleata, Oleates, — are liquid solutions of metallic salts or alkaloids in 
Oleic Acid, intended for external administration. They are not definite 
chemical compounds, though the term is also employed in trade to desig- 
nate certain solid preparations which are claimed to be chemical com- 
pounds of the same acid with various bases. [See under Acidum Olei- 
cum, ante, page 91.] There are three official Oleates, as follows, viz. — 

Oleatum Hydrargyri (20 per cent.). Oleatum Veratrinae (2 per cent.). 

Oleatum Zinci (5 per cent.). 



Oleoresinse, Oleoresins, — are liquid preparations consisting principally 
of natural oils and resins extracted from vegetable substances by percola- 
tion with Ether. They differ from fluid extracts in not bearing any uni- 
form relation of Cc to the gramme of drug, in containing principles 



PHARMACEUTICAL PREPARATIONS. 547 

which though soluble in ether are not in alcohol, and in some instances 
being devoid of principles which are insoluble in ether but soluble in 
alcohol. They are the most concentrated liquid preparations of drugs 
which can be produced, and are prepared by percolating the powdered 
drug with Ether until exhausted, recovering the greater part of the ether 
by distillation, and exposing the residue in a capsule to spontaneous 
evaporation until the remaining ether has evaporated. There are 6 official 
Oleoresins, viz. — 

Oleoresina Aspidii (10-15). Oleoresina Lupulini (50). 

Oleoresina Capsici (5). Oleoresina Piperis (5). 

Oleoresina Cubebte (18-25). Oleoresina Zingiberis (6-8). 

The figures in parentheses show the percentage of oleoresin yielded by 
each drug. 

Pigmenta, Paints (Unofficial), — are preparations for external use, 
which cannot be classed with the preceding. They are generally pre- 
scribed in skin diseases, for use over inflamed joints, or for application to 
the throat with a camel's-hair brush. 

K- Tinct. Iodi, *,). | K . Alcoholis, Saponis Yiridis, 

y-Etheris, t ^iij. Olei Cadini, .... aa t ^j. 

Tinct. Aconiti, ^ss. Sig. — Paint over the part. 

Ext. Belladon. Rad. Fl., . 3 iv. 

Morph. Sulph., gr. ij . R. Olei Tiglii, £j. 

Iodi, 3J SS - /Etheris, ^ij. 

Sig. — Paint 4 or 5 coats freely over the Tinct. Iodi, 3 v. 

inflamed and painful parts. M. Sig. — Paint on once in 3 days. 

Pilulae, Pills, — are spherical masses composed of medicinal agents and 
intended to be swallowed whole. The "mass" consists of the active 
ingredients and the excipient, the latter being the substance which gives 
to the mass its adhesive and plastic qualities. In official pharmacy the 
excipients are specified both as to composition and quantity in each case, 
and those directed to be used in the preparation of the 3 official Masses 
and the 15 official Pills are as follows, viz. : — 

5 are made with Soap and Water, viz. — Pil. Aloes, Pil. Aloes et Asafcetidae, Pil. Asa- 
fcetidae, Pil. Opii, Pil. Rhei. 

4 are made with Water alone, viz. — Pil. Aloes et Mastiches, Pil Cathartics Comp., 
Pil. Catharticae Vegetables, Pil. Rhei Comp. 

1 with Syrup, viz. — Pil. Aloes et Myrrhae. 

I with Mucilage of Tragacanth, viz. — Pil. Antimonii Comp. 

1 with Acacia and Water, viz. — Pil. Ferri Iodidi. 

2 with Glycerin and Water, viz. — Pilulae Phosphori, Pil. Ferri Carbonatis. 
1 with Confection of Rose, viz. — Pilulae Aloes et Ferri. 

I with Honey, Syrup and Water, viz. — Massa Ferri Carbonatis. 

I with Glycerin and Honey of Rose, viz. — Massa Hydrargyri. 

I has no excipient, viz. — Massa Copaibae, being a resin left after distillation. 

The pharmacopceial directions for the formation of the pill-mass vary 
in each case, but in general they prescribe that the ingredients shall be 



54-8 PHARMACEUTICAL PREPARATIONS. 

mixed intimately, then beaten with the excipient to form a mass and 
divided into a certain number of pills. Two of the official pills are 
directed to be coated with an ethereal solution of the Balsam of Tolu, 
viz. — Pilulae Ferri Iodidi and Pilulse Phosphori. Full descriptions of the 
various details of pill-making are given below. 

The number of official pills is 15, for the composition of which the 
student is referred to their several titles in the section of Materia Medica. 
They are named as follows, viz. — ■ 

Pilulae Aloes. Pilulae Cathartics Compositse. 

Pilulae Aloes et Asafcetidae. Pilulse Cathartics Vegetables. 

Pilulse Aloes et Ferri. Pilulee Ferri Carbonatis. 

Pilulae Aloes et Mastiches. Pilulae Ferri Iodidi. 

Pilulae Aloes et Myrrhae. Pilulae Opii. 

Pilulae Antimonii Compositae. Pilulae Phosphori. 

Pilulae Asafcetidae. Pilulae Rhei. 
Pilulae Rhei Compositae. 

Pills constitute a form of medicine very much used in extemporaneous 
pharmacy, and one with the preparation of which the compounder should 
be perfectly familiar, for it will constitute fully one-third of his work at 
the dispensing counter. Pills should not exceed 5 grains in weight, 
unless the ingredients are very heavy, as Bismuth, Calomel, Hydrargyrum 
cum Creta, etc., of which 6, 8, or 10 grains may be made into a pill 
which may be readily swallowed. A Bolus is a similar mass, but larger 
than a pill, while the names Granule and Parvule are given to masses 
smaller than the average pill. 

The Process of Pill-Making is briefly as follows : The ingredients 
ordered in the prescription are separately weighed out in the order of 
their bulk, commencing with that one of which the smallest quantity is 
to be used. If any require pulverization they should first be placed in 
the mortar, and reduced to powder ; then the other dry ingredients, next 
the soft extracts and the excipient selected, and the whole is worked up 
into a mass, the Pill-mass, by the aid of the mortar and pestle. The 
perfect pill-mass should be uniform throughout, should not show any 
particles of any one ingredient, should have such a consistence that the 
pills made from it will retain their shape, should not be too hard, nor too 
dry, nor should it stick to the fingers. The mortar should be large and 
shallow, of unpolished wedgewood ware ; having a thick, smooth and 
well-formed bottom, and a pestle which fits it. The operation of working 
up the mass is one of kneading it between the end of the pestle and the side 
of the mortar, and if proper ingredients and excipient are used, and if 
the work is well done, the mass will eventually loosen itself from both 
mortar and pestle. If it does not do so it should be removed with a 
spatula when sufficiently worked, and may be kneaded for a few minutes 
between the fingers. It should then be placed upon the tile or slab pre- 



PHARMACEUTICAL PREPARATIONS. 549 

viously dusted with a little Lycopodium or Starch in fine powder, and 
rolled into a long cylinder by the aid of a broad-bladed spatula, until the 
mass is of a length corresponding to the divisions on the tile-scale which 
represent the number of pills to be made. The mass should then be 
placed along the scale, and a cut made through it with the spatula at each 
division of the scale, the pieces being at once rounded separately into pills 
by the thumb and two fingers of each hand. A pill-machine is often 
employed, consisting of two metal plates having semi-cylindrical grooves 
on one side, and set into wooden boards, the whole forming a convenient 
apparatus for rolling the mass and then cutting it into the required num- 
ber of pills by one movement. The pills are then left to dry upon the 
slab while the label is being written, after which they are placed in a pill- 
box, or in a wide-mouthed bottle if they contain volatile ingredients, 
and surrounded by a Conspergative powder (Lycopodium, powdered 
Chalk, dusted Talc), to prevent their adhering together or losing their 
shape. 

Excipients used in pill-making are seldom mentioned in the prescrip- 
tion, but are usually left to the choice of the compounder. Some sub- 
stances need no excipient, but may be made at once into pills ; such 
being the softer Extracts and some Gum-resins, the former if too hard 
only needing a little water, and the latter a few drops of spirit to soften 
them to the required degree of plasticity. Every druggist has his favorite 
pill-excipient, many using a paste made of powdered Tragacanth i, Glycerin 
3^ and Water i part, while others use Extract of Malt, or a mixture of 
Syrup and powdered Acacia, for general use. Powdered Tragacanth to 
give tenacity, Glycerin to keep the mass soft, and Water to develop the 
adhesive qualities of many ingredients, will answer for fully nine-tenths 
of all the cases which occur in practice. These three excipients should 
stand on the dispensing counter ready for use, and all ready-made pastes 
or mixtures should be discarded, as being slovenly, dirty, and liable to 
change. The excipients described below are those in general use, and are 
arranged in the order of their comparative importance, viz. — 

Liquid Excipients. 

Glycerin, — is a very valuable excipient, as it continually attracts moisture from the 
atmosphere, and pills made from it do not get hard. It should always be used for Qui- 
nine pills. Glycerites of Starch or Tragacanth are generally useful excipients. The 
former is official, the latter is made in the proportion of ^ss to the f^ . 

Glucose, — is a good excipient, being colorless, adhesive, and not readily volatilized 
at ordinary temperatures. Since its introduction by Mr. Lascheid for this purpose it has 
steadily grown in favor. 

Honey, — may be used for dark-colored substances. It should be evaporated to one- 
half its bulk, and then if mixed with a little Tragacanth it makes an excellent excipient 
for insoluble powders. 

Extract of Malt, — is a pretty fair excipient, but has the disadvantage of its dark color. 



550 PHARMACEUTICAL PREPARATIONS. 

Syrup, — is a fair excipient for powders, but it should not be used for metallic salts, es- 
pecially Calomel, which it reduces in a short time. Syrup of Acacia is good where there 
is little room left for the excipient, but if kept too long, pills made with it become very 
hard and insoluble. 

Mucilage of Acacia, — is very adhesive, but not a good excipient for the same reason 
as given for the syrup. 

Water, — is only used alone as an excipient when the ingredients possess sufficient ad- 
hesiveness to be developed by the water. Such are the following powders : Aloes, Rhu- 
barb, Kino, Tannic Acid, Opium, Squill, Asafetida, — also Ferric Citrate, Berberine Sul- 
phate, etc. 

Alcohol, — is used to soften Camphor, Compound Extract of Colocynth, Guaiac, resinous 
extracts, gums, etc. 

Solid Excipients. 

Tragacanth, — is an excellent excipient, especially for substances which are too soft, 
giving them body and elasticity. 

Acacia, — is added to give more adhesiveness than can be obtained from viscid liquids 
alone. Pills made with it are generally very hard. It is used for Silver Nitrate, which may 
explode if mixed with vegetable extracts or glucose. 

Soap, — is the best for resinous and fatty substances, increasing the solubility of the 
former. It is more employed in the official pills than any other excipient, but should 
not be used for substances which are decomposed by an alkali, nor for Tartar Emetic. 

Bread-crumb [Mica Panis), — is an excellent excipient for Croton Oil, or other pow- 
erful liquid substances, as volatile oils. 

Confection of Rose, — is too bulky for general use, but is a good excipient for very 
active agents, like Strychnine, which are used in small quantity. 

Althaea, — is good for absorbing and adhesive purposes, but is too bulky for general use. 
-Petrolatum, Cacao Butter, and Resin Cerate, — are used for oxidizable substances, 
as Potassium Permanganate. 

Kaolin, — is well adapted for Silver Nitrate, and other substances which are easily de- 
composed. 

Liquorice, — is an old excipient, but not much employed now. In powder it may be 
used for oils. 



Conspergatives, — are absorbent powders which are dusted upon the 
finished pills and put around them in the box or vial in which they are 
dispensed, to keep them from sticking together and losing their shape. 
Powdered Liquorice was formerly much used for this purpose, but the best 
conspergatives are Lycopodium, Talc, Althaea, and Rice Flour, the latter 
especially for white pills. 

Substances Suitable for the pilular form of medicine are — 

Those acting in small doses. Heavy, insoluble substances. 

Those intended to act slowly. Fetid substances. 

Those to act on the lower bowel. Vegetable extracts. 

Gum-resins, Balsams, Turpentine. 

When the basis is an unadhesive substance, one of the other ingredients 
should be an extract or a vegetable powder, which will form a mass by 
moisture alone. Attention to this rule in prescribing pills will often pre- 
vent the increase of their size by inert excipients. - 



PHARMACEUTICAL PREPARATIONS. 55 I 

Substances Difficult to combine, except by peculiar treatment, are 
met with frequently. The following notes will cover most such cases : — 

Aloes, — is best treated on a heated slab with alcohol in very small quantity. Soap is 
the excipient in the official Pilulae Aloes. 

Butyl Chloral Hydrate, — should be treated with a little Confection of Rose and 
thick mucilage. 

Calcium Sulphide, — should be well triturated with an equal quantity of Sugar of 
Milk, and then worked up with a little powdered Liquorice-root and Tragacanth 
Mucilage. 

Camphor, — should be powdered with a little alcohol, and may be worked into a pill- 
mass with Glycerite of Tragacanth after the evaporation of the alcohol. 

Carbolic Acid, — requires nearly an equal part of wheaten flour or bread-crumb, with 
a very minute quantity of Glycerite of Tragacanth. Creosote may be made into a mass 
by the addition of Powdered Liquorice with a very little bees' wax. If made into a pill 
with Silver Oxide it will explode unless the silver salt be first diluted by trituration with 
Liquorice, Gentian, or some other inert powder. 

Iron and Quinine Citrate, — is very deliquescent with most excipients. Canada 
Balsam is the best for it. 

Copaiba, — may be made into pill-mass by the addition of a little Magnesium Car- 
bonate or Wax. 

Croton Oil, — is best worked up with bread-crumb, though powdered Liquorice and 
mucilage may be used. 

Ferrous Iodide, — in pill form requires special manipulation and protection to remain 
unoxidized. The official Pil. Ferri Iodidi is prepared with Iodine and Reduced Iron, 
has Liquorice, Sugar, and Acacia as excipients, and is protected by a coating of Balsam 
of Tolu. In other formulae, Acacia, Althaea, Cacao-butter, Elm bark, and Liquorice are 
used as excipients. 

Ferrous Sulphate, — is used in Blaud's Pill and in the official Pil. Ferri Compositae, 
with Potassium Carbonate, to form by mutual decomposition Ferrous Carbonate, which 
quickly passes into the ferric salt by exposure. Myrrh in powder and syrup are the ex- 
cipients used for the official pill. 

Gallic Acid, — makes a good pill with a very small quantity of Glycerin. Tannic 
Acid requires about one-fifth its weight of Glycerin and one-tenth of Mucilage. 

Phosphorus,— presents the problem of combining it in pill without letting it oxidize. 
This is believed to be accomplished by the pharmacopceial directions for the Pil. Phos- 
phori, according to which the Phosphorus is dissolved in Chloroform in a test-tube, then 
quickly worked into a mass with Althaea, Acacia, Glycerin and Water, and finally the 
pills are coated by shaking with an Ethereal solution of Balsam of Tolu. Carbon Disul- 
phide is a better solvent, but when it is used the pill-mass retains its disgusting odor. 

Potassium Acetate, — requires Canada Balsam to secure its stability in pill form. 
Potassium Iodide is best manipulated by rubbing it into a smooth paste with a very 
little water, then adding a small quantity of Liquorice powder. Potassium Perman- 
ganate should be worked up with Kaolin and a very little water. Resin Cerate, Soft 
and Hard Paraffin and Cacao-butter are also used as its excipients. 

Quinine, — requires very clean hands and tools, and a colorless excipient, as Glycerin 
or Glucose, to make a nice-looking pill. If one part of Tartaric Acid is added to four of 
the Quinine salt, the mass will be less likely to crumble and will be of less bulk. Qui- 
nine Sulphate may be made into small and soluble pills by simply triturating it with 
Aromatic Sulphuric Acid TT\nj to each 5 grains of the salt. The moulding into pills 
should be done at the moment when the mass has begun to dry. A drop of syrup or 
honey, added at this time, will prevent the too rapid hardening of the mass. 

Rhubarb, — in powder makes a good mass with one-fifth of its weight of Glycerin ; 
but Soap is the excipient ordered' for the official Pilulae Rhei. 

Substances Unsuited to the pilular form are — 
Those requiring large doses, and those which are volatile. 



552 



PHARMACEUTICAL PREPARATIONS. 



Emetics, and other agents administered for immediate effect. 

Essential Oils in quantity exceeding half a drop to each pill. 

Oils and other bodies which require much solid matter to make a mass 

except those having a very small dose, as Croton Oil. 
Deliquescent Salts, unless intended to be used immediately. 
Efflorescent Salts, unless deprived of their water of crystallization. 



Deliquescent Salts. 
Ammonii Iodidum. 

Nitras. 

Valerianas. 

Auri Chloridum. 

Calcii Chloridum. 

Chinolin Salts, except the Tartrate, which 

is stable. 
Lithii Citras. 

Bromidum. 

Salicylas. 

Magnesii Citras. 
Potassa. 

cum Calce. 

Potassii Acetas. 

Carbonas. 

Citras. 

Cyanidum, 

Hypophosphis. 

Sulphis. 

Tartras. 

Sodii Hypophosphis. 

Iodidum. 

Zinci Bromidum. 
Chloridum. 

Iodidum. 



Efflorescent Salts. 
Alumen (slightly). 
Ammonii Carbonas. 

Phosphas. 

Antim. et Potassii Tartras (slightly). 
Cupri Acetas. 

Sulphas. 

Magnesii Sulphas (slightly). 
Potassii et Sodii Tartras (slightly). 

Ferrocyanidum (slightly). 

Quininre Bisulphas. 

Sulphas (after a time). 

Soda. 

Sodii Acetas. 

Arsenas (slightly). 

■ Benzoas. 

Boras (slightly). 

Carbonas. 

Hyposulphis. 

Phosphas. 

Santoninas (slightly). 

Sulphas. 

Sulphis. 

Sti-ychninae Sulphas. 
Zinci Acetas. 
Sulphas. 



Coated Pills are manufactured upon a large scale by the great drug 
houses, extensive machinery being employed for the purpose. The coat- 
ing material used is either Sugar or Gelatin. The U. S. Pharmacopoeia 
directs that two of the official pills shall be coated by being shaken with 
a solution of Balsam of Tolu in Ether, viz. — Pil. Ferri Iodidi and Pil. 
Phosphori. In extemporaneous pharmacy it is rarely practicable to coat 
pills with anything except gold or silver leaf, and this is sometimes directed 
by the prescriber, the word "Deaurenter — let them be gilded" being 
used in the subscription. To do this neatly the pills should have no trace 
of powder on them, but should be first coated with a trifle of fresh muci- 
lage by rolling between the mucilage-moistened fingers, each pill being 
then dropped directly on to a sheet of gold or silver leaf, until a dozen or 
more are so deposited. The leaf and its pills are then allowed to slide into 
a globular boxwood shaker, or the leaf may be first placed in the shaker 
and the pills dropped on it there. A cautious circular movement being 
given to the shaker the pills are caused to travel around its walls, and 
when the cover is removed they will be found to have each received an 



PHARMACEUTICAL PREPARATIONS. 



553 



even coating of the metal used. Gold leaf should always be employed 
for pills of Blue Mass or Asafetida, as silver is amalgamated with the 
former and turned black by the latter. 

Albumen may be used for coating small numbers of pills, which should be of very firm 
consistence before the coating is applied. Each pill is rolled between two fingers with a 
little white of egg, and then revolved in a warm pan. Another method of finishing them 
is, after coating with albumen, to rotate them in a tray with powdered French chalk until 
their surfaces become smooth and shiny. When carefully done this process gives a very 
nice finish. 



Compressed Pills, as now largely manufactured by several reliable 
firms, consist of various medicinal powders pressed into pill or tablet 
shape by machinery. They are extremely convenient preparations for the 
physician's use, as quite a variety can be carried in a pocket-case, and as 
slight pressure is sufficient to reduce them to powder, they can be dispensed 
with facility and accuracy of dosage. The following list includes the 
most important of these preparations, the figures representing the number 
of grains in a pill in each case : — 



Acid, Arsenous, ^, ¥ L _i_ _i_ 
Benzoic, 5. 


Ferrum Arsenate, y, y. 
Proto -carbonate, 3, 5- 






Gallic, 5. 


Lactate, I. 






Salicylic, 2^, 5. 

■ Salicylic, 2^, and Morphine j 1 ^. 

Tannic, 2, 5. 

Aconitina, -fa. 


Pyrophosphate, 2. 

and Quinine Citrate, 2, 3, 

Hydrargyrum, I, 3, 5. 

Chloridum Corros. -g-L, ? L 


5- 

1 
' 20 


1 
» XT 


Aloes, 2. Aloes et Ferri (U. S. P.). 


Iodidum Rub., ^, T : g-. 






Aloes, 2, et Myrrh, 1. 

Aloes, %, et Rhei, i l / 3 , et Gentian, %. 


Iodidum Flavum, T L, y, 

Ipecac, et Opii, 2, 3, 5. 


/6, 


X- 


Aloin, 1, y, Yz- 
Ammonium Bromide, 5, 10. 


Morphine Sulphate, T \, y, l /e, 
Opium, Deodorized, I. 


%> 


%• 



Ammonium Chloride, 3, 5, 10. 
Atropine, ? L. 
Bismuth Subcarb., 5. 

Subnitrate, 5, 10. 

Borax, 5. 

Caffeine Citrate, I. 

Calcium Sulphide, T ^, y, y, I. 

Calomel, y, y z , I, 2, 3, 5. 

Calomel, 2, Opium, I. 

Camphor, Monobromated, 2, 3, 5. 

Cathartic Comp. and Vegetab. (U 

Cerium Oxalate, 2. 

Cinchona Alkaloids (Mixed). 

Cinchonine Sulphate, 2, 3, 4, 5. 

Cinchonidine Sulphate, 2, 3, 4, 5. 

Codeine, y. 

Digitaline, «L. 

Extract of Cannabis Indica, y. 

Extract of Ignatia Amara, y, y z . 

Extract of Nux Vomica, y,y. 

Ferrum (Quevenne's), 1, 2. 



s. f: 



Opium, y, and Lead Acetate, iy. 
Pepsin Saccharated, 2, 5. 
Podophyllin, ^,}i, }£, %, I, 2. 
Potassium Bromide, 5, 10. 

Chlorate, 5. 

Iodide, 5. 

Nitrate, 5. 

Permanganate, y, I, 2. 

Quinine Bisulphate, y, I, 2, 3, 4, 5. 

Salicylate, 2. 

Quinine Sulphate, y, 1, 2, 3, 4, 5. 

Quinquinine, 2, 3. 

Rhubarb, 3. Rhei Co. (U. S. P.). 

Rhubarb, 2, and Magnesia, 2. 

Salicin, 2y, 5. 

Santonin, I. 

Santonin, I, and Calomel, I. 

Sodium Bicarbonate, 5. 

Salicylate, 3, 5. 

Strychnine, T l„, ^, up to Jo- 
Zinc Phosphide, ^ up to y. 



The following prescriptions represent the composition of a few unoffi- 
cial pills in general use. A complete pill formulary is easily obtained, 
being published annually by the principal manufacturers. 



554 



PHARMACEUTICAL PREPARATIONS. 



Pills of Iron. 
R . Ferri Reducti, gr. 1. 



Mannae, gr. xv. 

Glucosi, q. s. 
Fiat massa, et div. in pil. xxv. 
Sig. — One after each meal. 



B 



Emmenagogne Pill ( Otto) . 

Ferri Sulph. Exsic., . . . gr. xlviij. 

Pulv. Aloes, gr. xij. 

Terebinthinae, gr. xxvij. 

01. Terebinth., rr\x. 

Fiat massa, et div. in pil. xxx. 
Sig. — Two, three times a day. 



Hooper" 1 s Female Pills. 



R 



. gr. xlviij. 
. gr. xxiv. 



Pulv. Aloes Socot. , 

Ferri Sulph. Exsic, 

Ext. Hellebori Nig. 

Pulv. Myrrhae, 

Saponis, 

Pulv. Canellae Alb., 

Pulv. Zingiberis, . 

Aquae vel Syrupi, q. s. 
Fiat massa, et div. in pil., quisque pondo 
gr. ijss. 

Sig. — One to three at a dose. 



aa gr. xij. 



aa gr. vj. 



R 



Anaphrodisiac and Sedative. 

Camphorae, gr. xxx. 

Lupulini, gr. xx. 

Fiat massa, et div. in pil. xx. 
Sig. — One thrice daily. 



R 



Astringent Pill. 






Plumbi Acetatis, . . . 


• 2T- 


xvj 


Pulv. Camphorae, . . . 

Pulv. Opii, 

Bismuthi Subcarb., . . 


• g r 

• g r - 

ST. 


xij. 
iij. 
xij. 


Ext. Gentianae, q. s. 






Fiat massa, et div. in pil. xij. 






Sig. — One thrice daily. 







Astringent Pill. 






. Argenti Nitratis, . . . 


g r 


XX. 


Pulv. Cretae (Gallicae), . 


gr 


lxxx. 


Petrolati, q. s. 






Fiat massa, et div. in pil. xl. 


»)■ 




Cholagogue Pills [Squib 




Resinae Podophylli, . . . 


gr. 


V J- 


Ext. Belladon. Alcohol., . 


gr- 


llj. 


Pulv. Capsici, 






Pulv. Sacch. Lactis, . aa 


g r - 


xxiv. 


Pulv. Acaciae, 


S r 


V J- 


Glycerini, Syrupi, aa, q. s. 






Fiat massa, et div. in pil. xxiv 






Sig. — One or two as required 






Aperient Pills. 




Pulv. Aloes Socot. , . . . 


g 1 '- 


xxiv. 


Pulv. Rhei, 


gi" 


xlviij 


Ffydrarg. Chlor. Mitis, . . 


g r - 


iv. 


Antim. et Potas. Tart., . . 


gr. ij- 


Fiat massa, et div. in pil. xxiv 






Sig. — One or two as needed. 







Tonic Pill /or Women. 

Strychnines Sulph., 

Acidi Arsenosi, ... aa gr. j. 

Ext. Belladonnae, . . . . gr. v. 

Quininae Sulph., . . . . gr. xxxv. 

Massae Ferri Carb., . . . gr. xc. 

Fiat massa, et div. in pil. xxxv. 
Sig. — One three times daily. 



Anti- Bilious Pills. 



Pulv. Scammonii, 
Pulv. Aloes Socot., 
Pulv. Gambogiae, 
Hydrarg. Chlor. Mitis, 
Potassii Bitart., . . . aa gr. xx. 
Ext. Taraxaci, q. s. 
Fiat massa, et div. in pil. xx. 



Potus, A Dri?ik (Unofficial), — is a solution or a mixture intended to 
be used ad libitum, and generally consists of a Potassium or Sodium salt, 
or a mineral acid, in dilute solution, sweetened and flavored. 

The " Imperial Drink " is made after the following formula : R . Potassii Bitartratis, 
rjij ; Olei Limonis, TT^v ; Aquae Bullientis, q. s. ad ^ xx. M. Fiat potus. Sig. — Use as 
a drink. 



Pulveres, Powders, — are usually prepared extemporaneously, but a 
few compound ones have been made official, the ingredients being simply 
directed to be rubbed together until reduced to a fine powder and thor- 



PHARMACEUTICAL PREPARATIONS. 555 

oughly mixed. Special directions are given for the preparation of two, 

— the Compound Effervescing Powder and the Compound Powder of 

Morphine. There are 9 official powders, named as follows, viz. — 

Pulvis Antimonialis. Pulvis Glycyrrhizne Compositus. 

Pulvis Aromaticus. Pulvis Ipecacuanhas et Opii. 

Pulvis Cretae Compositus. Pulvis Jalapae Compositus. 

Pulvis Effervescens Compositus. Pulvis Morphinae Compositus. 

Pulvis Rhei Compositus. 

The composition of each of these preparations will be found in the section on Materia 
Medica, and under the title from which its name is derived, except that of the Compound 
Effervescing Powder, which is placed under the title Potassium. Pulvis Ipecacuanhas 
et Opii is really a trituration, its ingredients being rubbed together with sugar of milk 
into a very fine powder. 

As prepared extemporaneously Powders are generally compound, and 
may be mixed on a slab with a spatula, but a much better method of 
mixing them is by trituration in a mortar. The latter should always be 
employed except in the case of substances which may explode if so 
treated, as Potassium Chlorate with oxidizable substances. (See ante, 
page 513.) The diluent best employed in powders is Sugar of Milk, on 
account of its hardness, its density, and its comparative insolubility. A 
coloring agent, as Carmine in minute quantity, is a useful ingredient, 
enabling the eye to judge of the degree of mixing and subdivision ob- 
tained. Powders containing soluble salts, extracts, volatile oils, camphor, 
or any other hygroscopic or volatile substances, should be dispensed in 
waxed paper. For ordinary powders the plain white paper of the drug 
stores will answer, but a better paper for small powders is one having a 
high surface finish and made very thin, as the white glazed French demy. 
Powders are often ordered in Wafers {Cachets), to be swallowed without 
unfolding. The division of powders into the number of Papers (C/iar- 
tulcB) ordered, and folding them neatly, requires a considerable amount 
of practice. A small machine is used, over which the ends of the papers 
are bent, in order to have them of the proper size for the box in which 
they are usually dispensed. If they are to be put into an envelope, less 
exactness of folding is required, and the mechanical contrivance may be 
dispensed with. 

Substances suitable to administration in the form of powders are those 

which are insoluble, those which would be chemically incompatible in 

fluid form, and certain pulverizable extracts. Those which are unsuited 

to this form are such as have a very nauseous taste or odor, substances of 

which the dose is large, those which are deliquescent, efflorescent, or 

very volatile, and those which liquefy on mixing. A list of deliquescent 

and efflorescent salts is found on page 552, while the following named, 

though dry alone, become moist when triturated together, viz. — 

Sodium Sulphate and Potassium Carbonate. 
Zinc Sulphate and Lead Acetate. 
Camphor and Chloral Hydrate. 



556 



PHARMACEUTICAL PREPARATIONS. 



Many substances cannot be powdered without the intervention of an- 
other body : thus Opium requires a hard substance like Sugar of Milk or 
Potassium Sulphate, Camphor requires a minute quantity of Alcohol, 
Myrrh needs Sugar or Gum, etc. Substances, as the alkaloids and their 
salts, which are very active and are used in very small doses, require some 
inert substance to give them bulk enough for division and handling. 
Sugar of Milk will be found the best agent for this purpose. Prescrip- 
tions may order the ingredients for a single powder, with directions to 
dispense a certain number of the same composition ; or they may give 
the quantities for the whole number of powders ordered, with instructions 
to divide into a certain number. The dispenser should carefully scan the 
prescription in order to avoid the multiplication of quantities where divi- 
sion is intended. The official powders are enumerated above ; and the 
following formulae will serve to illustrate those generally prescribed : — 



R 



Astringent Powder for Infants. 

Plumbi Acetatis, . . . . gr. ij. 

Pulveris Opii, gr. ss. 

Camphorae, gr. j. 

Sacchari Lactis, . . . . gr. iij. 
Trit., et div. in chartulas xij. 
Sig. — One every 2 or 3 hours in diar- 
rhoea of infants. For an adult the above 
represents one dose. 



R 



R 



Gastric Sedative. 




Bismuthi Subnitratis, . . 


• 3'h 


Pulveris Rhei, 




Pulveris Aromat., . 


aa 7, ss 


M., et div. in chartulas vj. 




Sig. — One before each meal 





Laxative Powder. 



R. 



Hydrarg. Chlor. Mitis, . . gr. x. 

Sacchari Lactis, . . . , gr. xx. 
M. , et fiant pulv. x. 
Sig. — One powder twice daily. 



Bismuth and Soda. 

Bismuthi Subnitratis, 

Sodii Bicarb., .... 

Pulv. Zingiberis, . . . 
M., et div. in chartulas xij. 
Sig. — One after each meal. 
Corrective in dyspepsia, acne and eczema. 



aa % ij. 
. gr. xl. 



Antipruritic Powder. 

R . Pulveris Camphorae, . . . 3J. 

Zinci Oxidi, 3 iv. 

Pulv. Amyli, '^j. 

M., et fiat pulvis. 

Sig. — Use locally as a dusting powder to 
relieve itching. 



Catarrh Pozvder. 



Bismuthi Subnitratis, . . 3 iij. 

Pulv. Acaciae, ^j. 

Pulv. Talci, 3 ij. 

Morphinse Muriatis, . . . gr. j. 
M. Sig. — Use by insufflation. 



Compressed Pills are really powders which have been compressed into 
pill shape by machinery. A little pressure from the blade of a spatula 
will restore them to powder form. 



Resinse, Resins, — are solid preparations obtained by precipitating the 
resinous principles of plants from their alcoholic solution by the agency 
of water. They differ from alcoholic extracts in containing only those 
principles which are soluble in alcohol and insoluble in water, while the 
extracts contain all principles which are soluble in alcohol. Besides 
Resina itself, which is the residue left after distilling off the volatile oil 
from Turpentine, there are 4 official Resins, three of which correspond 



PHARMACEUTICAL PREPARATIONS. 557 

to the above description, and one (Resin of Copaiba) is the residue left 
after distilling off the volatile oil from Copaiba. They are named as 
follows : — 

Resina Copaiba?. Resina Podophylli. 

Resina Jalapse. Resina Scammonii. 

Spiritus, Spirits, — are alcoholic solutions of volatile substances, which 
may be solids, liquids or gases. They are officially prepared either by 
simple solution, by solution with maceration, by gaseous solution, by 
chemical reaction, or by distillation. The menstruum is Alcohol or 
Deodorized Alcohol in nearly all instances, 4 having Water in addition, 
and 2 being alcoholic liquids of a specified alcoholic strength (Whiskey, 
Brandy). The official Spirits are 25 in number, as follows, viz. — 

Spiritus iEtheris, 32^. Spiritus Frumenti, 44-50. 

Spiritus /Etheris Compositus, 32^. Spiritus Gaultheriae, 5. 

Spiritus yEtheris Nitrosi, 4. Spiritus Glonoini, I. 

Spiritus Ammoniae, 10. Spiritus Juniperi, 5. 

Spiritus Ammoniae Aromaticus, 9. Spiritus Juniperi Compositus, 63^. 

Spiritus Amygdalae Amarse, 1. Spiritus Lavandulae, 5. 

Spiritus Anisi, 10. Spiritus Limonis, 5. 

Spiritus Aurantii, 5. Spiritus Menthae Piperita?, 10. 

Spiritus Aurantii Compositus, 20. Spiritus Menthae Viridis, 10. 

Spiritus Camphorae, 10. Spiritus Myrcias, 55- 

Spiritus Chloroformi, 6. Spiritus Myristicae, 5. 

Spiritus Cinnamomi, 10. Spiritus Phosphori, 0.12. 
Spiritus Vini Gallici, 39-47. 

The figures placed after Spiritus Frumenti, S. Juniperi Comp., S. Myrciae and S. Vini 
Gallici, represent the percentage of absolute Alcohol by weight in each ; those placed 
after the others indicate the quantity of the principal ingredient in grammes to each 100 
cubic centimeters of the preparation. Absolute Alcohol is the menstruum directed for 
Spiritus Phosphori. 

Suppositoria, Suppositories, — are solid bodies containing medicinal 
substances, and intended for introduction into the vagina, rectum or ure- 
thra. The Pharmacopoeia prescribes a general formula for their prepara- 
tion, according to which the medicinal portion should be incorporated 
with Oil of Theobroma by rubbing them together at a temperature of 
95 F. The mixture should then be poured into suitable moulds, and 
cooled on ice or in ice-cold water. Unless otherwise specified they should 
have the following shapes and weights, corresponding to their several 
uses : — 

Rectal Suppositories, — cone-shaped, about 1 gramme (15 grains) each. 
Urethral Suppositories, — pencil-shaped, about I gramme (15 grains) each. 
Vaginal Suppositories, — globular, about 3 grammes (45 grains) each. 

The only official Suppositories are those of Glycerin, (Suppositoria 
Glycerini), in which Stearic Acid is employed to give the requisite con- 
sistence. 



55§ PHARMACEUTICAL PREPARATIONS. 

In extemporaneous pharmacy Suppositories are usually prepared with 
Cacao-butter as a basis, but for those intended for the uterus or urethra a 
mixture of Gelatin and Glycerin is considered the best excipient, being 
firmer and more plastic than cacao-butter, and more easily handled. 
Hollow cones of cacao-butter, or some composition resembling it, are 
kept in the shops, and will be used by the average druggist in filling pre- 
scriptions for rectal suppositories unless prohibited, as they save him con- 
siderable labor ; the active drug being simply placed in the centre of the 
cone, which is then sealed by a plug fitting into its base. These con- 
trivances are by no means so efficient as the regular suppository, in which 
the medicinal agent is thoroughly incorporated with the excipient, for the 
former smear the rectum with a quantity of melted grease before the active 
ingredient is permitted to come in contact with its walls. The agents 
used in suppositories are chiefly extracts and alkaloids ; some few powders, 
and a few metallic salts are occasionally employed. Those for the adult 
rectum should contain about 15 grains of the excipient, for the vagina a 
drachm of cacao-butter is the average quantity. Those for the uterus and 
urethra are made of cylindrical instead of conical form, and about the 
diameter of a No. 9 catheter. 

The methods of compounding suppositories are two, viz. — that by 
the use of moulds (the official method), and that by hand. The former 
process is described above, but many prefer the hand method, which is 
as follows: The medicament is mixed with finely shaved Cacao-butter 
by the aid of a spatula, on a board or tile lightly dusted with Lycopo- 
dium or Starch. After a smooth and uniform mixture is thus obtained, 
the mass may be rolled into cylindrical form, cut into the required sizes 
and with the spatula given the required shape. When dispensed, they 
should be placed in a powder-box, between layers of cotton. 

Bougies or Pencils, as urethral and uterine suppositories are often 
termed, may be prepared by melting together White Gelatin 3, Glycerin 
1, and Distilled Water 1 part by weight, then adding the medicament, 
and drawing the mass into a glass tube previously oiled inside. When 
cold the bougie may be pushed out and cut into suitable lengths. 

Suppositories and bougies may be prescribed in the manner illustrated 
by the following formulae : — 



Anodyne Suppository. 


Wade 's Bougies. 


R. Ext. Opii, .... . . gr. vj. 


\& . Iodoformi, 3J. 


Ext. Belladonna; Fol. Al- 


Bismuthi Subnitrat, . . . %). 


coholici, gr. ss. 


Chloralis Hydratis, . . . gr. viij 


Ext. Hyoscyami, . . . . gr. ij. 


Morphinse Sulphat., . . . gr. iij. 


Olei Theobromae, q. s. 


01. Rosse, mjc. 


M. Fiant suppositoria vj. 


Gelatini, et Glycerini, q. s. 


Sig. — One into the rectum morning and 


M. Fiant bougia xij. 


night. 


Sig. — One into urethra thrice daily. 



PHARMACEUTICAL PREPARATIONS. 



559 



R 



Anthelmintic. 

Santonini, 

Olei Theobromae, . . 
M. Fiant suppositoria vj. 
Sig. — One into the rectum as directed. 



gr. xij. 

Si- 



Quinine Suppository . 
R . Quininae Sulphatis, . . . gr. v. 
Olei Theobromae, . . . . gr. x. 
Fiat suppositorium unum, mitte tales sex. 





Bougie for Gleet. 




R. 


Zinci Sulphatis, 

Ac. Carbolici, .... 
Pulv. Hydrastis, . . . . 
Ext. Belladonnas Fol. Al 


mjij. 

gr. xij. 




coholici, 

Gelatini, et Glycerini, q. s 


gr. xij. 


M 


Fiant bougia xij. 




Si 


g. — One into urethra night 


and morn 


ing. 







In the British Pharmacopoeia the following 9 suppositories are described, viz. — 

Suppositoria Acidi Carbolici cum Sapone, Carbolic Acid Suppositories, — Carbolic 
Acid, 12 grains ; Curd Soap, in powder, 180 grains ; Glycerin of Starch, 40 grains; to 
make 12 suppositories, each containing I grain of Carbolic Acid. 

Suppositoria Acidi Tannici, Tannic Acid Suppositories, — Tannic Acid, 36 grains ; 
Oil of Theobroma, 144 grains ; to make 1 2 suppositories, each containing 3 grains of 
Tannic Acid. 

Suppositoria Acidi Tannici cum Sapone, Tannic Acid Suppositories with Soap, — 
Tannic acid, 36 grains ; Glycerin of Starch, 30 grains ; Curd Soap, in powder, 100 grains ; 
Starch, in powder, q. s. ; to make 12 suppositories, each containing 3 grains of Tannic 
Acid. 

Suppositoria Glycerini, Glycerin Suppositories, — Gelatin, cut small, ]/ z oz. ; Gly- 
cerin, by weight, i]/ z ozs. ; Distilled Water, a sufficiency to make as many suppositories 
as desired, according to size, each containing 70 per cent, by weight of Glycerin. 

Suppositoria Hydrargyri, Mercurial Suppositories, — Mercurial Ointment, 60 grains ; 
Oil of Theobroma, 120 grains ; to make 12 suppositories, each containing 5 grains of Mer- 
curial Ointment. 

Suppositoria Iodoformi, Iodoform Stippositories, — Iodoform, 36 grains ; Oil of Theo- 
broma, 144 grains ; to make 12 suppositories, each containing 3 grains of Iodoform. 

Suppositoria Morpbinae, Morphine Suppositories, — Morphine Hydrochlorate, 6 
grains ; Oil of Theobroma, 174 grains ; to make 12 suppositories, each containing J / 2 grain 
of the Morphine salt. 

Suppositoria Morphinse cum Sapone, Morphine Suppositories with Soap, — Mor- 
phine Hydrochlorate, 6 grains; Glycerin of Starch, 30 grains ; Curd Soap, in powder, 
100 grains; Starch, q. s. to make 12 suppositories, each containing ]/ 2 grain of the Mor- 
phine salt. 

Suppositoria Plumbi Composita, Co?npound Lead Suppositories, — Acetate of Lead, 
36 grains ; Opium, in powder, 12 grains; Oil of Theobroma, 132 grains; to make 12 
suppositories, each containing 3 grains of Lead Acetate and I grain of Opium. 



Syrupi, Syrups, — are concentrated solutions of Sugar in Water or in 
aqueous liquids. They sometimes contain Acetic Acid, and occasionally 
Alcohol ; and are termed simple, medicated ox flavored, according as they 
are simple solutions of sugar in water alone, or contain soluble medicinal 
substances, or flavoring ingredients. The Sugar used should be very dry, 
and its official description corresponds with the granulated sugar of com- 
merce. The permanency of these preparations chiefly depends on their 
possessing the proper relative proportions of sugar and water. They are 
prepared either by solution with heat, by agitation without heat, by add- 
ing a medicated liquid to simple syrup, by digestion or maceration, or by 
cold percolation ; these processes being all officially directed except the 
last. They are best preserved by being poured while hot into pint bottles, 



560 



PHARMACEUTICAL PREPARATIONS. 



which should be corked securely while full, and the tops dipped into 
melted sealing-wax. Fermented syrups are useless for dispensing pur- 
poses. The number of official syrups is 32, as follows, viz. — 



Syrupus. 




Syrupus Ipecacuanhas. 


Syrupus Acaciae. 




Syrupus Krameriae. 


Syrupus Acidi Citrici. 




Syrupus Lactucarii. 


Syrupus Acidi Hydriodici. 




Syrupus Picis Liquidae. 


Syrupus Allii. 




Syrupus Pruni Virginianae. 


Syrupus Altheae. 




Syrupus Rhei. 


Syrupus Amygdalae. 




Syrupus Rhei Aromaticus. 


Syrupus Aurantii. 




Syrupus Rosae. 


Syrupus Aurantii Florum. 




Syrupus Rubi. 


Syrupus Calcii Lactophosphatis. 


Syrupus Rubi Idaei. 


Syrupus Calcis. 




Syrupus Sarsaparillae Compositus, 


Syrupus Ferri Iodidi. 




Syrupus Scillae. 


Syrupus Ferri, Quininae et ! 


Strychninae 


Syrupus Scillae Compositus. 


Phosphatum. 




Syrupus Senegae. 


Syrupus Hypophosphitum, 




Syrupus Sennae. 


Syrupus Hypophosphitum 


cum Ferro. 


Syrupus Tolutanus. 




Syrupus Zingiberis. 



Tincturse, Tinctures, — are alcoholic solutions of medicinal substances; 
and with one official exception (Tincture of Iodine), are made from non- 
volatile bodies. They are prepared by percolation, maceration, solution 
or dilution ; the menstrua employed being chiefly Alcohol, Diluted Alco- 
hol, and Alcohol and Water in various proportions. In one case (Tinc- 
ture of Sanguinaria) Acetic Acid is an ingredient of the menstruum, in 
two the Aromatic Spirit of Ammonia, and in several Glycerin is contained 
therein. 

For Tinctures of Fresh Herbs (Tinctures Herbarum Recentium), the Pharmaco- 
poeia prescribes a general formula, according to which, when not otherwise directed, they 
are to be prepared by macerating 50 grammes of the fresh herb, bruised or crushed, in 
100 cubic centimeters of alcohol, for 14 days, then expressing the liquid and filtering. 

The official Tinctures number 71, and are named in the following list, 
the figures placed after each name giving the number of grammes of the 
drug in each 100 cubic centimeters of the tincture. 



Tinctura Aconiti, 35. 


Tinctura Cardamomi, 10. 


Tinctura Aloes, 10. 


Tinctura Cardamomi Composita, 2. 


Tinctura Aloes et Myrrhae, 10. 


Tinctura Catechu Composita, 10. 


Tinctura Arnicae Florum, 20. 


Tinctura Chiratae, 10. 


Tinctura Arnicae Radicis, 10. 


Tinctura Cimicifugae, 20. 


Tinctura Asafcetidae, 20. 


Tinctura Cinchonae, 20. 


Tinctura Aurantii Amari, 20. 


Tinctura Cinchonae Composita, 10. 


Tinctura Aurantii Dulcis, 20. 


Tinctura Cinnamomi, 10. 


Tinctura Belladonnae Foliorum, 15. 


Tinctura Colchici Seminis, 15. 


Tinctura Benzoini, 20. 


Tinctura Croci, 10. 


Tinctura Benzoini Composita, 12. 


Tinctura Cubebae, 20. 


Tinctura Bryoniae, 10. 


Tinctura Digitalis, 15. 


Tinctura Calendulae, 20. 


Tinctura Ferri Chloridi, 13.6. 


Tinctura Calumbae, 10. 


Tinctura Gallae, 20. 


Tinctura Cannabis Indicae, 15. 


Tinctura Gelsemii, 15. 


Tinctura Cantharidis, 5. 


Tinctura Gentianae Composita, 10. 


Tinctura Capsici, 5. 


Tinctura Guaiaci, 20. 



PHARMACEUTICAL PREPARATIONS. 



561 



Tinctura Guaiaci Amraoniata, 20. 

Tinctura Humuli, 20. 

Tinctura Hydrastis, 20. 

Tinctura Hyoscyami, 15. 

Tinctura Iodi, 7. 

Tinctura Ipecacuanhas et Opii, 10. 

Tinctura Kino, 10. 

Tinctura Kramerise, 20. 

Tinctura Lactucarii, 50. 

Tinctura Lavendulse Composita, o.< 

Tinctura Lobeliae, 20. 

Tinctura Matico, 10. 

Tinctura Moschi, 5. 

Tinctura Myrrhse, 20. 

Tinctura Nucis Vomicae, 20. 

Tinctura Opii, 10. 

Tinctura Opii Camphorata, 0.4. 

Tinctura Opii Deodorati, 10. 



Tinctura Physostigmatis, 15. 

Tinctura Pyrethri, 20. 

Tinctura Quassiae, 10. 

Tinctura Quillajae, 20. 

Tinctura Rhei, 10. 

Tinctura Rhei Aromatica. 20. 

Tinctura Rhei Dulcis, 10. 

Tinctura Sanguinarise, 15. 

Tinctura Scillae, 15. 

Tinctura Serpentariae, 10. 

Tinctura Stramonii Seminis, 15. 

Tinctura Strophantbi, 5. 

Tinctura Sumbul, 10. 

Tinctura Tolutana, 10. 

Tinctura Valerianae, 20. 

Tinctura Valerianae Ammoniata, 20. 

Tinctura Vanillae, 10. 

Tinctura Veratri Viridis, 40. 



Tinctura Zingiberis, 20. 



Triturationes, Triturations, — form a class of powders having for 
their diluent Sugar of Milk, and possessing a definite relation between the 
active ingredient and the diluent. The Pharmacopoeia prescribes a gen- 
eral formula for these preparations, according to which 10 grammes of the 
Substance and 90 of Sugar of Milk are to be well mixed by a spatula, the 
latter being added in successive quantities, and both triturated in a mortar 
until the substance is intimately mixed with the diluent and finely com- 
minuted. There is but one official Trituration (Trituratio Elaterini), 
though the Pulvis Ipecacuanhas et Opii practically belongs to this class, 
except in respect of the proportions prescribed. Sugar of Milk is em- 
ployed as the diluent because of its hardness and its comparative insolu- 
bility. The first of these qualities secures the fine comminution of the 
active ingredient, whereby the action of the medicine is increased and 
better distributed. Its insolubility makes it the best diluent for powders 
or triturations administered from a spoon or glass with fluid, as is so often 
done, for unlike cane sugar it is not readily dissolved and does not leave 
the active substance behind on the surface of the utensil. Triturations 
are excellent forms for the administration of powerful alkaloids, which 
may thus be divided with great accuracy into the minute quantities re- 
quired. Mercury and its salts are especially adapted to this method of 
preparation, being more uniformly divided and hence more active than 
when administered in any other form. Triturations of mercury with sugar 
were commonly used in England a hundred years ago, and triturations of 
many substances were employed by the Arabian physicians of the 13th 
century ; but the subsequent adoption of these preparations by the homce- 
opathists produced such a prejudice against them in the ranks of the regu- 
lar profession, that until recently any one using them stood in danger of 
being stigmatized as a homoeopath. Their recognition by the U. S. 
Pharmacopoeia under their proper title does away with any such imphca- 
36 



562 



PHARMACEUTICAL PREPARATIONS. 



tion, though it is much to be regretted that the compilers of the last re- 
vision of the British Pharmacopoeia should have shown their fear of a 
name by continuing the title " Pulvis Elaterini Compositus " to designate 
a preparation which in every respect is a trituration. The preparations of 
Pepsin daily prescribed by physicians all over the country are really sugar- 
of-milk triturations of that ferment, and not pure Pepsin as many suppose. 
Prof. H. G. Piffard, Med. Dept. Univ. of the City of New York, in his 
treatise on the Materia Medica and Therapeutics of the Skin (N. Y., 
1881), after detailing several microscopical examinations of pills and 
triturations, uses the following language : — 

" It is to be expected, therefore, that the protoiodide trituration will prove, ceteris pari- 
bus, more active than the pill, and such we have found it. Since we have used 
the triturations, however, in preference to the ordinary pills, patients more rarely com- 
plain of disagreeable sensations. We have been enabled to materially reduce the size of 
the dose in order to obtain the desired effect. In other words, a larger proportion of the 
drug is utilized for specific purposes, while but a small amount remains to give rise to local 
irritation I have nothing to add to this, except that I continue to use tritura- 
tions of Mercury and other substances with increasing satisfaction. Beside those men- 
tioned I employ Calomel, Cyanide of Mercury, Black Oxide of Mercury and Corrosive 
Sublimate in this form." 



The following examples will illustrate the mode in which Triturations 
may be prescribed : — 



& . Hydrarg. Oxidi Flavi, . . 

Sacchari Lactis, 

Trit., et div. in chartulas xxiv. 
Sig. — One twice daily. 



gr. ss. 
gr.l. 



; . Hydrarg. Chlor. Mitis, . , 
Sacchari Lactis, q. s. 

Trit., et div. in chartulas x. 
Sig. — One powder daily. 



gr- 



R . Morphinse Sulph. , . . . 
Sacchari Lactis, .... 
Trit., et div. in chartulas viij. 
Sig. — One every six hours. 



g r -J- 
gr. xvj. 



. Acidi Arsenosi, gr. ss. 

Sacch. Lactis, gr. xl. 

Trit. , et div. in chartulas xx. 
Sig. — One powder thrice daily. 



Trochisci, Troches, — also called Pastilles, Tablets, or Lozenges, — are 
small flattened cakes of medicinal substances, prepared from a mass 
made with a basis of Sugar, some having Mucilage of Tragacanth, others 
Orange-flower Water, Syrup of Tolu, etc., as excipients. They are con- 
venient preparations for the pocket-case, and are especially useful when 
the active ingredients are intended to come into contact with the mucous 
surface of the throat. There are 15 official Troches, named as follows, 



Trochisci Acidi Tannici. 

Trochisci Ammonii Chloridi. 

Trochisci Catechu. 

Trochisci Cretse. 

Trochisci Cubebse. 

Trochisci Ferri. 

Trochisci Glycyrrhizse et Opii. 



Trochisci Ipecacuanhse. 
Trochisci Kramerise. 
Trochisci Menthse Piperitse. 
Trochisci Morphine et Ipecacuanha?. 
Trochisci Potassii Chloratis. 
Trochisci Santonini. 
Trochisci Sodii Bicarbonatis. 



Trochisci Zingaberis. 



Troches and Tablets are not readily compounded at the dispensing 



PHARMACEUTICAL PREPARATIONS. 



563 



counter, but may be obtained in all first-class shops, being prepared in 
great variety by the manufacturers. Besides the official Troches, those 
named in the following list are generally for sale : — 

Compressed Tablets. 

Ammonium Chloride, gr. iij. 

Charcoal, gr. x. 

Cocaine Hydrochlorate, gr. \, etc. 

Dover's Powder, gr. v. 

Mercury, Yellow Oxide, gr. T i^. 

Pepsin and Pancreatin. 

Potassium Bicarb., gr. v. 

Potassium Chlorate, gr. v. 

Potas. Chlorate and Borax, aa gr. 2^. 

Potas. Chlorate and Ammon. Chloride. 

Spencer's Chloramine Pastilles. 

Sodium Bicarb., gr. iv, Ammon. Carb. , gr. 

X, 01. Menth. Pip., gtt. ]/ 6 . 
Sodium Salicylate, gr. iij. 
Antiseptic, Hydrarg. Chlor. Corr. , gr. vijss. 
Fehling's Test for grape-sugar in the urine. 



Troches [Lozenges). 

Alum, gr. ij. 

Alum, gr. \y z , Catechu, gr. ij. 

Ammonium Chloride, gr. ij, and Cubeb, 

g r - J- 
Ammon. Chlor., gr. ij, Liquorice, gr. viij. 
Benzoic Acid, gr. ]/ 2 . 
Borax, gr. iij. 

Bismuth, gr. ij, and Charcoal, gr. v. 
Bronchial, — Oleores. Cubebae, gr. A, Tolu, 

gr. A, 01. Sassafras, gr. T L, and Ext. of 

Liquorice, gr. vij. 
Brown Mixture. 
Carbolic Acid, gr. j . 
Ginger and Sodium Bicarbonate. 
Guaiac, gr. ij. 
Kino, gr. ij. 
Lettuce, gr. j. 
Lime-juice. 
Logwood, gr. ij. 
Magnesia, gr. iij. 
Pellitory, gr. j. 
Pepsin, gr. iij, Charcoal, gr. iij, Magnesia, 

gr. ij, and Ginger, gr. j. 
Potassium Bitartrate, gr. iij. 
Potassium Citrate, gr. iij. 
Santonin, gr. )/ 2 , and Calomel, gr. y z . 



Hypodermic Tablets. 

Morphine Sulphate, gr. ^ to \- 
Morph. Sulph. and Atropine Sulph. 
Atropine Sulphate, gr. airo" sV 
Strychnine Sulphate, gr. yi^-. 
Apomorphine Muriate, gr. 2V" To- 
Pilocarpine Muriate, gr. -%-§—\. 
(And several others.) 



Unguenta, Ointments, — are soft, fatly mixtures of medicinal agents 
with a basis of lard, petrolatum, or fixed oils with a solid fat such as wax 
or spermaceti. They are intended for application to the skin by inunc- 
tion, and have a melting point which is below the ordinary temperature 
of the human body. Of the 23 official Ointments 1 is prepared by chem- 
ical reaction (Unguentum Hydrargyri Nitratis), 3 by fusion and 17 by 
incorporation of the ingredients with each other by mixing them by 
trituration or through the agency of a spatula and a porcelain slab. Un- 
guentum itself is prepared by fusing together 80 of Lard and 20 of 
yellow Wax, and is the basis of 3 other ointments, while 14 have Benzo- 
inated Lard as their basis. 



Unguentum. 

Unguentum Acidi Carbolici (5). 
Unguentum Acidi Tannici (20). 
Unguentum Aquae Rosae. 
Unguentum Belladonnae (10). 
Unguentum Chrysarobini (5). 
Unguentum Diachylon. 
Unguentum Gallae (20). 
Unguentum Hydrargyri (50). 
Ung. Hydrargyri Ammoniati (10). 
Ung. Hydrargyri Nitratis (7). 

Unguentum 



Ung. Hydrargyri Oxidi Flavi (10). 
Ung. Hydrargyri Oxidi Rubri (10). 
Unguentum Iodi (4). 
Unguentum lodoformi (10). 
Unguentum Picis Liquidae (50). 
Ung. Plumbi Carbonatis (10). 
Ung. Plumbi Iodidi (10). 
Ung. Potassii Iodidi (12). 
Unguentum Stramonii (10). 
Unguentum Sulphuris (30). 
Unguentum Veratrinae (4). 
Zinci Oxidi (20). 



564 PHARMACEUTICAL PREPARATIONS. 

The figures in parentheses show the percentage of extract or other 
active ingredient in the ointment. The composition of each may be 
found in the section on Materia Medica under the title from which the 
preparation is named, except Unguentum, which will be found under the 
title Adeps, and Unguentum Diachylon under Plumbum. 

Ointments and Cerates are frequently ordered on extemporaneous for- 
mulae, though the numerous official preparations of these classes would 
seem to give the physician a sufficiently wide field for selection. The 
basis used is usually either the official Ceratum or Unguentum, but Petro- 
latum, Lard, Lead Plaster with a fixed oil, etc., may be used. Lard is 
probably the best basis for all ointments, as it softens the skin better than 
any other similar substance. Its disadvantage is that it soon becomes 
rancid, so that preparations made with it must be quickly used. Cerates 
only differ from ointments in their firmer consistence, melting at tem- 
peratures above 104 F., while the latter melt below the ordinary tem- 
perature of the body. Oleaies are described fully on page 90. 

The process of compounding an ointment or a cerate is sufficiently sim- 
ple, being generally a mere maUer of triturating the ingredients together 
in a mortar, or of their incorporation on a slab by means of a spatula. 
Rarely will melting be required in the compounding of extemporaneous 
ointments. When extracts, powders or gritty substances are ordered, the 
ingredients should be first pulverized into a fine powder, then triturated 
with a small quantity of the basis into a smooth, impalpable paste ; the 
remainder of the basis being added gradually, until the whole is thor- 
oughly incorporated. A warm mortar may be required for hard extracts. 
Soluble salts should be triturated with a little water before adding the 
excipient. Camphor needs a little alcohol to enable it to be pulverized; 
and Iodine should be rubbed to a fine powder, then a little alcohol 
added and finally the excipient by degrees. Sulphur Iodide requires 
persevering work with a small portion of olive oil. Borax should be 
triturated with glycerin and Red Mercuric Oxide with distilled water. 
A bone or horn spatula should be used for all ointments, as steel or iron 
blades will injure many substances, particularly alkaloids, free acids, tan- 
nin or iodine, and several of the mercurial salts. Volatile substances 
should be added last, and quickly worked in, so that their evaporation 
may be as slight as possible. 

Ointments are dispensed usually in amber-colored glass pots with wooden 
or metallic covers, or in porcelain jars called Gallipots. In hospital and 
dispensary practice the common chip pill-box is used, but soon becomes 
•excessively dirty and disagreeable to handle. 



PHARMACEUTICAL PREPARATIONS. 



565 



Ungucntum Iodoformi Compositum. 

. Iodoformi, gj. 

Ol. Anisi, rr^xx. 

Ol. Rosre, 

01. Ylang-ylang, . . . aa Vf\ v. 

Ung. Aquae Ros?e, . . . j|j. 
M. Fiat unguentum. 
Sig. — Ointment. 



Unguentum Anti-pruriticum. 

r& . Camphorae, 

Chloralis Hydrat. , . aa v > ). 
Tere una ad liquorem, dein 
adde cum tritu — 

Unguenti Aquae Rosae, . ^j. 
M. Fiat unguentum. 
Sig. — Ointment for itching. 



Vina, Wines, — when medicated are practically the same as tinctures. 
The menstruum directed to be used is the official White Wine (Vinum 
Album), which should contain from 10 to 14 per cent, by weight of abso- 
lute alcohol. It is, however, reinforced by the addition of alcohol to the 
amount of 15 per cent, in all the medicated wines except that of Ipecac, 
which has 10 per cent. In the two Ferric Wines the alcoholic reinforce- 
ment is in the shape of the tincture of sweet orange peel. The official Wines 
are 10 in number, 2 of which are not medicated, and stand first in the 
following list • four are prepared by solution or admixture, 2 by percola- 
tion and 2 by maceration during seven days. They are named as fol- 
lows : — 



Vinum Album, 10-14. 
Vinum Rubrum, 10-14. 
Vinum Antimonii, 0.4. 
Vinum Colchici Radicis, 40. 
Vinum Colchici Seminis, 15. 



Vinum Ergotae, 15. 
Vinum Ferri Amarum, 5. 
Vinum Ferri Citratis, 4. 
Vinum Ipecacuanhae, 10. 
Vinum Opii, 10. 



The figures placed after the first two show the percentage of absolute alcohol by weight 
required in each ; those placed after the others indicate the quantity of the principal in- 
gredient in grammes to each 100 cubic centimeters of the preparation. 



PART III. 



SPECIAL THERAPEUTICS. 



Authorities. The principal authorities to whom references are made, 
with their initials, are included in the following list. When a statement 
is not followed by any reference by name or initial, it is to be understood 
as coming from the writer of this book. 

References and Bibliography. 

(A) Aitken. — The Science and Practice of Medicine, by Wm. Aitken. 

(Ag) Agnew. — The Principles and Practice of Surgery, by D. Hayes Agnew. 

(B) Bartholo-iv. — Materia Medica and Therapeutics ; also On the Antagonism between 

Medicines and between Remedies and Diseases, by Roberts Bartholow. 
(Br) Briinton. — Pharmacology, Therapeutics and Materia Medica, by T. Lauder Brunton. 

(C) Carter. — A Practical Treatise on Diseases of the Eye, edited by Green. 
(CI) Clarke. — A Manual of the Practice of Surgery, by W. Fairlie Clarke. 

(DaC) Da Costa. — Notes of Clinical Lectures, delivered by Professor J. B. Da Costa at 
the Pennsylvania and Jefferson Hospitals. 

(D) Druitt. — A Manual of Modern Surgery, by Robert Druitt. 

(E) Emmet. — Principles and Practice of Gynaecology, by Thos. Addis Emmet. 
(El) Ellis. — A Practical Manual of Diseases of Children, by Edward Ellis. 

(F) Eothergill. — The Practitioner's Handbook of Treatment, by J. M. Fothergill. 

(G) Goodell. — Lessons in Gynaecology, by William Goodell. 

(H) Ha7)iilton. — Nervous Diseases, etc., by Allan McLane Hamilton. 

(L) Leishman. — A System of Midwifery, by William Leishman. 

(M) Murrell. — A Manual of Pharmacology and Therapeutics, by Wm. Murrell. 

(M & P) Meigs a?id Pepper. —Diseases of Children, by J. F. Meigs and Wm. Pepper. 

(N) Niemeyer. — A Text-book of Practical Medicine, by Felix von Niemeyer. 

(O) Osier. — The Principles and Practice of Medicine, by Wm. Osier. 

(P) Phillips. — Materia Medica and Therapeutics, by Chas. D. F. Phillips. 

(Pf ) Piffard. — Materia Medica and Therapeutics of the Skin, by H. G. Piffard. 

(R) Ringer. — A Handbook of Therapeutics, by Sidney Ringer. 

(Ros) Rosenthal. — Diseases of the Nervous System, by M. Rosenthal. 

(S) Stillt. — Therapeutics and Materia Medica, by Alfred Stille. 

(St) Sturgis. — The Student's Manual of Venereal Diseases, by F. R. Sturgis. 

(T) Tanner. — An Index of Diseases and their Treatment, by Thos. H. Tanner. 

(Tr) Trousseau and Pidoux. — On Therapeutics, by Trousseau, Pidoux, and Paul. 

(Tt) Tait. — Diseases of Women, by Lawson Tait. 

(W) Wood. — Therapeutics, its Principles and Practice, by H. C. Wood. 

(Wa) Waring. — Practical Therapeutics, edited by Buxton. 

(Y) Yeo. — A Manual of Medical Treatment, by I. Burney Yeo. 

Besides the above-named, occasional references are made to other works by the same 
authors. References will also be found, with names in full, to Anstie, Brown-Sequard, 
Clymer, Cohen, Flint, Fordyce-Barker, Gross, Hammond, Hilton, Lister, Loomis, Mitch- 
ell, Nelaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, A. A. Smith, Thomas, and 
many names of writers in current medical literature. 

566 



ABASIA ABDOMINAL PLETHORA ABORTION. 567 

Applied Therapeutics may be studied either with the various thera- 
peutic agents as the objects of chief consideration, as in the first part of 
this work; or with the different diseases and morbid conditions forming 
the objects of study in respect to their modification and treatment by 
medicines. In the following pages the latter method is followed, the 
therapeutics of each affection being exhibited in the form of an Analyti- 
cal Index to the recognized text-books of the day. Every indication for 
the use of a drug, or statement regarding its value, is followed by the 
name or initial (in parenthesis) of its author : these references enabling 
the book to be used as an Index to the Authorities, for more strict differ- 
entiation between indicated remedies, — while the brief analyses given 
include sufficient material to make each section a synopsis of the most 
advanced therapeutics of the disease named in its title. 

Abasia and Astasia. 

Sodium Phosphate, by hypodermic injection, once a day for 25 days, cured 
a case of unilateral abasia-astasia (Charcot's " neurasthenie dimidiee "), in the 
municipal hospital at Jerusalem. The patient should be taught to walk as 
one teaches an infant, and compression of the posterior region of the trunk 
may be made with an appropriate bandage (Roux). [Compare Hysteria.] 

Abdominal Plethora. 

Cathartics, saline and hydragogue cathartics are of value in congestion of 
the portal circulation (B). Saline Mineral Waters, especially the purgative 
saline waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B). 
Grape-cure has helped many cases, particularly those of hepatic engorge- 
ment and sluggish portal circulation ; is best used after a preliminary course of 
powerful mineral waters (P). Aliment is very important ; a dry diet is particu- 
larly indicated in cases of dyspepsia and hepatic enlargement due to excessive 
beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich 
sauces, solid vegetables, especially cucumbers, soups and fruits. Biscuits, 
fresh meat, lemons, fish, fowl and game, may be used. [Compare Hepatic 
Congestion, Obesity.] 

Prescriptions. 

R. Potassii Bicarbonatis, I R. Resinae Podophylli, . . . gr. vj. 

Sodii Sulphatis, .... aagiv. Ext. Colocynthidis Co., . gr. xij. 

Solve in Ojss Aquae, et adde — Ext. Belladonnae Fol. 

Acidi Tartarici (cryst.), . . ^ij. Alcoh., gr. iij. 

Cork quickly and firmly. y^d to be Fiat massa, et div. in pil. no. xij. 

taken thrice daily. Sig. — One pill every night. 

Abortion. 

Opium, cautiously in threatened abortion, is often very valuable (Wa) ; the 
tincture, rt^xx-xxx by rectum (Parvin) ; Opium to check uterine action and 
Ergot to restrain hemorrhage (B). Ergot, small tonic doses give excellent 
results in threatened abortion (P). Tannin, combined with Opium and Ipecac 
(W). Cimicifuga, to prevent miscarriage when uterus is irritable and pro- 
lapsed (R). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, 
one of the most powerful remedies against the hemorrhage indicative of ap- 
proaching abortion (Wa) ; the tincture in doses of 5 to 10 drops, every }4 to 3 



568 ABSCESS. 

hours, useful against the hemorrhage (P). Viburnum Prunifolium, in threat- 
ened and habitual abortion, has a very high reputation. Aurum Chloride, to 
avert the tendency to habitual abortion (B). Iron, with Potassium Chlorate, 
throughout the pregnancy, when fatty degeneration the cause of habitual abor- 
tion (McLane). Asafcetida, is highly efficient in habitual abortion ; given in 
pills of gr. jss each, 2 daily, gradually increased to 10 daily, as soon as a new 
pregnancy occurs, and continued until the labor is over (Turazzo). Tampon- 
ade, of the cervix uteri, with cotton or sponge, dipped in vinegar or glycerin, 
when abortion is inevitable and it is desirable to hasten it and restrain hemor- 
rhage. Empty the uterus thoroughly with the finger, placenta-forceps liable 
to do harm (Barker). Abortifacients (see pages 56 and 295) ; Quinine and 
Ergotin, of each gr. ij in pill every 3 hours, the routine abortifacient of many 
irregular practitioners. Only by the production of such violent irritation of the 
abdominal and pelvic organs as generally endangers life, can the pregnant 
uterus be stimulated to expel its contents (P). The abortifacient effect of 
Savine and other drugs cannot be obtained unless by the administration of a 
quantity sufficient to endanger life (B). 

Prescriptions. 
R . Ext. Ergotse Fluidi, . . . 3 v. | R. Acidi Tannici, gr. xv. 



Tinct. Opii Deodorat., . . £iij. 

Syrupi Limonis, ijjj. 

M. Sig. — A teaspoonful thrice daily. 



Pulv. Ipecacuanha, . . . gr. xij. 

Extracti Opii, gr. iij. 

Ft. pil. xij. Sig. — One every six hours. 



Abscess. 

Poultices to check or to assist in maturation ; may be smeared with Bella- 
donna or Opium (R). Belladonna, as plaster to subdue (B) ; painted around 
areola (Wa) ; internally often successful in aborting abscesses (R). Calcium 
Sulphide, half-grain doses frequently repeated, to abort abscess or to hasten 
formation of pus (B) ; gr. T ^ every hour or two, gives striking results in healing 
large abscesses (R). Calcium Phosphate, in large abscesses (R). Mercury 
and Morphine, the Oleate locally, diminishes induration due to old abscesses 
and prevents the formation of new ones (R). Carbolic Acid, a weak solution 
as injection after evacuation, also as a dressing (Lister). Silver Nitrate, a 
strong solution in Nitrous Ether if applied early to adjacent surface will check 
inflammation (B). Blisters or Iodine, as counterirritants around or adjacent 
to seat of disease (R). Potassium Permanganate, 3j to the pint of water, to 
correct fetor (B). Iodine, the tincture injected after opening large abscesses 
(R) ; especially in scrofulous abscess (Wa). Salicylic or Boracic Acid, as 
dressings (B). Sarsaparilla, a very useful remedy in chronic abscess with pro- 
fuse discharge (P). Cod-liver Oil, improves and lessens discharge from scrof- 
ulous abscesses (Wa). Surgical. Opening necessary in all deep abscesses, 
or when on face, near anus, mammary, or if danger of its opening into an in- 
ternal cavity. Open with grooved director and forceps ; never open a deep 
abscess with a plunge (Hilton). Drainage-tube may be required, also irriga- 
tion of the cavity and pressure (Agnew). Weaning of child necessary in 
chronic mammary abscess (Gross). Psoas abscess may result from strain or 
laceration of muscle, as by heavy lifting, effort to recover balance when skat- 
ing, etc., as well as from spinal disease ; the symptoms are often obscure, sim- 
ulating those of chronic malaria. Early opening by lumbar incision neces- 
sary ; then tonics, good food, and daily irrigation of the cavity with an 
antiseptic solution. [Compare Suppuration, Carbuncle.] 



P?-escriptions. 



R . Syrupi Ferri, Quininae et 

Strychnines Phosphatum, Jf yj. 
Sig. — A teaspoonful in water thrice daily. 
To repair waste from suppuration. 



R. Syrupi Hypophosphitum, . Bjvj. 
Sig. — A dessertspoonful thrice daily. 



ACIDITY ACNE. 



569 



Quinine Sulph., %). 

Ferri Pyrophosphatis, . . . gj. 

Strychninae Sulph., . . . . gr. j. 

Ac. Phosphor. Dil., . . . gij. 



Syrupi Zingiberis, 
Aquae, q. s. ad . 



3 J J- 



M. Fiat mistura. 
thrice daily. 



Sig. — A teaspoonful 



Acidity. 

Acids, Hydrochloric or Phosphoric before meals; acid wine, a genuine 
Rhine wine best ; Sulphurous Acid ttlv-xxx well diluted, for acid fermentation 
of starchy foods (R) ; acids after meals for alkaline pyrosis (R). Tannic Acid, 
useful in pill, gr. iv with Try of Glycerin (B). Carbolic Acid, often arrests 
eructations (B). Alkalies, atter meals, for immediate relief, effects only tem- 
porary, Bicarbonates best (R) ; frequent use of alkalies enhances the mischief 
(B). Nux Vomica, l^ij-iij of tincture before meals ; is excellent in small doses 
(B) ; especially in acidity of pregnancy (R). Pulsatilla, Tl\,v of tincture every 
4 hours in acid dyspepsia (P). Silver Oxide, extremely useful (B). Man- 
ganese Oxide, gr. x-xx of the purified black oxide relieves (B). Kino, a favorite 
remedy (B). Ipecacuanha, in acidity of pregnancy (R). Mercury, gr. ss of 
gray powder thrice daily, when acidity with clayey stools (R). Atropine, the 
sulphate, thrice daily by mouth, gave excellent results in a case of gastric hy- 
persecretion of acid ; after the third day pain had stopped and vomiting 
ceased. Bismuth, gives excellent results, combined with Opium or Morphine, 
sometimes with Magnesia (R). Diet, use lemon-juice, aerated or old bread, 
plain biscuits ; avoid new bread, pastry, and vegetables. 



R. Bismuthi Subnitrat., . 

Acidi Carbolici, . . . 

Mucil. Acaciae, . . . 

Aquae Menth. Pip., . 
M. Sig. — A tablespoonful 
daily for adults. 



Prescriptions. 

R. 



3"j- 




gtt. ij- 


" v - 


2j- 




g"j- 




or 4 


times 



Sodii Bicarbonatis, . . ^ij. 
Spt. Ammonise Aromat. , % ij. 
Tinct. Zingiberis, . . . %]. 
Infus. Gentianae Co. (U. 

S. P., 1870), q. s. ad, J^viij. 
M. Sig. — A tablespoonful or two. 



Acne. 

Alkalies, internally, yield the best results in a number of cases (Bulkley) ; 
alkaline lotions for cases with seborrhcea (B). Borax, a weak solution in rose- 
water (Sj-^viij), of great benefit locally in acne simplex (Wa). Potassium 
Bromide, in moderate doses, has proved curative in some obstinate cases (R). 
Sulphur, internally and as a lotion ; in severe forms an ointment of the Iodide 
or Hypochlorite, Z'\] ad Jj (R). Belladonna, locally, is of some service, 
checking the abundant secretion from the sebaceous follicles (R). Arsenic, in 
old cases, especially in acne indurata, but often disappoints; given with Brom- 
ides it prevents the bromic acne (R) ; Arsenic Bromide is adapted to most cases 
of acne vulgaris (Pf). Phosphorus, is an excellent substitute for arsenic (B) ; 
the compound syrup of the Hypophosphites in acne indurata (R). Mercury, 
in lotion, is much employed (B) ; a weak lotion of the Bichloride to the face two 
or three times daily (R) ; the Iodo-chloride (gr. v-xv ad ^) as irritant applica- 
tion (Fox) ; or ointments containing the Bichloride or Biniodide may be 
employed instead of the green soap application (Pf). Glycerin, internally, has 
been used with success (B). Berberis, rr^ v of a fresh tincture thrice daily for 
the acne of girls at puberty. Calcium Sulphide is indicated in cases character- 
ized by a tendency to pustulation (Pf ). Bismuth, locally as a cosmetic (B). 
Magnesium Sulphate, as a purgative daily before breakfast, in cases of acne 
vulgaris depending on derangement of the stomach and bowels (Duhring) ; the 
salt, finely triturated, is an excellent dusting-powder and in five-grain doses 
internally, 3 or 4 times a day, is often very efficient in acne vulgaris and other 
obstinate eruptions due to derangement of the gastro-intestinal tract. Ergot, 



570 



ACNE ROSACEA. 



is well used in various forms of acne (See Acne Rosacea). Sapo Mollis, as an 
active irritant in subacute cases, applied every night as long as bearable, then 
emollients until irritation subsides, when the soap should be removed (Pf). 
Water, hot sponging for 15 or 20 minutes several times a day, followed by Gly- 
cerite of Starch to allay irritation (R) ; the local use of very hot water is of the 
greatest benefit in all inflammatory forms of acne (Bulkley). Puncturing each 
papule with a lancet point, followed by very hot water, and ointments of Sul- 
phur Iodide, Ammoniated Mercury, etc., diluted (Pf). Diet and Hygiene, 
require careful attention (B) ; powerful tonics are often required (Bulkley). 
[Compare Acne Rosacea, Seborrhcea.] 



Preset', 



R • Potassii Acetatis, . . 

Tinct. Nucis Vomicae, 

Ext. Rumicis Fluidi, . 
Misce. Sig. — A teaspoonful, largely di 
luted, half an hour before meals. 



gss-j. 
3*. 



iptions. 

R. 

M 



R. 






M 



Potassii Acetatis, . . . 
Tinct. Nucis Vom. , . . 
Infusi Quassiae, vel 
Tinct. Cinchona? Co., ad ,^iv. 
Sig. — Teaspoonful in water 



ifter 



meals, as an antacid tonic. 



R . Magnesii Sulphatis, . . ,^jss. 

Ferri Sulphatis, . . . . gr. xvj. 

Acidi Sulphurici, . . . ^ij. 

Aquae, . . . . q. s. ad jfviij. 
M. Sig. — A tablespoonful in a glass of 
water before breakfast. 



Sulphuris, %]. 

Glycerini, J|j. 

Aquae Rosae, ^ vij . 

Siaf. — Lotion. 



gr- 



R . Hydrarg. Chlor. Corr. 
Alcoholis, q. s. 
Aquae Destil., . . . . % ij. 
M. Fiat sol. Sig. — A teaspoonful in 
% pint of water as a lotion, twice daily. 



R. Bismuthi Subnit., . . . 3J. 

Ung. Hydr. Ammoniat., ^ij. 

Ung. Aq. Rosae, . . ad £]. 
M. et fiat unguentum. 



R . Hydrarg. Iodo-chlor. , . gr. v-xv. 

Adipis, j5j. 

Fiat unguentum. An irritating applica- 
tion, requiring care. 



Acne Rosacea. 

Resorcin, as paste, with equal part of Zinc Oxide, applied to the affected 
part several times a day, to promote peeling of the skin in the treatment of 
acne rosacea; in 3 or 4 days the skin becomes like parchment, when the appli- 
cation must be stopped to avoid cracking of the skin, and a dressing of gelatin, 
glycerin, zinc oxide, and hot water is applied, covered with cotton wool ; in a 
few days the dressing will come off, bringing the skin with it. Some few dan- 
gerous results have followed this practice, but there have been a number of 
very satisfactory cases (Unna). Ergot is well used in acne rosacea and other 
forms of acne; a good fluid extract with glycerin and water, giving ^ss inter- 
nally per diem (B). Magnesium Sulphate, finely triturated, is an excellent 
dusting-powder for cases of acne rosacea; and in 5-grain doses thrice daily 
internally (See Acne). Bismuth, the Oleate as an ointment, and the greased 
surface powdered over with a mixture of Oleate of Zinc, Bismuth Subcarbonate 
and Starch (Shoemaker). Antipyrin, with Coca, often gives marked relief, when 
abnormal irritability of the gastric nerve endings leads to vaso-motor disturb- 
ances of the nose and face (Whitla). Bromides, with Arsenic, for women, 
when acne rosacea due to cessation of menstruation (Id). Electricity, the gal- 
vanic current, 5 to 8 elements of an ordinary battery, both poles applied to the 
nose and continually moved about, or the anode on the zygoma and the nose 
gently stroked with the cathode ; these applications repeated once in 2 or 3 
days, for at least 10 to 15 sittings, have proved uniformly successful in 31 cases 
(Helbing). Chloral will aggravate rosacea. 



ACTINOMYCOSIS ADDISON S DISEASE ADYNAMIA. 



571 



R. 



M 



meals. 



Antipyrini, .... 
Extr. Cocae Fluidi, 
Tinct. Aurantii, 
Glycerini, . . . . 
Sig. — 3J thrice 



55- 



Prescriptions. 



aa 3J. 

daily between 
(Whitla.) 



M 



Potassii Iodidi, .... gr. xl. 
Potassii Bromidi, . 
Liq. Acid. Arsenosi, 
Tinct. Sumbul, . . 
Aquae Camphorae, . ad ^xij. 
Sig. — ^ ss in water after meals. 



3Jss. 

'J- 



Actinomycosis. 

Sodium Salicylate, produces amelioration of symptoms (Netter). Potassium 
Iodide, in full doses, 80 grains daily at first, diminished as its physiological effect 
is produced, is promptly curative, acting probably by augmenting tissue resist- 
ance. This drug has cured six human cases in Holland, and one in France ; 
also 71 out of 185 oxen so treated in Chicago (Netter). 



Addison's Disease. 

Arsenic, with cod-liver oil, gives the best results (Da C). Iron and other 
tonics are useful, especially a combination of the chloride, glycerin and chloro- 
form (Greenhow). Phosphorus, has seemed to exert a beneficial influence 
(Wilks). Adrenal Extract has been employed in a few cases with some benefit 
while used (See page 138). 

Treatment must be symptomatic, and is of little use, the disease being always 
fatal (H). 

Prescription. 



R. Tinct. Ferri Chloridi, 

Spt. Chloroformi, . . aa^j. 
Glycerini, J v j- 



M. Sig.- 
thrice daily. 



-A dessertspoonful in water 
(Green/wzv.) 



Adynamia. 

Cinchona, or Quinine, with Arsenic, for pale, badly-fed town-dwellers (R) ; 
as a general tonic when flesh flabby, skin perspiring (P). Arsenic, for swelled 
feet of old or weakly persons, and breathlessness from weak heart (R) ; as a 
tonic in continued doses of gr. -£$ to -^ (Wa). Nux Vomica, in adynamia of 
drunkards ; Tinct. Capsici gvj ; Tinct. Nucis Vom. 3'\] ; gtt. xx in water every 
four hours (B). Calcium Phosphate, when from prolonged town-life or over- 
work ; gr.j with grain j each of Iron Phosphate and Calcium Carbonate as a 
dose (R) ; Hypophosphites, of Lime or Soda, in nervous or general debility 
(R). Iron, promotes appetite and digestion; gr.j-iij of the Sulphate, or the 
official Iron and Aloes pill, or with Manganese (B) ; anaemic subjects (R). 
Hydrastine, as substitute for Quinine, to promote appetite and digestion and 
improve assimilation (B). Digitalis or Eucalyptus, in debility with weak heart 
action (B). Bitters, especially Calumba and Gentian, are useful for a short 
time (B). Sanguinaria, when stomach needs stimulation (P). Sarsaparilla, in 
broken-down, syphilitic constitutions (P). Orchitic Extract. [See page 136.] 
Alcohol is of great value, but has been abused ; hurtful when it increases tem- 
perature and pulse, dryness of tongue, etc. (B) ; a wine with much ether in 
debility of old age, especially where sleeplessness, indigestion and stomach 
cramps (R). Aliment, sugar and saccharine fruits, vegetables, oil, milk, cod- 
liver oil, wine of good body and strength (B) ; Porter or Rum-and-milk for 
town-living women (R). Sea-bathing is useful in chronic illness, with much 
debility (R). Turkish Baths, when debility is caused by the tropics, but caution 
necessary ; when town-dwellers become stout and flabby, are easily tired, suffer 
from alack of energy and from mental depression, a course of baths is bene- 
ficial (R). [Compare Anemia, Convalescence, Neurasthenia.] 



572 



AFTER-PAINS AGALACTIA ALBUMINURIA. 



Tonic Prescriptions. 



R . Liq. Potas. Arsenitis, . . n\x. 

Ext. Nucis Vom. Fluidi, . rt^xx. 

Tinct. Gentianae Compos. , 

Tinct. Cinchonas, 

Tinct. Calumbse, 

Vini Kobe, aa^iv. 

M. Sig. — A wineglassful after each 
meal. 

R. Tinct. Nucis Vom. , . . . j^ij. 
Tinct. Cinchonas, . . . adgiv. 
M. Sig. — A teaspoonful after each 
meal. 



R • Acidi Arsenosi, . . 
Quininae Sulphat. , 
Ferri et Potass. Tart. 
M. Ft. pil. no. xxx. 

after each meal. 



R 



Quininae Sulph., 
Strychninse Sulph., 
Tr. Ferri Chloridi, 
Ac. Phosph. Dil., . 
Syr. Limonis, . 



- gr-J- 

• 3J- 

Sig. — One pill 



3J- 

g r - j- 

l 1J : 

ad£ vj. 



M. Sig. — A teaspoonful in water thrice 
daily, in nervous debility. 



After-pains. 

Opium, more certain in action than any other remedy (Wa) : Morphine and 
Atropine (gr. 1 /- an d gr. y^y), combined (B), hypodermically (Wa). Belladonna, 
as ointment, much used in France (L). Camphor, gr. x with gr. }i of Mor- 
phine, an effective remedy (B) ; ^j in ^vj of mucilage, tablespoonful doses 
every hour or two (Wa). Chloral, will stop the pains, but large doses (gr. 
xx-xl) are necessary (R). Chloroform, the Linimentum Chloroformi, jfj with 
Linim. Saponis ^vj, applied on flannel to the abdomen (Barker). Quinine, gr. 
v-x night and morning, with the above chloroform liniment locally, in neuralgic 
after-pains which do not yield to opiates, the uterus being tender on pressure 
(Barker). Gelsemium, suspends them, large doses (rr^xx) necessary (B). Cimi- 
cifuga, relieves the pains, and allays general nervous excitement (P). Ergot 
is better than Cimicifuga (R). Poultices, warm, over the hypogastrium, with 
soothing injections into the vagina (L). 



Agalactia. 

Ricinus, gr. v of extract, or 3j-ij of strong decoction, daily in water; also 
the leaves, or an infusion, locally to mammae (T). Gossypium, an emulsion of 
the seeds has repute in India, as a galactagogue ; a wineglassful of the decoc- 
tion every 20 or 30 minutes (P). Pilocarpus, remarkably increases the secre- 
tions (B) ; Pilocarpine is a galactagogue, and probably the only example of this 
class we possess, it distinctly increasing the secretion of milk in nursing women 
(M). Tea, a good black tea is thought to promote the milk supply. [Compare 
Lactation.] 

Albuminuria. 

Aconite, in incipient albuminuria with high body temperature (R). Lead, 
diminishes the albumen (R). Turpentine, gtt. ss-j, every 2 to 4 hours, or one to 
two drop doses night and morning, of great value in chronic albuminuria with- 
out other marked symptoms of Bright's disease (P). Gallic Acid, the most 
efficient agent in the acute form to restrain loss of albumen (P). [See Aitken's 
formula below.] Cannabis Indica is indicated when bloody urine (R). Chim- 
aphila, has unquestioned power over albuminuria (P). Cantharis, TT\j of the 
tincture every 3 hours, after the subsidence of acute symptoms, especially when 
bloody urine (R). Fuchsin, in doses of gr. j-iij, completely arrested albumin- 
uria with oedema in many cases (Bouchut). Alkalies, the citrates and acetates 
as diuretics (R); the Buffalo Lithia Water of Virginia is highly recommended. 
Strontium Lactate, has been used with benefit, but should not be given when 
scanty urine or symptoms of unemia are present. Nitro-glycerin, Try of a one 
per cent, solution to dilate the peripheral vessels, relieving the heart and les- 
sening the renal congestion (B), Turkish Baths, benefit by relieving the 



ALCOHOLISM. 573 

kidneys of work (R). Milk-cure, with buttermilk, has proved very efficient in 
many cases (B). Chalybeate Waters, especially those having purgative quali- 
ties, are beneficial (B). [Compare Bright's Disease.] 

Prescriptions. 

R- . Acidi Gallic!, 3J _, j- R Liq. Ferri et Ammonii 

Ac. Sulphurici Dil., . . ^ ss. Acetatis (U. S. P. ), . 3VJ. 

Tinct. Lupuli, . . . . J^j. Sig. — Teasp. to a tablesp. according to 

Infusi Lupuli, • q. s. ad ^vj. | age, well diluted, thrice daily. 

Sig. — Tablesp. thrice daily. — (Aitken.) \ (Eas/iam.) 



Alcoholism. 

Arsenic, for distressing vomiting, one drop of Liquor Arsenicalis (Fowler's 
solution), before breakfast (R). Capsicum, in dyspepsia of chronic alcoholism, 
and to induce sleep; also as a substitute for the alcohol; with Bromides or 
Arsenic and bitters to assist in overcoming habit, by removing the distress at 
pit of the stomach ; the tincture in 10-minim doses should be taken shortly 
before meals, or whenever there is depression or craving for alcohol ; it obvi- 
ates the morning vomiting, and promotes appetite and digestion (R). Ammo- 
nia, a full dose (Jss) of the spirit will often sober a drunkard speedily (R); 
a few drops of Liquor Ammoniae, diluted, have prompt action (S) ; gj of the 
aromatic spirit with Capsicum (see formula below). Ammonium Chloride, is 
remarkably efficient in straightening up a subject of acute alcoholism ; 3ss in 
Yz pint of water, swallowed at one draught, by a patient on the verge of deli- 
rium tremens, is said to quickly restore the faculties. Ammonium Acetate, 
the solution, in full doses, is one of the most efficient agents for quickly straight- 
ening up a drunkard. Hydrastine, the sulphate in doses of gr. -fa increased to 
gr. -fo, hypodermically four times a day, is one of the "cures." and has been 
used for this purpose in Canada for many years. Aurum and Arsenic Bromide, 
the solution (Barclay's), is an excellent tonic remedy for alcoholism, and may 
be used by hypodermic injection, in doses of itlx four times daily. Kola is a 
good general tonic for cases of chronic alcoholism. Cinchona, especially Cin- 
chona Rubra, for gastric catarrh of drunkards (B) ; Quinine, gr. ij-vj daily to 
raise the nervous tone (P). Nux Vomica, for after stomachal disorders (B) ; 
in the tremor of chronic alcoholism is of much value (P); the tincture in 5-minim 
doses with 15 of Tinct. Capsici, in water every 4 hours, is exceedingly effective 
in diminishing the craving for spirits and sustaining the nervous system. 
Strychnine, the Nitrate, gr. -^"tV hypodermically thrice daily for ten days, is 
an absolute cure for dipsomania (Luton); a very valuable remedy for chronic 
alcoholism and dipsomania, not merely curing the attacks, but abolishing the 
desire for drink, the patients abstaining from spirits of their own accord (Fom- 
brak). [See page 357. J Glycozone, is one of the best remedies for the gastric 
catarrh of chronic alcoholism (Edstm). Potassium Bromide, 3j every 4 to 6 
hours in the " horrors " (B). Phosphorus, in chronic alcoholism, recommended 
by Anstie (R). Opium, cautiously, if at all (B); Morphine with tonics before 
meals for pain, nausea, and want of appetite (R). Cocaine has been pro- 
nounced of great benefit, restoring appetite, inducing sleep and promoting 
digestion, while it soothes the brain and induces a feeling of contentment and 
calm (R). Cimicifuga, is said to be useful in the treatment of the drunkard's 
stomach (R). Chloral is very successful, but must be cautiously used with old 
worn-out drunkards (B). [See page 223.] Picrotoxin, small doses for the 
tremor, gr. ^ repeated (B). Lupulin, is the best substitute for alcohol, and is 
extremely serviceable in delirium tremens (B). Zinc Oxide, is very useful in 
chronic alcoholism, to diminish the craving, to relieve the gastric catarrh and 
lessen the tremor (B). Keeley Injection contains Strychnine and Atropine, 
also Codeine and Cocaine for subjects of the opium-habit. (A T . Y Med. 
Record.) [See under Patent Medicines.] Acute Alcoholic Poisoning [see 
page 114] requires an emetic or the stomach-pump, cold douche to the head 



574 



ALOPECIA AMAUROSIS AND AMBLYOPIA. 



and breast, warmth to the feet and limbs. Artificial respiration may be re- 
quired. Milk, mucilaginous drinks, and black coffee, are the principal reme- 
dies. A milk diet often creates a disgust for alcohol. [Compare Delirium 
Tremens, Vomiting, and Neuritis.] 



Prescriptions. 



R 



Tinct. Capsici, . . . . !f ss. 
Potass. Bromidi, . . . ^ss. 
Vel Liq. Potass. Arsenit., rt\l. 
Vel Tinct. Nucis Vom. , g ij . 
Spt. Ammoniae Aromat. , ,^iij. 
Syr. Tolutani, . q. s. ad. Jvj. 
M. Fiatmistura. Sig. — A dessertspoon- 
ful in water four or five times daily. 



R. Tinct. Nucis Vom., . . ^j. 

Tinct. Gentianae Co. , . . giij. 

Spt. Limonis, ^l v j- 

Spt. Chloroformi, . . . ^j. 

Aquae, . . . . q. s. ad ^vj. 
M. Sig. — One-sixth to be taken 
times daily, for insomnia. 



3 or 4 



R. Zinci Oxidi, ^j. 

Piperini, gr. xx. 

M. Fiant pil. no. xx. Sig. — One 
thrice daily. 



pill 



R. Tinct. Gentianae Co., 
Tinct. Calumbae Co. , 
Tinct. Nucis Vom., . 
M. Sig. — A dessertsp. 

meal, for rum-stomachs. 



R. 



Ext. Lupulini Fl., . . 
Ext. Aromatici Fl., 
Tinct. Capsici, . . . 
Mucil. Acaciae, . 
Aquae Menth. Viridis, 
Fiat emulsum. Sig. — A 
two as required. 



• fjj. 

. mjxxx. 

before each 
(Loomis.) 

■ El 

I ■ aa^vj. 

. ad £ iv. 
teaspoonful or 



Alopecia. 

Cantharides, the tincture, I part to 8 of castor oil, well rubbed into roots of 
hair, night and morning (Wa). Arsenic, n\v of Liq. Arsenicalis ter die, exer- 
cises a more or less powerful influence (Wa). Nitric Acid, with olive oil, makes 
a serviceable liniment (Wa). Pilocarpine, has a decided influence on the growth 
of the hair (B). Glycerin in combination with the above remedies (Wa). Sul- 
phur Iodide, has been found very effectual, used internally and externally 
(Wa). Thyroid Extract, [see page 132]. Oxygen, applied under a rubber cap 
fitted to the head, into which oxygen was pumped, with entire satisfaction, in 
the case of a girl who had lost nearly all her hair in consequence of alopecia 
areata (Stoker). Frequent Shaving may often save the hair in alopecia after 
illness. Use clean brushes with long bristles, and brush against the natural 
lay of the hair. [Compare Tinea.] 



Prescriptions. 



R . Ol. Amygdalae Expres. , 

Aq. Ammoniae, .... aa^j. 

01. Rosmarini, 7, ij. 

Alcoholis, ^ij. 

Aq. Destillat., %'\). 

Mellis Despumat. , . q.s. ad J viij. 
Sig — Lotion for the hair. ( Wilson.) 



R 



M 



Tinct. Cantharidis, 
Tinct. Capsici, . 
Glycerini, . . . 
Spt. Odorat., . . 
Sig. — Hair tonic. 



ad': 



3JSS. 

rr^xx. 
3 SS - 



V J- 



( Gross. ) 



R 



R. Tinct. Macis, ...... gjss. 

Olei Olivae, . . . . q. s. ad^'x]. 

Sig. — Lotion for baldness. \Hebra.) 



Pilocarpin. Hydrochlorat. , gr j. 

Aquae Destillat., . . . %]. 
M. Sig. — Ten to thirty drops twice 
daily, according to age, to improve the 
growth of the hair. {Ba?-tholow.) 



Amaurosis and Amblyopia. 

Arnica, has long been a popular remedy for amaurosis in Germany ; Man- 
noir employed it with much success (P, Wa). Rue, in minim doses night and 
morning, for dimness of vision from functional amaurotic condition ; Elgajaki 
says it produces dimness of vision, and in smaller doses improves the eyesight 



AMENORRHGEA. 575 

(P). Strychnine will cure amblyopia from lead, tobacco, and alcohol (B); gr. 
4 X o hypodermically (Nagel); hypodermically in tobacco and traumatic ambly- 
opia, and in progressive nerve atrophy not dependent on intercranial disease 
(R). Guaiac, is advised for cases of amaurosis occurring in persons of rheu- 
matic diathesis (Wa). Santonin, has given very satisfactory results in amau- 
rosis (Wa). Veratrine, as lotion brushed over eyelids, brows and temples once 
a day, is often useful, but should not be permitted to touch the conjunctiva, or 
great pain will result (Wa). [See formula below.] Potassium Iodide, in 
amblyopia from lead-poisoning (Wa). Seton, a small seton in the temple kept 
open for a long period, has been found effectual when other remedies failed 
(Wa). Amaurosis and Amblyopia are names formerly much used to denote 
the various conditions of blindness, before ocular diagnosis became as exact as 
it now is. Amblyopia is still used to designate certain impairments of vision 
not accounted for by any organic changes visible {Roosa). 



Prescriptions 

R . Veratrinae, gr. x. 

^Etheris, ^ij. 

Alcoholis, % ^j. 

M. Sig. — Use with a brush once a day 
over eyelids, eyebrows and temples. 



R. Strychninae Sulphatis, . . . gr. j. 

Alcoholis, ........ gj. 

Aquae Destillatae, . q. s. ad g iv. 
Sig. — A teaspoonful thrice daily before 
meals, when not used hypodermically. 



Amenorrhcea. 

Aconite, in sudden suppression from cold or wet feet (R, P). Pulsatilla, in 
sudden suppression (B); often of the greatest value in the functional form (P). 
Iron, when from anaemia, the most frequent cause ; small doses preferred. 
Solution of Acetate, or Ferri et Ammonii Citras (gr. ij), or Ferri et Strychninae 
Citras (gr. j), also chalybeate waters ; make a careful diagnosis before giving 
iron (B). Aloes, when dependent on anaemia (B); at the periods, with hot 
pediluvia, friction, etc. (R, P). Potassium Permanganate, gr. j thrice daily in- 
creased to gr. ij is the best of all remedies for bringing back the menses, having 
specific action on the uterine tissue (R); excellent in amenorrhcea from cold 
feet, and is by far the best emmenagogue ; in pill it may explode, best in cap- 
sule with powdered elm or licorice (Parvin). Manganese Binoxide, in pill, 
gr. ij thrice daily, is a very efficient emmenagogue. Mercury, the Biniodide is 
a certain and safe emmenagogue, gr. y% in pill, four times daily. Oxalic Acid, 
is highly praised, gr. %-^i in mixture, every hour (Poulet). Apiol, when from 
functional inactivity; first give Iron for the blood; next aloetic purgatives, 
then apiol (gr. xv) just preceding the period; or a daily dose for a week, or 
several days before (B); the best emmenagogue next to Potass. Permang. 
(Parvin). Senega, a saturated decoction of the root, to extent of a pint in 24 
hours, during the preceding two weeks, advantageous (P). Polygonum, has 
given excellent results when used in gss doses four times daily for a week (B). 
Cimicifuga, has been recommended (R); is of very great value (P). Arsenic, 
combined with Iron, when from functional inactivity of ovaries (B). Aurum 
Salts, in amenorrhcea from torpor of ovaries (B). Ignatia, in suppression of 
hysteria (P). Cinnamon, causes a flow of blood to the womb (Goodell). Indigo, 
is considered very efficient, in doses of from Z] to 3'iv ; larger doses produce 
nausea and vomiting. Nux Vomica, small doses of the extract, of benefit in 
some obstinate cases (Wa). Silver Nitrate, in substance, applied lightly to the 
os uteri, at time of the expected discharge (Wa). Colocynth, in chlorotic 
amenorrhcea (P). Ergot, has cured when due to plethora (B); when anaemia 
after use of iron (R); in chlorotic (P); TT\j every % hour for 5 or 6 hours the 
day before and that of the expected flow, is very efficient when the cessation is 
not due to anaemia (A. A. Smith). Senecio Aureus, seems to have a well- 
founded reputation. Rue, in functional inactivity ; TnJ-v of the oil (B, P). 
Sanguinaria, functional amenorrhcea, in absence of plethora (B, P). Savine, 



570 



ANiEMIA. 



general atony ; n^v-x of the fluid extract (B, R, P). Serpentaria, with anaemia 
or chlorosis (B). Ammonium Chloride, for headache (R). Sitz-baths, hot, 
for six days before period ; mustard may be added at period ; often effectual in 
sudden suppression (B). Spinal Ice-bag, to lower dorsal and lumbar verte- 
brae, or cold sponging; useful (R). Electricity, in atony of uterus and ovaries 
(B). [Compare Anaemia, Chlorosis.] 



Prescriptions. 



R . Olei Sabinae, 

OleiRutae, aa £j. 

Tinct. Polygon. Hydropip., 5 j. 
01. Amygdalae Expres. , 
Mucil. Acacise, 

Aquae Menthae Pip., . aasjij. 
Fiat mistura. Sig. — A teaspoonful two 
or three times daily. 

{Bartholow. ) 



R. Ext. Aloes, 3J. 

Ferri Sulph. Exsic, . . 55 ij. 

Asafoetidae, 3 iv. 

Plant pilulae 100. Sig. — One pill after 
each meal, gradually increased to three. 
{Goode/L) 



R. Tinct. Ferri Chloridi, . . giij. 
Tinct. Cantharidis, . . . 7,]. 
Tinct. Guaiaci Ammon., . ^ iss. 

Tinct. Aloes, ij ss. 

Syrupi, q. s. ad £ vj. 

Fiat mistura. Sig. — A tablespoonful 

thrice daily, in simple atonic amenorrhoea. 

{H. C. Wood. Dewees.) 



Quininae Sulphat., . 
Extr. Nucis Vom., 
Olei Sabinae, . . . 
Aloes Socotrin, . . 
Cantharidis, . . . 



Fiant pilulae xlviij. 
lily. 



31SS. 
gr. xij. 

^ss. 
gr. viij. 
gr. xxiv. 



Sig. — One pill thrice 



Anaemia. 

Nux Vomica, stimulates the blood-making organs, and is used as an adjunct 
to restorative remedies (B). Iron, its chief value is to improve digestion, also 
to furnish hematin to the blood; the astringent preparations are the best and 
they should be given after meals, chalybeate waters are also useful (B). Some 
persons require bland preparations, especially when the gastric mucous mem- 
brane is irritable ; a pale and flabby tongue indicates large doses of the chloride 
or sulphate (R). Arsenic, as an adjunct to Iron, and when iron cannot be borne 
or fails (B). Aurum Arsenate, is highly beneficial ; the solution of Aurum and 
Arsenic Biomide renders excellent service in anaemia. Orchitic Extract, has 
seemed serviceable. Adrenal and Thymus Extracts have been used with bene- 
fit. Nuclein, has rendered good service. Bone Marrow, is highly efficient in per- 
nicious anaemia. [See page 133.] Cerebrinin, has been used with good results. 
[See page 137.] Quinine, for badly-fed town dwellers (R). Hypophosphites, 
are useful, but should not be given with iron, cod-liver oil, or stimulants (R). 
Calcium Phosphate, in anaemia of growing persons, and of women weakened by 
rapid child-bearing or excessive menstruation (R). Calcium Lacto-phosphate, 
for nursing mothers, or in waste from suppuration (B). Acids, added to purga- 
tive salts as tonics to the mucous membrane (R). Pepsin, is recommended by 
Hollmann. Manganese, alone not of much use ; is best combined with Iron 
(B) ; is not. like iron, found in the feces, nor does it cause constipation (Wa). 
Pepto-mangan, is highly esteemed by many clinicians. [Seepage 338.] Gal- 
vanization, as an aid to remedies (B). Cold Sponging, needs great caution, as 
it may lower the tone by minute degrees (R). Diet and Hygiene, of prime 
importance. Nourishing, digestible food, in as large quantities as can be as- 
similated — milk, eggs, animal broths ; afterward fish, poultry, game, mutton, 
etc. Moderate daily out-of-door exercise, in pure air, is indispensable. Bath- 
ing, especially sea-bathing, aids restoration. Wines, often useful. Red wines 
are the best. [Compare Adynamia, Convalescence.] 



ANESTHESIA ANEURISM. 



577 



Tonic Prescriptions. 



$ . Tinct. Ferri Chloridi, . 3 iv. 

Ac. Phosphorici Dil., . gvj. 

Spt. Limonis, .^ij. 

Syrupi, . . . . q. s. ad ^yj. 
Misce. Sig. — A dessertspoonful in water 
after meals. To the above may be added 
g ij of the Liquor Strychninse Hydrochlo- 
ratisof the B. P. (Goodell.) 



R. Hydrarg. Chlor. Corr., . gr.j-ij. 

Liq. Acidi Arsenosi, . . 3J. 

Tinct. Ferri Chlor., . . 

Ac. Hydrochlor. Dil., aa^iv. 

Syrupi, ^iij. 

Aquae, . . . . q. s. ad 2;vj. 
Misce. Sig. — A dessertspoonful in a 
wineglassful of water after each meal, as 
an alterative tonic. {A. H. Smith, .) 



U . Fer.ri Sulph. Exsiccat. , 

Potass. Carbonatis, . aa ^ij. 

Syrupi, q. s. 

Fiant pilulae no. xlviij. Sig. — One pill 
after each meal, gradually increased to 
three. {Blaud.) 



U . Quininse Sulphatis, 
Ferri Sulph. Exsic, 
Strychninae Sulph., 
Fiant pilulae xx. Sig.- 

daily. 



. . gr. xx. 
. . gr. xl. 
. . gr. ss. 
-One pill thrice 
{Bart/iolow.) 



R. 



Massae Ferri Carbonat., ^j. 

Acidi Arsenosi, . . . . gr. j. 

Quininse Sulphatis, . . gr. xl. 
Fiat massa, et div. in pilulas no. xl. 
Sig. — One or two pills thrice daily. 



Anaesthesia. 

Morphine, subcutaneously before the inhalation, diminishes danger, and les- 
sens the after-pain if operation is performed (Nussbaum) ; Morphine gr. ^ and 
Atropine gr. ^3-, hypodermically, after emergence from anaesthesia, will re- 
lieve the nausea and vomiting ; a preliminary injection of Morphine lessens 
the stage of rigidity and spasm, enables a smaller quantity of the anaesthetic 
to be used with full effect, prolongs the stage of insensibility, prevents shock, 
and antagonizes the cardiac and respiratory depression (B). Chloral, as an 
aid to Chloroform in surgery and obstetrics, 10 to 15 grains given 20 minutes 
before the anaesthetic, seems to intensify the effect and enable a less quantity 
to be used, also tiding the patient over the excited stage (Brodnax) ; in children 
a full dose of chloral before anaesthesia enables the latter to be obtained during 
sleep without using force (Id). Atropine, is decidedly the best antagonist to 
the respiratory paralysis of Ether, and should be given hypodermically (gr. -fa) 
as soon as alarming symptoms manifest themselves (Amidon) ; the writer of 
this book has saved at least four subjects of chloroform-narcosis by the hypo- 
dermic use of Atropine after both heart and respiration had apparently failed. 
Alcohol, ^j-ij of whisky or brandy before inhalation, to sustain the heart and 
prolong narcosis (B). [Compare pages 101 and 231 for the general subject of 
Anaesthesia, and page 33 for a list of Local Anaesthetics. See also the 
article Coca, page 245, for the use of Cocaine as a local anaesthetic] 



Aneurism. 

Potassium Iodide, in large doses (gr. xv-^ss), 3 or 4 times a day, gives great 
relief and has cured (B) ; combined with recumbent position and restricted 
diet (R). Veratrum Viride aids surgical expedients ; also in large internal 
aneurisms, with absolute recumbence and a little Opium to relieve pain, vom- 
iting to be avoided (B). Ergot, with recumbent position; favors coagulation 
of the blood in sac (B) ; Ergotin (P). Gallic Acid and Iron, internally, have 
cured cases of aortic aneurism (Speer). Chloroform inhalation for great dysp- 
noea (R). Lead Acetate, a valuable auxiliary to the more important items of 
rest, diet and mechanical appliances, gr. iij-v ter die (Wa) ; its use limited to 
the sacculated form (S). Electrolysis, galvano-puncture in deep aneurisms ; 
not very successful (B). The object sought is the coagulation of blood within 
the aneurismal sac ; cures have not been attained by this treatment, but in 
many it has produced great amelioration of the" most distressing symptoms 
(Petit). Aliment, milk regimen, for denutrition (B) ; a low diet, with absolute 

37 



57§ ANGINA PECTORIS ANTHRAX ANTRUM. 

rest ; Ergotin and Potassium Iodide for deep aneurisms beyond reach of surgi- 
cal treatment (B). Rest, in recumbent posture, and light, unstimulating diet, 
are primary and essential elements in the treatment of aneurisms. Surgical 
Treatment includes ligation of the vessels, also pressure by a tourniquet or 
bags of shot, the operator's ringers, etc., applied to the main artery above the 
tumor, and the introduction of fine wire into the sac to favor coagulation. 

Prescriptions . 



R . Potassii Iodidi, . . . . 5jj. 


R 


Acidi Gallici, g]. 


Tinct. Veratri Viridis, . ^jss. 




Ext. Ergotae, 


Tr. Cinchonas Co., . . Jj. 




Digitalis, aa gr. xx. 


Tr. Cardamomi Co., . . ,^jss. 




Fiat massa, et div. in pill xx. 


Tr. Gentians Co., . . . ^ss. 




Sig. — One every two hours. 


Syrupi Simplicis, 








Alcoholis, aa^iv. 


R 


. Plumbi Acetatis, . . . gr. xxxvj 


Aquae, . . . . q. s. adj^xsy 




Extract! Opii, gr. iv. 


Misce. Sig. — £ss thrice daily. Each 




Confectionis Rosas, . . q. s. 


dose has gr. xv of Potassium Iodide. 




Ft. pil. xij. One every -four hours. 



Angina Pectoris. 

Aconite, believed by Gubler to be appropriate, and by Fleming to have been 
curative in many severe cases resisting other remedies (P) ; in cardiac disease 
its action is uncertain (Br). Arsenic, lessens or prevents paroxysms, if used in 
the intervals (Anstie). Amyl Nitrite, as inhalation, affords signal relief (R) ; 
unsafe in advanced degeneration of cerebral vessels and fatty degeneration of 
heart (B) ; gives great relief during pardxysms (Br). Sodium Nitrite, is less 
rapid in action than Amyl Nitrite, but is more efficient in preventing return of 
symptoms (Br). Laurocerasus, as anodyne (P). Strychnine, in the milder 
forms ; very small doses, gr. T ^ to ^ (P). Glonoin, doses of tu^^ have been 
used with success (Pf, R). Chamomile, in pseudo-spasms of hysterical persons 
(P). Ether, aborts a mild attack (B) ; Sulphuric Ether, in the nervous form ; a 
spoonful immediately on commencement of attack will greatly mitigate it 
(Anstie). Phosphorus, often serviceable (R). Morphine, hypodermically, 
especially when cardiac dyspnoea ; strengthens the heart (R). Turpentine, ap- 
plications, hot, over chest, to mitigate severity of the paroxysms, especially in 
the aged (Wa). Quinine, when intermittent (Wa) ; or when any malarial taint 
present (Br). Brandy, in frequent small doses, with hot bran poultice over 
heart, and warmth to extremities. Cocaine, in doses of gr. y$ to % thricedaily 
for two days, proved curative in four very severe cases (Laskevitch). Cactine 
is efficient in pseudo-angina pectoris. Chloral, may be well prescribed in pseudo- 
angina pectoris (De Holstein). 

Anthrax. 

Nitric Acid, strong, applied steadily (after thorough cleansing and drying) to 
destroy the diseased mass (D). Bromine, to saturate the surface (D). Nitric 
Acid, fuming, is the preferable caustic (Greenfield). Quinine and Carbolic Acid, 
internally, are indicated in all forms, also stimulants, as Ammonia, Ether, and 
Alcohol (Greenfield). Eschar should be promptly destroyed, to avoid con- 
tagion (R). Excision and Cauterization demanded, when from direct inocula- 
tion ; the two most successful measures (Greenfield). Carbolic Acid, a 2 or 3 
per cent, solution injected subcutaneously around the pustule thrice daily, and 
applied on compresses soaked in the solution (Jarnvosky) ; of 24 cases so treated 
17 recovered (Matveieff). 

Antrum, Disease of. 

Hydrogen Dioxide, the solution 1, to 12 of water, injected through the ostium 
for diagnosis of empyema of the antrum ; if pus be present it is driven out, and 
fills the nose as a white foam (Brown). Chloroform, by inhalation, small 



ANUS — APHONIA. 



579 



quantities frequently, for treatment of acute catarrh extending to the antrum, 
extremely efficient, both as a remedy therefor and as a preventive of suppura- 
tion therein (Potter). Operative Measures, that in most favor is to enter the 
antrum through the alveolus of the second molar tooth (Garretson) ; to give 
free drainage and enable medication of the diseased mucous membrane, it is 
best to enter the antrum in its most dependent portion, through the upper part 
of the alveolus or immediately above it, between the roots of the 2d bicuspid 
and ist molar; a gold tube then fitted to the opening, so as to project beyond 
the mucous membrane, will give free drainage, without sacrificing a sound or 
even diseased tooth (Brown). Boric Acid, in saturated solution, as wash to 
cavity twice a day, the after treatment ; occasionally injecting Iodine, Zinc Sul- 
phate, or Bismuth Subnitrate (Id). 



Anus, Fissured. 

Hydrastis, locally, promotes healing (B). Rhatany, as injection, night and 
morning, after enema in the morning to move the bowels (Pf, Tr). Iodoform, 
improves and relieves pain (B). Iodo-tannin, well applied, effective (B). 
Belladonna, locally of great service for painful spasms of sphincter (P). 
Opium, with gall-ointment for fissures of anus ; mild purgatives should be sim- 
ultaneously employed (R). Sulphur, as a mild purgative, to cause soft motions 
(R). Tannin, Z] in Glycerin l|ij, introduced on a tent, night and morning, 
with great advantage (Wa). Collodion, as protective covering (P). Potassi- 
um Bromide, with 5 parts of Glycerin, as local application (R). Silver Nitrate, 
in solution, to the ulcer after careful cleansing and applying a 4 per cent, solu- 
tion of Cocaine, which prevents the pain due to the silver solution ; followed by 
Iodoform oint. gr. xxx to the 3 ; this is most efficient (Adler). Castor Oil, as a 
mild purgative (R) ; to keep motions soft (Br). Surgical Means, the most 
efficient ; forcible dilatation of sphincter, or partial division in severe cases, 
through the mucous membrane, and a few fibres of sphincter. Anal fissure, 
when uncomplicated with some other rectal affection, is curable in many cases 
by non-operative methods of treatment (Adler). Mercury, an ointment of the 
Oxide, 30 grains to the §, has cured many cases (Id). 



Prescriptions. 



R . Tinct. Kramerise, . . . . gj. 

Ext. Kramerise, 3 ij . 

Aquae, ad J$ viij . 

M. Sig. — One-fourth as injection, night 
and morning, after using enema. 



M 



Hydrarg. Chlor. Mitis, . . gr. iv. 
Ext. Belladonnse, 

Pulv. Opii, aa gr. ij. 

Ung. Sambuci, ^j. 

Sig. — To be applied frequently in 



anal fissure. {AlUngham.} 



R. 



I'y 



Sulphuris, 

Pulveris Aromat., 
Confec. Rosae, . . . . aa^ij. 
Misce. Sig. — One-third to be taken at 
bedtime as a laxative. 



R . Plumbi Acetatis, 

Zinci Oxidi, .... 
Pulv. Calamine. . . 
Adipis Benzoinat. , 
M. Sig. — Ointment for 

fissure. {Allingham. ) 



aa gr. x. 
. . gr. xx. 

use in anal 



Aphonia. 

Ignatia, in aphonia of hysterical women (P). Atropine, in hysterical apho- 
nia and for fatigue of vocal cords, gr. y^ to -g^, morning and evening (B). 
Nitric Acid, rr^v-x of the dilute acid, for hoarseness of singers, in fatigue of 
vocal cords, and when aphonia is stomachal (B). Benzoin, the tincture by in- 
halation in laryngeal catarrh (Br). Oil of Rue, as inhalation in chronic catarrh 
(Br). Uranium Nitrate, as spray in very chronic catarrh (Br). Alum, gr. 
x-^j aquae, as spray, in chronic coughs and hoarseness (R). Borax, a piece 



580 APHTHAE — APOPLEXY. 

the size of a pea allowed to dissolve in the mouth (R). Glycerite of Tannin, 
locally in chronic inflammation of the throat (R). Sulphurous Acid, by inhal- 
ation, spray, or fumigation, in clergyman's aphonia (R). Ipecacuanha, wine, 
as spray, when congestion of vocal cords (R) ; in laryngeal catarrh (Br). Am- 
monium Chloride, as vapor inhaled, of great value in catarrhal aphonia (Wa). 
Turkish Bath, at commencement of a feverish cold (R) ; in acute laryngeal 
catarrh (Br). Galvanism, localized, the best treatment for hysterical aphonia. 



Prescriptions 

&. Acidi Nitrici Dil., . . . . s;ij. 

Tinct. Calumbae, . . . . 3jj. 

Aquae, ad^'xv. 

M. Sig. — A dessertsp. in a winegl. of 
water thrice daily. 



R . Liq. Ammonite, 

Aquae, aa ^j. 

M. Sig. — A teaspoonful in a pint of 
hot water for each inhalation. 



Aphthae. 

Potassium Chlorate, the best remedy ; a solution of gr. x to the ^, as wash, 
alone or with Borax (Br) ; and gr. x to xx by the stomach (B). Borax, with 
honey, or as glycerite of borax, frequently used (R) ; crystals allowed to dis- 
solve in the mouth (W). Sulphurous Acid, as solution, strong or diluted, locally 
(R), diluted as spray (B). Mineral Acids, formerly much used (B). Mercury, 
Hydr. cum Creta in small doses to remove the indigestion on which aphthae 
often depends (B); Borax being used locally, when aphthae exist in the mouth 
(Wa). Copper Sulphate, a weak solution painted over mucous membrane (R). 
Potassium Iodide, gr. j-v in J; j aquae, locally (B). Salicylic Acid, one part 
(dissolved in alcohol) to 250 of water (R). Quinine, gr. j every 2 or 3 hours, in 
infants (B), especially when consequent on diarrhoea (Br). Coptis, the infu- 
sion has repute in New England (B). Bismuth, freely to the parts (B) ; as a 
local application (Br). Glycerin, will sometimes cure (R). Rhubarb, the com- 
pound powder, to remove indigestion (Br) ; is highly useful in small doses 
(Wa). Limewater, as a mouth-wash, is much used. 



R . Acidi Sulphurosi, . . . 3 ij 
Aqua?, . . . . q. s. ad ^ ij 
M. Sig. — Mouth-wash, or maybe used 



Prescriptions. 

R. Pulv. Rhei Co., ... 3 ij. 

Sacch. Lactis, . . . . q. s. 
Triturat. et div. in pulv. xij. Sig. 



as a spray. One thrice daily. 



Apoplexy. 

Aconite, when full strong pulse, hot, dry skin, plethoric cases, is the best 
remedy (P) ; to lower blood-pressure and prevent further hemorrhage, where 
the pulse is strong and arterial tension'high (Br). Elaterium, as a purgative ; 
a large dose (gr. ij) in suppository with soap ; or as an injection into the large 
bowel (P). Croton Oil, as purgative, a drop may be put on the back of the 
tongue (Br); rr\,X or l A each hour (R). Colocynth, as a derivative purgative 
(Br) ; appears to act well (P). Cold Water, often harmful, though frequently 
used; is injurious when face pale, surface cool, circulation depressed (B). 
Electricity, very mild galvanic currents to promote absorption ; caution neces- 
sary, especially if much headache and vertigo (B). Diet and Hygiene, of great 
importance in patients subject to apoplexy; avoid stimulating food and drink 
(especially beer), over-eating, excitement, haste, exposure to hot sun, heated 
rooms, etc. At no subsequent period should a full animal diet or the use of 
undiluted wines be indulged in (A). Diagnosis. Should be carefully differ- 
entiated from alcoholism, with which it is often confounded. [Compare Cere- 
bral Congestion, also page 1 14.] 



APPETITE ARTHRITIS. 



581 



Prescriptions. 



R. Tinct. Aconiti, . . . . mjc. 
Aquae Cinnamomi,q, s. adf) ij. 
M. Sig. — A teasp. every % hour for 2 
hours, then every half-hour. 



& . Ext. Colocynthidis Co., gr. xx. 

Olei Tiglii, rri^ij. 

Fiat massa, et div. in pil. iv. Sig.- 
One pill as required, until free purgation. 



Appetite. 

Ignatia, will correct diseased appetite (P) ; especially in hysterical subjects 
(Br). Anthemis, will stimulate the appetite. Cannabis Indica, produces a 
ravenous appetite. Bitters, to stimulate the appetite (R). Food should be 
savory and well cooked, Habits require examining into, when lost appetite 
complained of. Fluoride of Sodium of Potassium will produce almost total 
anorexia, and may be employed with advantage in bulimia (Da C). [Compare 
Dyspepsia.] 

Prescriptions. 



rjt . Gentianse Quassise, 

Cinnamomi, .... aa^ij. 
Sig. — Put into a pint of boiling water, 
and when cold, strain ; take a winegl. thrice 
daily as an appetizer. 



R . Anthemidis, .... 

Quassise, aa 3J- 

Sig. — Put in a pint of boiling water, and 
when cold, strain ; take a winegl. thrice 
daily before meals as an appetizer. 



Arthritis, Rheumatoid. 

Aconite, highly spoken of, as liniment, conjoined with internal use (Wa). 
Cimicifuga, when joints enlarged and much stiffened, and when traceable to 
uterine derangement, is very useful (R) ; when pains worse at night (Wa). 
Viburnum Prunifolium, the fluid extract with that of Cimicifuga, 20 drops of 
each thrice daily, gradually increased to 30, produced steady improvement in 
a well-marked case of eight years' standing, involving nearly all the articula- 
tions. Iodine, the tincture internally, said to be better than potassium iodide 
(R). Iodoform, 10 parts to 20 of Ether and 20 of Alcohol, as liniment to the 
joint, applied by a pencil, and covered with oiled silk (Gubler). Iodides, often 
signally benefit, especially when due to syphilitic, mercurial, or mineral poison- 
ing (B) ; large doses of Potassium Iodide sometimes required (R) ; combined 
with Guaiac, or Corrosive Sublimate, often curative in cases resisting these 
remedies given separately (Wa) ; Potassium Iodide should always be fairly 
tried (Da C). Guaiac, the ammoniated tincture, in doses of 3j-ij in milk, often 
gives excellent results (Da C). Colchicum, with alkalies, extremely useful (B). 
[See Gout, for formulas.] Arsenic, when referable to nervous affections (B) ; 
as a bath containing ^iv washing soda and gr. xx. of Sodium Arsenate ; in 
large doses, continued for some time, sometimes of great benefit, but action is 
capricious (R) ; in small doses is of great benefit (Da C). Aurum, the Bromide 
of Gold and Arsenic has proved curative in arthritis deformans, characterized 
by great pain, stiffness and swelling of the joints (E. A. Wood). Lithium 
Salicylate, very efficient in acute and progressive subacute articular rheuma- 
tism, and has some effect also in chronic cases, where some of the joints are 
deformed, swollen and painful ; gj may be given daily, in doses of gr. vij to x, 
in water (Vulpian). Lithium Bromide, of great value in acute and chronic (B). 
Phenocoll, with Piperazin, 15 grains of each daily, in a pint or more of car- 
bonated water, has rendered good service in gouty and rheumatic affections. 
Piperazin, should be used in all cases of difficult diagnostic differentiation, from 
its remarkable power over uric acid and urate concretions. Potassium Bro- 
mide, sometimes allays the severe pain (R). Arnica, the tincture and infusion 
are said to be of great value (P). Cod-liver Oil, internally and locally, of much 
value (R). Baths, Turkish or sulphur ; the cold douche, which may be slightly 
warmed in winter, use for one or two minutes and rub dry (R). Adhesions 



582 



ASCITES. 



may be broken up under anaesthetics (Da C). Massage may be used with 
benefit to ameliorate the condition in chronic cases, where a cure cannot be 
obtained (Da C). Counterirritation, by the actual cautery (or flying blisters) 
to the affected articulations, passive movements of the joints, sulphurous baths, 
in conjunction with Potassium Iodide internally in doses of 7^ to 30 grains in 
the 24 hours (Letulie). 

Prescriptions. 



R. Vini Colchici Seminis, . 3 iij. 
Spt. Ammon. Aromat , . .^xiij. 
M. Sig. — A teasp. every 3 hours, until 
some physiological effect is produced. (B.) 



R. Lithii Bromidi, .... 3 iij. 
Syr. Zingiberis, . . . . 3 ss. 

Aquas, 3J SS - 

M. Sig. — A teasp. thrice daily, 
jointly with a lotion of the same. 



Ascites. 

Digitalis, when ascites is part of a general dropsy due to cardiac or renal 
disease; is of the greatest service, except where there is aortic regurgitation and 
cardiac hypertrophy (P) ; a fresh infusion the best preparation (R) ; its action 
increased by combination with Squill and Mercury (Br). [See formula below.] 
Jalap, the most generally approved hydragogue purgative is the compound 
powder, with Podophyllum (B) ; with Potassium Bitartrate, combined in form 
of electuary, may be persevered with daily, though apt in sortie cases to cause 
gastric derangement (Saundby). Stillingia, in ascites due to hepatic changes 
(B). Elaterium, as hydragogue cathartic, gr. ]/e, with a grain of Ext. Hyoscy- 
ami, and a drop of some aromatic oil, is the most efficient of its class in ascites, 
but its action is very exhausting (W) ; cautiously in debilitated subjects, and is 
contraindicated where gastro-intestinal irritation or inflammation present 
(B). Arsenic, when ascites is due to feeble heart, and in that of old age (B) ; 
did excellent service after tapping in a woman aged 82, from whom the writer 
removed 6% gallons of ascitic fluid at one tapping, when almost moribund, 
with the result that she lived ten years longer (Potter). Diuretin, is often of 
very marked benefit, especially in cases of cardiac and renal origin. [See 
under Dropsy.] Aurum, has an ancient reputation ; is efficient in ascites due 
to chronic hepatic disease (Gcetzner), or induration of the abdominal organs 
(Schroff). Diuretics, are of little use when the accumulation is excessive, the 
venous pressure seems to be too great for them to act (Saundby). Copaiba is 
an excellent remedy in hepatic dropsy (Br) ; the resin in doses of 10 to 1 5 grains 
is often serviceable in cases of moderate effusion (Saundby). Milk-diet is an 
ancient remedy for ascites, and often successful, causing profuse alvine and 
urinary discharges (B) ; is sometimes very serviceable when the renal action 
is inadequate (Br). Surgical, paracentesis abdominis should be done in all 
cases where excessive effusion ; laparotomy, and washing out of the peritoneal 
cavity, in cases of tubercular peritonitis with effusion, which has recently been 
treated successfully thereby (Saundby). [Compare Dropsy.] 



Prescriptions. 



R. Potassii Bitart, . . . . ^ss. 

Mellis, '%). 

Sig. — A teasp. every 2 hours until bowels 
are freely moved. 



R 



M 



Resinse Copaibae, . . . 3 iij. 

Alcoholis, 3 v. 

Spt. Chloroformi, . •?>']■ 
Mucil. Acacise, . . . . ijij. 
Aquae, . . . . q. s. ad ^ xij. 
Sig — A tablesp. thrice daily. 



R. Potassii Bitart., . . 

Pulv falapae, . . . 

Mellis", 

Sig. — A teasp. every 
bowels are freely moved. 



.^j'ss. 
hours, 



R 



until 



Hydrarg. Chlor. Mitis, 

Pulv. Digitalis, 

Pulv. Scillse, aa gr. vj. 

Fiat massa, et div. in pil. vj. 
Sig. — One pill thrice daily, in ascites 
from hepatic changes. 



ASPHYXIA AND APNGEA. 583 



Asphyxia and Apnoea. 

Of the New-Born. — Clean the mucus out of nostrils and throat ; catheterize 
the trachea, and suck up the mucus. Marshall Hall's method,— by placing 
child on abdomen, then bringing into lateral posture, repeating slowly and 
deliberately. Schultze's method, — by placing the thumbs upon the anterior 
surface of thorax, the indices in the axillae, and the other fingers along the 
back, the face of the child being from you ; rotate the child, by swinging 
upward, so that the inferior extremities turn over toward you. In a moment 
re-rotate to the original position. Do not support head or legs in the forward 
rotation ; their bending upon or toward the abdomen gives a forced expiration. 

From Foreign Bodies in Air Passages. — If the foreign bodies are round and 
smooth, invert the patient head downwards and strike upon the back. The 
bristle-probang is a good instrument for the removal of fish-bones, coins, etc., 
from the gullet ; or a pair of curved forceps will often render good service. 
The writer removed a gold plate with three teeth attached, from the oesophagus 
of an insane woman, by passing down a curved piece of stout wire, having the 
end bent upon itself to form a hook. After the hook was passed to one side of 
and below the obstruction, the wire was half rotated, so as to engage the plate, 
which came up on the second trial of the improvised instrument. Tracheot- 
omy or Laryngotomy may be necessary, as a final resort. 

From Drowning. — Remove the person from the water as rapidly and gently 
as possible, turn the face downwards for a moment, and depress the tongue, in 
order that water, mucus, etc., may be removed from immediately over the 
entrance of the windpipe. Give the patient plenty of fresh air, fully exposing 
neck and chest to the breeze, unless that be inclement. Turn gently on the 
face, one forearm being under the forehead, and raise the body up that the 
water may have free discharge from the mouth. Place the patient upon the 
side and apply stimulants (Ammonia, etc.) near to the nostrils; or the cold 
douche to the face and chest, in order to excite respiration. 

The above measures being ineffectual, convey the body to the nearest con- 
venient spot, strip it carefully and dry it, and place it on a warm bed, with 
head and shoulders slightly raised, and at once employ one of the following 
methods : — 

Silvester's Method. — Pull the tongue forward, to prevent obstruction to en- 
trance of air into the windpipe; produce expansion of the chest by drawing 
the arms from the sides of the body and upwards until they almost meet over 
the head. Then bring the arms down to the sides again, causing the elbows 
almost to meet over the pit of the stomach, and thus producing contraction of 
the chest. This imitation of the act of respiration should be continued at the 
rate of fifteen or sixteen times a minute, as in health. 

Marshall Hall's Method. — The person should be placed flat on the face, 
gentle intermittent pressure being made with the hands on the back, the body 
turned on the side, or a little beyond, then on the face, and the same pressure, 
etc., continued as at first. The whole body must be worked simultaneously. 
The same number and frequency of these artificial processes of respiration 
should be employed as in the other method. 

The Michigan Method. — Lay the body face down, the head upon the arm, 
and stand astride it ; grasp it then about the shoulders and armpits, and raise 
the chest as high as you can without lifting the head quite off the arm, and 
hold it about three seconds ; then replace the body upon the ground, and press 
the lower limbs downward and upward, with slowly-increasing force, for ten 
seconds ; then suddenly let go, to perform the lifting process again. 

Whichever process be employed, the effort to restore the temperature of the 
body must be maintained, the body being well rubbed in an upward direction 
with the hands, with warm flannels, etc. ; bottles of hot water, hot bricks, etc., 
being applied to the stomach, the axillae, the soles of the feet, etc., stimulants 
and beef tea being judiciously administered when restoration is about taking 



584 ASTHENOPIA ASTHMA. 

place. The attempts at resuscitation must be persevered in for several hours, 
if necessary. In artificial inflation, always press the larynx and trachea against 
the vertebral column, so as to close the oesophagus and thus prevent the air 
entering the stomach. Laryngotomy or Tracheotomy, with or without cathe- 
terization, or* forced insufflations of air or oxygen, have proved successful, as 
also has electro-puncture (Garratt). 

After Long Submersion is Recovery Possible ? — According to Harley, dogs 
kept under the water \]/ z minutes always died, if water had entered the lungs. 
If it had not, the trachea being plugged, they survived a submersion of 4 min- 
utes. When persons rise after sinking they usually get some air, and less 
speedily come into a state from which recovery is impossible. The greatest 
period between the last inspiration and the stoppage of the heart is 4 minutes. 
Some think that no recovery has been made after complete cessation of the 
heart's action. We infer that after complete submersion for 5 minutes recov- 
ery is improbable, unless the person had been previously choked, or in a faint- 
ing state, so that no water entered the lungs. But in Anderson's case, the 
patient had been under water at least 15 minutes, and in Garratt' s the time 
was variously estimated at from 15 to 60 minutes. 

When is a Case Hopeless ? — Harley says, " If the eyes are open, the pupils 
dilated, the conjunctiva insensible, the countenance placid, the skin cold, 
frothy mucus round the nostrils and mouth, no attempt at respiration, and the 
heart's action inaudible (when the ear is applied to the chest), the case is 
hopeless." 

Signs of Death. — The following have been suggested as methods of decid- 
ing whether death has occurred : Tie a string firmly about the finger ; if the 
end of the finger becomes swollen and red, life is not extinct. Insert a bright 
steel needle into the flesh ; if it tarnishes by oxidation in the course of half an 
hour, life may be considered not extinct. Inject a few drops of Liquor Am- 
monia? under the skin ; during life a deep red or purple spot is formed. Moisten 
the eye with Atropine ; during life the pupil will dilate. Look at a bright 
light or at the sun, through the fingers held closely side by side ; during life 
the color is pink ; after death a dead white. After death a dark spot is said 
to form gradually on the outer side of the white of the eye, from drying of the 
sclerotic, so that the dark choroid shows through. Putrefaction is an absolute 
sign of death ; better delay for it than run any risk of burying alive. 



Asthenopia. 

The proper glasses ; cold douche ; rest of eyes. Atropine, systematically 
instilled, to prevent strain, and control spasm of the accommodation (C) ; cau- 
tiously in persons over 35 or 40 years old. [Compare Eye Diseases, Myopia.] 



Asthma. 

Potassium Iodide, when from acute bronchial catarrh, gr. xv-xx each 2, 3, 
or 4 hours (R) : the best medicament to suppress the asthmatic attack, in bron- 
chial asthma, is Potassium Iodide and Chloral (Lazarus) ; is the specific in 
asthma, if any drug can be so called ; should be given with Lactucarium (SeeV 
Chloral, is highly efficient in spasmodic asthma ; may arrest a paroxysm (R). 
Nux Vomica, in nervous subjects (B) ; often of great benefit in spasmodic 
asthma (P) ; the tincture, in drop doses every five minutes has rendered extra- 
ordinary results in both cardiac and bronchial asthma, and in asthma of per- 
ipheral reflex origin, as from phimosis (Macfarlan). Antipyrin, is successfully 
employed in bronchial asthma. Aconite, in spasmodic (P) ; often averts the 
attack, if given at commencement; useful also in the asthma following coryza 
and sneezing in children (R). Ipecacuanha, the wine as spray to the fauces, 
sometimes useful in severe bronchial asthma, but not of much service in gen- 



ASTHMA. 585 

uine asthma (R) ; nauseant and emetic doses in the spasmodic form (B). Lo- 
belia, gtt. x of the tincture every # hour during paroxysm ; rr^x ter die, with 
additional doses at night, in bronchitic asthma when worse at night ; cautiously 
if heart disease (R) ; often gives permanent relief (B). Pilocarpine Hydrochlo- 
rate, gr. £ in water, at bedtime, promptly and effectively relieves, in cases of 
bronchitic asthma with hypertrophic rhinitis ; in some of nine years' standing 
it apparently gave permanent relief (VVyss). Grindelia, gives relief in spas- 
modic form (B) ; three grains of extract thrice daily, to prevent attacks, or tt\,xx- 
xxx of fluid extract every half-hour or hourly from onset of paroxysm (R). Ar- 
senic, as cigarettes, as well as by internal administration (B) ; rr\j of liquor ar- 
senicalis ter die, in attacks from bronchitis, local irritation, etc., allied to hay 
fever (R). Belladonna, relieves paroxysm when expectoration abundant, skin 
cool and moist (B) ; internally in large doses, also in cigarettes (Br). Atro- 
pine, hypodermically is more efficient, gr. ^ at bedtime to abort morning par- 
oxysm (B) ; large doses required, but very satisfactory (R) ; was much valued 
by Dr. Salter and M. See (P). Duboisine, may be used instead of Atropine. 
Antimony, in an affection of children like asthma, dissolve a grain of Tartar 
Emetic in half a pint of water, and give a teaspoonful of this every }£ hour for 
the first hour, then hourly ; if vomiting induced, lessen the dose (R). Coffee, 
a small cup of very strong coffee often useful in a paroxysm (R) ; asthmatics 
should not use it as a beverage (P). Stramonium, twenty grains of the dried 
leaves or ten of the powdered root may be smoked ; Datura is sometimes better : 
Stramonium preparations are often of bad quality, asthmatics advised to grow 
the drug themselves (R). Cocaine, hypodermically, is used with the best re- 
sults, even where other remedies failed to relieve (Mosler) ; the leaves of the 
coca-plant make the best cigarettes for asthma (Nachtigal). Chloroform, in- 
haled from warm water; anaesthetics relieve, but increasing doses required, 
leading to habit (R). Ether, in full dose, may avert a mild attack (B). Amyl 
Nitrite, inhaled, quickly checks spasmodic asthma (R). Ethyl Iodide, very 
valuable in spasmodic form, and lessens liability to subsequent attacks ; vc[y- 
xx thrice daily by inhalation (B). Cannabis Indica, has been useful (R). Sul- 
phurous Acid, by inhalation, spray, or fumigation (R). Morphine, hypoder- 
mically, quickly cuts short a paroxysm (B) ; in some cases morphine will in- 
duce a paroxysm (R). Apomorphine, gr. y 1 ^ hypodermically, has been found 
effective ; or gr. T \ every 3 or 4 hours in camphor water, with or without Mor- 
phine or Ipecacuanha. Tobacco, smoking, sometimes relieves (R). Pyridine, 
the fumes are highly efficient (See). Asafcetida, has been recommended (R) ; 
palliative only (P). Colchicum, in gouty subjects (R). Bromides, relieve but 
soon lose effect (R). Eucalyptus, smoked with Stramonium, Belladonna, To- 
bacco (B). Quinine, after acute symptoms subside, as antipyretic to succeed- 
ing fever and restorative tonic (B). Potassium Nitrate, the inhalation of fumes 
of burnt nitre paper will sometimes avert a paroxysm ; different methods of 
preparation useful for different cases (R). Silver Nitrate, sometimes injected 
into trachea (R). Chamomile Oil, has been found very serviceable (P). San- 
guinaria, is very useful in humid asthma, and occasionally so in the spasmodic 
form (R). Oxygen inhalations are serviceable, but should not be used if heart 
disease is present (R). Carbonic Acid, in 5 to 10 per cent, solution, by inhala- 
tion, is well borne and renders good service (P). Carburetted Hydrogen, the 
inhalation of ordinary illuminating gas never failed to abort a paroxysm in a 
lady who had sought professional assistance in vain, and who was in the habit 
of shutting herself up in a small room, in which she allowed the gas (unlighted) 
to escape, and after three minutes her maid, who stood outside the door, came 
in and brought her out; the patient was always in a semi-dazed state, but in a 
few minutes became quite herself, with free and easy breathing (White). Gal- 
vanism, of pneumogastric often relieves ; + pole beneath mastoid process ; — 
pole to epigastrium. Faradism of no use (B). Prophylaxis, avoidance of ex- 
citing causes, especially indigestible food, wet, damp, and sudden changes of 
temperature. Attention to the stomach will do most for many asthmatic 
patients. An important point is to take the heaviest meal early in the day, and 
very little solid food after 2 p. m. Shower-bath and out-of-door exercise, not, 



586 



ASTIGMATISM ATHEROMA ATROPHY. 



however, to a fatiguing extent (R). In special cases of reflex origin from ex- 
posed nerve-filaments, operative treatment of the nose and naso-pharynx, by 
galvanic cautery or otherwise is required (Lazarus). 



Prescriptions. 



R 



Ammonii Bromidi, . . gr. clx. 
Ammonii Chloridi, . . gr. xc. 
Tinct. Lobelia?, . ... ft iij. 
Spt. Etheris Comp. , . . Hjj. 
Syrupi Acacia?, . q. s. ad i| iv. 
M. Sig. — A dessertspoonful in water, 
every hour or two, for the paroxysm. 

{Pepper.) 



R. 



M. 



Ext. Grindelia? Fluidi, 


^ss. 


Ext. Lobelia? Fl., . . 


• ZV> 


Ext. Belladonnae FL, 


3J- 


Potassii Iodidi, . . . 


J5"J- 


Glycerini, 


,?"j- 


Sig. — A dessertspoonfu 


1 as required. 


Ext. Stramonii, . . . 


• g r - ij- 


Potassii Iodidi, . . 


ffjss. 


Ammonii Carbonatis, 


3J- 


Tinct. Lobelia?, . . . . 


3JSS. 


Aqua? Chloroformi, . . 




q. s. ad 


gviij. 


mistura. Sig. — A 


tablespoonful 



Ft. 
every four to six hours. 



Arsenical Cigarettes. 



R 



Sodii Arsenatis, . ... ft ss-j. 

Aqua? Distillata?, . . . gj. 

Moisten unsized white paper, and roll 

into cigarettes, each containing gr. j£ to 

gr. j. of the salt. Two or three of these to 

be inhaled daily. (Bartholow.) 

R . Belladonna? Fol., . . . ft), 

Stramonii Fol., 

Hyoscyami, . . . . aa :£ss. 

Extracti Opii, gr. iij. 

Aqua? Laurocerasi, . . q. s. 

Dissolve the opium in the water, and 

moisten the leaves therewith. When dry, 

roll into twelve cigarettes. Smoke two to 

four daily. {Trousseau.) 



R. Spt. Etheris Compos., 
Liq. Morph. Sulph., 

(g r -j ad.^j), . . . aa£j. 
M. Sig. — Ateaspoonful every half- hour 
or hour in the paroxysm. 



Astigmatism. 

Atropine, a weak solution to aid examination of eye by dilating pupil, and 
paralyzing accommodation (B). Duboisine, as substitute for atropine, has more 
rapid action, with shorter duration of effects, and less conjunctival irritation. 
Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylindrical in 
mixed astigmatism. Pray's Test Letters, to determine degree and direction of 
the defect (C). [Compare Eye Diseases, Myopia.] 



Atheroma. 

Phosphorus, in minute doses, with cod-liver oil (B). Arsenic often of great 
value in atheroma, especially where imperfect action of kidneys (Br) ; indicated 
when there are puffy eyes, drowsiness, intellectual torpor (B). Lemon-juice, 
daily used, is said to retard atheromatous degeneration of the vessels. Aurum 
and Arsenic Bromide is very efficient in atheroma and calcareous degeneration 
of the arteries (Barclay). Quinine, gr. iij.— x daily, in atheroma, is used with 
advantage (B). Ammonium Bromide, to promote absorption of deposit (Wa). 
Digitalis, may be useful in general capillary atheroma ; cautiously ! (W). 
Cod-liver Oil, with Phosphates, Hypophosphites, or Calcium Lactophosphate, 
in combination (B), [Compare Aneurism.] 



Atrophy. 

Cod-liver Oil, has proved beneficial (Wa). Olive Oil, by inunction, every 
12, 6, or 4 hours, successfully employed (Wa). Arsenic, has had remarkable 
success in muscular atrophy (Tr). Electricity, in progressive muscular atrophy, 
the induced current very strong at first, then weaker as improvement ; inter- 



BALANITIS BED-SORES BILIOUSNESS. 5 87 

rupted currents from vertebral column and plexuses to nerves of affected mus- 
cles ; in more extended forms, the constant current to the nerves, the induced 
to the muscles (Ros). Massage, removes the waste products and restores the 
muscular power (Br). [Compare Emaciation, Locomotor Ataxia.] 



Balanitis. 

Mercury, Hydr. Chlor. Corr. gr. j to ^jss Aquae Calcis, as lotion, if not much 
inflammation (Br). Oil, on linen, to inflamed part, beneath foreskin, which 
must be again drawn forward ; strict cleanliness. Astringent Lotions, of Alum 
or Zinc Sulphate, with warm water injections (Br). Lime-water, the best lotion 
if much inflammation (D). Tannin, in alcohol, equal parts, as dressing after 
washing with a weak solution of common salt. Carbolic Acid, a 5 per cent, 
solution, on cotton rag after washing, thrice daily, is generally sufficient. 
[Compare Phimosis, Gonorrhoea.] 



Bed-sores. 

Alcohol, Brandy, or Eau-de-cologne, to harden skin of parts exposed to 
pressure (R) ; as wash to parts threatened (B). Glycerin, or glycerin cream, 
rubbed over the parts exposed to pressure, after washing, morning and even- 
ing, is one of the best preventives (R). Alum, ^ss, whites of four eggs, Tinct. 
Camphorae, ^ij, an excellent application (B). Charcoal, sprinkled over the 
black slough, which then should be covered with a poultice (R). Galvanic 
Couplet, of zinc and silver, connected by a copper wire; one element on sore, 
the other on the adjacent part (B). Silver Nitrate, a solution (gr. xx-^j) to be 
painted on the threatened but unbroken skin, as soon as it becomes red, will 
prevent sores ; if Nitrous Ether solution be used, gr. v to the 3 is enough (R). 
Iodoform, dusted over sores (R). Linen, air-dried better than that which is 
ironed or mangled, by reason of its greater softness. Aristol, is an excellent 
application. 

Biliousness. 

Podophyllum acts as a cathartic (B) ; corrects deficient secretion of bile, espe- 
cially in children and infants ; gr. ■£$ to -^, every six hours, to correct white or 
clayey stools ; also in general hepatic derangement (P). Aconite, in occasional 
doses, improves the effect of Podophyllum (R). Mercurial Cathartics, act only 
as purgatives ; Calomel gr. j-x, or Pil. Hydrarg. gr. v-x ; Mercury as purga- 
tive restricted to cases where there is excess or deficiency of bile (B) ; frequent 
small doses of gray powder for deficiency (R) ; Calomel, gr. iij, followed by 
3ij each of Rochelle and Epsom Salts, when the tongue is heavily coated and 
furred (Gross). Mercury, Yellow Oxide, in doses of gr. ■£$ to ■£$, in trituration 
with sugar of milk, exceedingly efficient in many disordered conditions of the 
alimentary canal and its appendages (Schaffer). Bryonia, is worthy of com- 
mendation in the ordinary bilious headache with vomiting, and in the general 
hepatic derangement known as sluggish liver (P). Hydrastis, gtt. v-xv of 
fluid extract daily before meals, for biliousness with chronic gastric catarrh and 
dyspepsia (B). Mineral Acids, before meals, Hydrochloric Acid and Pepsin 
after meals, in atonic dyspepsia (B). Stillingia, when deficient biliary secre- 
tion (B); may be used in place of Mercury (Br). Ammonium Iodide, gr. j-iij 
in water each 2, 3, or 4 hours, for catarrh of duodenum and biliary ducts (B). 
Ammonium Chloride, is much employed in Germany for hepatic derangements, 
and with good success. Euonymus, is considered very efficient by many prac- 
titioners in cases of hepatic dyspepsia, or " bilious attacks," so-called. Man- 
ganese, for gouty subjects. Rhubarb, as a cholagogue. Aloes, in biliousness 
with constipation. Angostura, is suitable to the worst forms of bilious fevers 
(P). Calumba, is of benefit in many forms (P). Alkalies, and their laxative 



588 



BLADDER BLEPHARITIS. 



salts, in the bilious state, with uric acid diathesis (B). Milk-cure, in obstinate 
cases ; buttermilk or skimmed milk often agrees best (B). [Compare Dys- 
pepsia, Hepatic Congestion, Duodenal Catarrh. 1 



Prescriptions. 



R. Ext. Stillingiae FL, . . 3 v. 

Tinct. Aloes, ^ij. 

Tinct. Nucis Vom., . . gj. 
M. Sig. — Twenty drops in water thrice 
daily. (B.) 



R. Ext. Euonymi, . . . 

Ext. Hyoscyami, . . 

Ext. Gentianse . . . 
Fiat massa, et div. in pil. 
One pill every other day. 



gss. 
gr. xv. 
gr. vj. 
xij. Sig. 



R. Hydrarg. Oxidi Flavi., . gr. j. 
Sacch. Lactis, q. s. 

Triturat. et div. in chart, xlviij. 

Sig. — One powder dry on the tongue 
twice daily. 

R. Massse Hydrargyri, 

Ext. Colocynthidis Co., aa gr. iij. 

M. et div. in pil. ij. 

Sig. — Take at once, and follow it in a few 
hours with a saline cathartic. 



Bladder, Irritable. 

Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or 
irritable mucous membrane (B) ; gtt. v-xx of tincture every 3 or 4 hours 
give gradual but sure relief (P). Cantharis, in women, without acute inflam- 
mation (B) ; incontinence on coughing (R). Benzoic Acid, when from en- 
larged prostate, removes fetor of urine ; also renders phosphatic or alkaline 
urine acid (P). Ammonium Benzoate, may be used instead of Benzoic Acid 
(Br). Gelsemium, the best remedy for irritable bladder of women of hysterical 
type, with constant desire to urinate (B). Cubeb, is often successful in women, 
but Cantharis generally better (B) ; is of especial value when vesical catarrh 
present (P). Aquapuncture, strange to say, has been used with considerable 
success (B). Cannabis Indica, in spasm of the bladder, and in irritable condi- 
tions of that organ is generally useful. Eucalyptol, is often very efficient, but 
frequently fails, tt\,ij on sugar two or three times a day. Carbonic Acid, by in- 
jection through a catheter, after washing out the bladder, may be employed in 
almost all forms of irritability of the bladder, unless acute inflammation be 
present (P). [Compare Cystitis, Dysuria, Enuresis, Lithiasis, Calculi, 
Urinary Disorders.] 

Prescription. 

R Tinct. Gelsemii, ... 3 ss. 
Sodii Bromidi . . . . 5 iij. 
Ext. Tritici Fluidi, . . ^iss. 



Sig. — A teaspoonful in water every four 
hours, for irritable bladder. 



Bladder, Paralysis of. 

Cannabis Indica, in retention from spinal disease (R). Ergot, in paralytic 
dysuria, especially when sensation of bladder being only partially emptied 
(P); when incontinence from paralytic sphincter, and in paralysis from over 
distention (Wa). Arnica, has proved curative (P). Strychnine, gr. fa to fa, is 
useful (B). Cantharis, often given with excellent effect, when bladder atonic 
(Wa). Galvanism, may greatly benefit (B); electro-magnetic current from 
the bladder to the spine, of great use (Wa). 



Blepharitis. 

Pulsatilla, internally and externally (P). Mercury, after detaching crusts, 
rub in brown citrine ointment (B); should be diluted with vaselin or simple 
ointment (Br). Tannin, powdered, or tannic acid solution, gr. j-x to the ^ 
(B). Alum, after acute symptoms subside (B); a solution, gr. viij to ^j aquas, 
every % or % hour, an excellent application (R). Hydrastis, as lotion, very 



BOILS BONE DISEASES. 589 

serviceable (P). Bismuth, equal parts of the Subnitrate and Glycerin, to the 
inflamed surface, in ciliary and glandular blepharitis (Wa). Ergot, the fluid 
extract locally, gives excellent results (B). 

Prescriptions. 

R. Aluminis, gr. x. I R. Unguent. Hydrarg. Nitrat., 7,). 

Aquae Rosae, jfij. Petrolati Molli, giij. 

M. Sig. — Lotion for the eyelids. (B.) | Sig. — Ointment for margins of lids. 



Boils. 

Chloral Hydrate, is probably the best local application ; the boil should be 
kept covered with a tampon of cotton soaked in a solution of Chloral Hydrate 
Sijss in Glycerin and Water, aa 3v (Spehn). Calcium Chloride, in solution, ex- 
ternally as a fomentation, will hasten maturation ; or Lime-water on compress 
covered with oiled silk, promotes suppuration more quickly than ordinary 
poultices (P). Sulphides, in small doses (gr. ^ to % of Calx Sulphurata) every 
hour or two, or Sulphurous Mineral Waters will abort or mature, and aid to 
expel pus (R); of no use in the boils of diabetes (R). Belladonna, as plaster, 
to subdue inflammation, or lint wetted with Atropine, gr. iv, Rose-water, ^j 
(B); with Glycerin locally, to allay pain ; internally often successful (R, Wa). 
Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of water thrice 
daily. Silver Nitrate, gr. v-xx to ^j of Nitrous Ether, painted over adjacent 
part, to abort ; specific if used early (R). Boric Acid, gr. xij daily, in 2 wafers; 
also a 4 per cent, aqueous solution, warm, externally by gentle friction, 4 or 5 
times a day, and on compresses to the parts — will abort furuncles yet in the 
commencement of development, rapidly cure those matured, and prevent new 
ones (Alison). Arsenic, long-continued, for succession of boils (B); to lessen 
tendency to recurrence (Br). Opium, a thick extract locally (R). Camphor- 
ated Alcohol, smeared over boils in the earliest stage, then, when skin dry, 
smear with camphorated oil, to abort (R). Sodium Phosphate, the best remedy 
for the systemic condition which produces boils (R). Carbolic Acid, undiluted, 
on a thread passed through centre of boil while recent, will abort it ; a Car- 
bolic Acid solution (5 per cent.) on dressings after opening a boil, will prevent 
a second crop, due, as is often the case, to the migration of cocci into the skin 
from the original boil. Counter-irritation, by blisters or Iodine around the boil 
(R). Collodion, at papular or pustular stage (R). Salicylic Acid, locally to 
destroy the parasitic organism (staphylococcus pyogenes), on which boils de- 
pend. [See formula below.] Hydrarg. Biniodide, the ointment locally, with 
Calcium Sulphide, gr. j daily in divided doses internally, leaves little to be 
desired so far as treatment is concerned. Corrosive Sublimate, the B. P. solu- 
tion (1 in 87$), dropped into the ear twice daily, in furunculosis of the ear, also 
on cotton wool in the canal, gives satisfactory results and prevents return. 
Aluminum Acetate, a solution in water (1 to 4) causes the speedy abortion of 
boils in the external auditory canal (Grosch). Poultices to assist maturation 
and allay pain, may be smeared over with Belladonna or Opium (R). [Com- 
pare Acne, Carbuncle.] 

Prescriptions. 



R. Calcis Sulphurat., . . . gr. iij. 
Sacch. Lactis, . . . q. s. 
Triturat. et div. in chartas xxx. 
Sig. — One powder every 2 hours. 



R- . Acidi Salicylici, . . . . £ij. 

Emplast. Saponat, . . rijij. 

Emplast. Diachyl., . . ,^j. 

Sig. — Ointment for boils. {Heitzmann.) 



Bone Diseases. 

Iodine, in scrofulous affections of bones, should be used locally, with Fer- 
rous Iodide or Cod-liver Oil internally, nutritious diet, wine, out-door exercise 
(Wa). Cod-liver Oil, in scrofulous affections, may be relied on if perseveringly 



59° 



BREATH BRIGHT S DISEASE. 



used, and accompanied by good hygienic conditions (Wa). [Compare Caries, 
Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] 



Breath, Fetid. 

Potassium Permang., gr.j to ^j aquas rosae, as a wash for the mouth (B). 
Chlorine, as solution of chlorinated lime, to remove fetor (B). Carbolic Acid, 
a dilute solution, as wash for mouth (W). Camphor, is used as a corrective (R). 
Thymol, in solution, as a mouth-wash is very efficient in removing the odor of 
tobacco from the breath. Look for bad teeth, disordered digestion, and in very 
offensive cases for gangrenous lungs ; cleanliness of teeth and mouth are 
essential. 

Prescriptions. 



R . Calcis Chlorat. , .... giij. 
Aquae Destillatae, 

Alcoholis, aa 3 Ij. 

Olei Rosae, W\} v - 

M. Sig. — A teaspoonful in a glassful of 



water as a lotion for the mouth. 



(B- 



B 



M. 
hours 



Acidi Salicylici, . . . . £j. 
Liq. A_rnmonii Acetatis, ( ^iij. 

Glycerini, ijj. 

Aquae, . . . . q. s. ad ^w). 

Sig. — A tablespoonful every six 
[Robinson.) 



Bright's Disease, Acute. 

Aconite, should be given immediately on the appearance of the nephritis in 
scarlatina (R) ; as a diuretic, advocated (P). Strontium Lactate, is highly 
efficient (see page 452) ; is more useful in acute nephritis than in chronic (Da C). 
Pilocarpus, is much used (Da C); large doses very depressant to the heart, but 
tt^v-x of the fluid extract every half-hour or hour will produce sweating; may 
be combined with tincture of Digitalis (Smith) ; or Pilocarpine Nitrate, to excite 
skin when symptoms urgent, gr. T ^ to ]/% for adult (B) ; the dose should be small 
at first ; it is not a suitable drug for children (Y) ; I have latterly resumed its use, 
often with benefit (O). Turpentine, in drop or half-drop doses every 2 to 4 
hours, controls the dropsy in a remarkable manner (P) ; hot turpentine epithems 
are serviceable, but may increase the action of the kidneys (Wa). Belladonna, 
has often proved useful (P); may be used with benefit (Wa). Hyoscyamus, 
may be used instead of Belladonna (Wa) ; is useful in irritable kidneys (P). 
Cantharis, after subsidence of the acute stage, one-minim dose every 3 hours 
will stop the hematuria (R). Digitalis, (infusion ^ss) the best remedy in renal 
dropsy from acute desquamative nephritis (B) ; only diuretic as long as dropsy 
lasts (R). Cannabis Indica, as diuretic ; is especially useful when bloody urine 
(R). Eucalyptus, sometimes effective ; cautiously, or it will aggravate symp- 
toms (B). Jalap, the compound powder is the most generally useful purgative, 
used in the early morning, to produce free watery evacuations, when uraemic 
symptoms supervene (B). Gallic Acid, checks albuminuria (B). [See Albu- 
minuria, for formula.] Juniper, as diuretic; often aggravates (P). Diuretics, 
the stimulating ones, which act on the secreting cells of the kidneys, are con- 
traindicated ; but this is not the case with those which simply favor the flow of 
water though the kidneys, and of such diuretics Water is the best (Y). Alkaline 
Salts, as Potassium Citrate, Sodium Benzoate, or Sodium Bicarbonate, may be 
usefully added to the water (O). Diluents, as milk, and Potassium Bitartrate 
in solution, should be used freely to relieve the congestion and remove obstruc- 
tions from the tubules (B). Iron, after the acute symptoms have subsided, as a 
tonic, the most suitable preparation being Basham's mixture (the now official 
Liquor Ferri et Ammonii Acetatis) in ^ss doses thrice daily (Da C). Poultices, 
large, of linseed meal, made light and soft as possible, beneficial (Wa). Cup- 
ping, in lumbar region, ameliorates acute desquamative nephritis, and con- 
gestion of the kidney (B) ; cupping or leeches over the loins, with opiates freely, 
diluents, and demulcents, with rest and antiphlogistic regimen, often suffice 
(Wa). A Vapor-bath or Warm Pack, to increase the action of the skin. [Com- 
pare Albuminuria, Hematuria, Scarlet Fever, Uraemia.] 



BRIGHT S DISEASE, CHRONIC. 
Prescriptions. 



591 



R. Ext. Pilocarpi Fl., . . §ss. 

Vini Ipecac, 3 jss. 

Mucil. Acaciae, . . . . 7,). 

Aq. Cinnamomi, . . ad^Y). 
M. Sig. — A teasp. every four hours 
until free diaphoresis. 



R. Pulv. Jalapae Comp. , . . ^iv. 
Div. in chartulas no. iv. 
Sig. — One in water before breakfast. 



R. 



Potassii Acetatis, . . . 7, ijss. 
Infusi Digitalis, . . . ,^iij. 
Infusi Juniperi, .... 3 iij. 
M. Sig. — A tablesp. every 2 to 4 hours 
as a diuretic. 



R . Liq. Ferri et Ammonii 

Acetatis (U. S. P.), ^viij. 
Sig. — A tablesp. thrice daily, as soon as 
hematuria disappears. 



Bright's Disease, Chronic. 

Lead, diminishes the albumen (R). Gallic Acid, to lessen albuminuria (A). 
(See under Albuminuria for formula.] Hydrastis, lessens excretion of albu- 
men (B). Potassium Bitartrate, to prevent dangerous accumulations in cellu- 
lar tissue or important cavities, also to draw off effete matters ; care must be 
used, as it is a brisk purgative and is weakening (R) ; in form of cream-of-tartar 
lemonade, an agreeable diuretic (B). Jalap, the compound powder occasion- 
ally as derivative cathartic, to relieve the kidneys (Da C). Nitroglycerin, 
^Itgo" t0 dilate peripheral vessels, relieves the heart and the renal congestion 
and diminishes albumen (B). Fuchsin, in doses of gr. vij-xv daily, used with 
considerable success in different stages of the disorder, and was well borne 
(Riess). Oleum Erigerontis, lessens albumen, lowers vascular tension, im- 
proves general condition, and favorably influences the headache, nausea, and 
other uraemic symptoms (B). Cod-liver Oil, is very useful (R). Cannabis In- 
dica, as diuretic when bloody urine (R). Turpentine, sometimes given in very 
small doses as a diuretic, and to check hematuria (R) ; half-drop or drop doses 
every 2 to 4 hours very successful in dropsy with albuminous urine depending 
on non-desquamative disease of the kidneys. Jaborandi, is very satisfactory 
in uraemia (B) ; large doses very depressant to the heart (Smith) ; ttl, xx of the 
fluid extract ter in die if the urine decreases much (Da C). Iron, to improve 
digestion and correct anaemia ; the tincture of the Chloride or Tinct. Ferri Ace- 
tatis preferred (B) ; in chronic tubular nephritis with cardiac hypertrophy the 
Liq. Ferri et Ammonii Acetatis, £ss ter in die, with an occasional vapor bath 
(Da C). Chimaphila, has power over various forms of nephritic disease, espe- 
cially when albuminuria present (P). Eucalyptus, in chronic desquamative 
nephritis, cautiously used, will improve (B). Elaterium, for the dropsy, as a 
derivative cathartic; must be cautiously used (R). Bromides, are useful in the 
convulsions (R). [See Uraemia.] Potassium Iodide, has improved some 
cases, which were possibly due to syphilis (R). Aurum, the Chloride in pill 
gr. -^ to -^y ter in die, persistently, in chronic interstitial nephritis, to arrest 
hyperplasia of the connective tissue; may be combined with Arsenic, which 
has a similar influence (B). Mercuric Chloride, acts in the same manner, 
gr. -^ bis die (Da C). Milk-cure, has been very successful ; skim-milk alone 
for some time, then gradual addition of other diet (B). "Water, in large draughts 
as diuretic, when excretion of solids is deficient (Br.) ; hot fomentations to lum- 
bar region (B). Baths, warm and Turkish, when uraemic symptoms and 
dropsy ; discretion needful, as baths may weaken (R). Mineral Waters, espe- 
cially the Buffalo Lithia Water, of Virginia, which has many advocates. Food 
should be nourishing ; milk, eggs, and rare beef are particularly suitable (Da C). 
Peanuts are an excellent article of food for subjects of kidney disease, by whom 
foods rich in animal albumen are to be avoided (Furbringer). [Compare 
Dropsy, Uraemia.] 



592 BRONCHIECTASIS BRONCHITIS. 

Prescriptions. 
(Compare those under Bright' s Disease, Acute.) 



r£ . Tine. Nitro-glycerini, I per cent. 

Sig. — One drop, gradually increased to 
five, four times daily, on sugar. (B.) 



R. Strychninae Sulphatis, .gr. X- 

Tinct. Ferri Chloridi, . % ss. 

Acidi Acetici, .... gjss. 

Curacose, 3jj. 

Liq. Ammonii Acetat. , ad | vj. H . Auri et Sodii Chloridi, . gr. jss. 

M. Sig. — A tablesp. every 6 hours, fol- Aquee Destillatse, . . . 3 iv. 

lowed by a glass of water. For the anaemia. I Solve. Sig. — A teasp. ter in die. 



Bronchiectasis. 

Quinine, the most useful remedy as a tonic (B). Phosphates, are undoubt- 
edly useful, so also are the Hypophosphites (B). Chlorine, in solution as a 
stimulant and deodorizer, or as inhalation to lessen fetor (Br). Palliation of 
the cough and expectoration, with care of the general health of the patient, is 
all that can be accomplished. [Compare Emphysema.] 



Bronchitis, Acute. 

Acetanilid, in dose of gr. iv every two hours, has often arrested the attack 
within 24 hours. Aconite, gtt. ss-j every hour (B) ; in catarrh and bronchitis 
of measles (R). Tartar Emetic, in the first stage, gr. ^j to ■£%, especially if 
cough is violent (B) ; gr. j to a quart of water, a teasp. of this every hour for 
the wheezing and cough of slight bronchitis in children (Smith); gr. % to ^ 
every 2 or 3 hours (R). Ipecacuanha, as wine, when expectoration profuse and 
difficult to expel (R) ; in dry stage (P) ; Ipecac, when secretion is scanty and 
dry, but use Squill when the secretion, though copious, is difficult to expel 
(Br). Lobelia, as expectorant (B) ; for paroxysmal dyspnoea (R). Camphor, 
in oil by hypodermic injection in bronchitis from cold ; the first injection acts 
like an expectorant, and after the fourth the expectoration ceases completely, 
even in the most serious cases (Alexander) ; has but slight value in the bron- 
chitis of the emphysematous. Sanguinaria, after subsidence of acute symp- 
toms, as expectorant (B) ; very successful (P). Quinine, to reduce temperature 
(R). Colchicum, useful when gouty diathesis (P). Opium, Morphine and 
Quinine combined, or Dover's powder, to abort an attack ; also with expecto- 
rants to allay cough (B) ; in frequent and violent coughs, without obstructed 
oxidation ; also to check excessive secretion (R) ; as sudorific very useful, gr. x 
of Dover's powder (P). Carbolic Acid, as spray, a 5 per cent, solution with 
steam atomizer, prompt and efficient. Apomorphine, the Hydrochlorate inter- 
nally in doses of gr. ■£$ every three hours, the best of all expectorants. Cimi- 
cifuga, an excellent expectorant, and useful when acute symptoms have sub- 
sided (B). Nitric Acid, tt\,x of the dilute acid relieves (B). Asafcetida or Am- 
moniacum, the last best, in bronchitis with wheezing of old people (R). Asa- 
fcetida, is an excellent stimulant of respiration, especially when the capillaries 
have become clogged with the products of inflammation, and suffocation seems 
imminent ; here also the Cold Bath is a means of enabling the patient to expel 
the mucus, the equal of which has not been yet advanced ; it may be used for 
even very young infants, and should be but momentary for them (W). Am- 
monium Carbonate, when the expectoration is profuse, and the condition low 
(R). Ammonium Acetate, from its sudorific action, is always indicated, espe- 
cially in children (Dessau). [See formula below.] Cubeb, very useful, espe- 
cially when secretion copious and system relaxed (P). Copaiba, after subsid- 
ence of the fever, the most serviceable expectorant, but nauseous (B). Counter- 
irritants, mustard as large poultice, with linseed or oatmeal, or both, very 
useful (R). Iron, Lead, Zinc Oxide, to check profuse secretion (R). Heat to 



BRONCHITIS, CAPILLARY. 



593 



chest by linseed poultices, of great service. Diet, should be light and in liquid 
form. Temperature of atmosphere in room should be about 8o° F., and the 
air moistened by steam. [Compare Cough.] 



Prescriptions. 



R. Antim. et Potassii Tart. , gr. ij. 

Liq. Ammonii Acetatis, 3 iv. 

Spt. Etheris Nitrosi, . . gj. 

Tinct. Aconiti, . . . . % ss. 

Syr. Simplicis, . q. s. ad Jvj. 
M. Sig. — A teaspoonful every 2 
hours. In first stage. 



or 3 



R 



3 iv. 



Liq. Ammon. Acetatis, 

Spt. Etheris Nitrosi, 

Syr. Ipecac, . . aa 3Jss. 

Syr. Senegse, . . . . ^j. 

Syr. Limonis, ^j. 

M. Sig. — A teaspoonful every 3 hours 
for children. [Dessau.) 



R. Tinct. Aconiti, . . . . n\viij. 
Aquae Cinnamomi, . . . !§j. 
M. Sig. — A teaspoonful every }4 hour 
for 2 hours, then every hour. In acute in- 
flammatory form. 



R. 



Ext. Cimicifugae Fl., . . ^ss. 
Tinct. Opii Deodorat., . zj. 
Syr. Tolutani, . q. s. ad Jij. 
M. Sig. — A teaspoonful every 4 hours. 

(B.) 



R- . Tinct. Sanguinaria;, 

Tinct. Lobeliae, . . aa zj. 

Vini Ipecac, 3 i j . 

Syrupi Tolutani, . q.s.^^^iv. 
M. Sig. — A teaspoonful every 3 hours. 
(B). 

R- . Apomorph. Hydrochlor. , gr. % . 

Ac. Hydrochlor. Dil. , . TTLiij. 

Syrupi Senegas, . . . , _^v. 

Aquae Destillat %). 

M. Sig. — A teaspoonful every 2 hours, 
for a child of 3 years as expectorant. 
Should be put up in a blue bottle. 



R. 



M 



Vini Ipecac, £ij. 

Liq. Potassii Citratis, . z,iv. 
Tinct. Opii Camphorat., 
Syr. Acaciae . . . . aa 5J. 
Sis'. — Tablesp. terdie. In first stage 



of ordinary acute bronchitis. [Da Costa.) 



R 



M. 



Ext. Eriodyctii Fl. , . . z,vj. 
Ext. Senegae FL, . . . z,iv. 
Syr. Pruni Virginianae . 3 ij. 
Aquae, . . . . q. s. ad Jiv. 
Sig. — Teaspoonful every 3 hours. 



Bronchitis, Capillary. 

Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of 
very young or very old (B) ; as wine, when expectoration profuse and difficult 
to expel (R) ; in very young infants should be used in place of antimony 
(M & P). Squill, as expectorant, may be used with benefit (Wa). Antimony, 
Sulphurated, gr. -^ in combination with Dover's powder, every 2 or 3 hours, 
when the temperature very high, and pulse full and strong ; must be stopped 
as soon as nausea and vomiting begin (M & P). Lobelia, for paroxysmal dysp- 
noea (R). Ammonium Carbonate, when expectoration profuse and strength 
diminishing ; in severe bronchitis or broncho-pneumonia of children, 'especially 
when prostrate and livid (R) ; has probably a specific action on the diseased 
tissue and its products (Clymer). Ammonium Iodide, in small, rapid doses, 
often gives great relief to the catarrhal process (Da C) ; often gives the most 
astonishing relief (B). Ammonium Muriate, gr. ij every 2 hours, either alone 
or with Potassium Chlorate (Clymer). Serpentaria, in capillary bronchitis of 
children gives excellent results (B). Turpentine, one of the best stimulants when 
vital powers are depressed and peripheral circulation feeble (B). Camphor, to 
allay cough and promote expectoration (B). Hydrocyanic Acid, for cough and 
tendency to spasm. Hydrargyrum Subsulphate, is effective as emetic (B). 
Mustard, as poultice or bath, useful (R) ; the most important part of the treat- 
ment (M & P). Poultices, to encircle the whole chest in children (R) ; fol- 
lowed by a jacket of cotton wool around the chest. Steam, by inhalation, 
may be impregnated with sedatives, or with Carbolic Acid ; is of great impor- 
tance (M & P). Quinine, in that form of capillary bronchitis occurring in trop- 

38 



594 BRONCHITIS, CHRONIC. 

ical climates, and where marked debility (M & P). Stimulants, are often 
necessary, especially in the suffocative form, and where marked prostration 
(M & P). Emetics are necessary when suffocative symptoms become prom- 
inent. [Compare Cough.] 

Prescriptions. 



R. Ammonii Iodidi, . . . gj-ij. 
Ammonii Carbonat, . . ^ij-iij. 
Syr. Glycyrrhizae, 
Syr. Tolutani, . . . aa ^ ij. 
M. Sig. — A teasp. every 2 or 3 hours. 



R . Liq. Ammonii Acet. , . ^ ss. 

Syr. Ipecac, gj. 

Liq. Morphinae Sulph. 

(gr-jad^j), . . . . Tr\xl. 

Syr. Acaciae, ^j. 

Aquae, gjss. 

M. Sig. — A teasp. every 2 hours for a 

child 2 years old. When surface pale and 

R . Quininae Sulphatis, . . gr. vj. expression languid, skin cool. (M. & P.) 

Ac. Sulphurici Dil., . . TT^xij. 

Syr. Simplicis, . . . . ^ss. R. Ext. Serpentariae Fl. , 

Aquas, ^ ijss. Ammonii Carbonat., . . gij. 

M. Sig. — A teasp. every 2 hours to ! Syr. Tolutani 3J SS - 

child of 2 or 3 years; older children re- | M. Sig. — A teasp. every 2, 3, or 4 
quire more quinine. (M. & P.) I hours. 



Bronchitis, Chronic. 

Antimony, when expectoration copious and difficult to expel (R). Arsenic, 
in cigarettes, when emphysema (B). [See Asthma, for formula.] Sulphur, 
gr. v-x, in severe cases, with abundant discharge, especially where constitu- 
tional debility (R). Sulphurous Acid Gas, inhalations, or the acid in form of 
spray, sometimes beneficial (R). Hydrogen Dioxide, the solution internally, 
doses of 5j-iij, diluted with 3 to 4 of water, gives great relief in chronic bron- 
chitis with dyspnoea. Lobelia, for paroxysmal dyspnoea (R). Ammonium 
Chloride, combined with stimulating expectorants, such as Serpentaria, Sangui- 
naria, or Eucalyptus (B) ; when secretion is thick and abundant, may be 
applied by an atomizer (R). Carbolic Acid, as inhalation of spray, 1 part to 100 
of water ; may be combined with tincture of Iodine (R) ; a 5 per cent, solution 
in steam atomizer as inhalation. Hydrastis, fluid extract, locally and internally 
(B) ; of great value internally and externally in chronic coryza (P). Senega, 
especially in the aged (R). Iodine, by inhalation, sometimes used (R) ; the 
Iodides, especially Ammonium Iodide, are very serviceable in combination 
with expectorants (B). Colchicum, in gouty subjects (R). Balsam of Peru, and 
of Tolu, when copious secretion of pus (R). Ammonia, as inhalation, to lessen 
expectoration (R). Oleum Anthemidis, in pulmonary catarrh with excessive 
secretion and difficult expectoration, a very useful remedy, TT\jj-iv (P). Ara- 
moniacum, the mistura, with Ammonium Chloride or Carbonate, efficient in 
the bronchitis of old people, with wheezing and abundant secretion (R). [See 
Bronchorrhcea, for formula.] Benzoin, gj of the compound tincture to boil- 
ing water, as inhalation ; eases cough and lessens expectoration (R) ; is some- 
times used by atomization (B). Phosphates, for the resulting cachexia (B) ; the 
Calcium Phosphate (R). Serpentaria, as stimulant. Alum, powdered, dusted 
over surface (B). Silver Nitrate, locally (gr. v-xx to the 3) on sponge probang 
(B). Camphor, to allay cough and promote expectoration (B). Sumbul has 
decided efficacy (P). Opium, with expectorants, to allay cough (B) ; when 
cough frequent and violent, without any signs of obstructed oxidation ; also to 
check excessive secretion (R). Codeine, gr. l /e every 3 to 6 hours, when other 
opiates are not well borne (P). Ethyl Iodide, by inhalation, is very valuable 
by reason of its local influence, Tr^v-xx thrice daily (B). Grindelia, an excel- 
lent expectorant, and especially when cough is troublesome (B). Strychnine, 
as a respiratory stimulant and to check the reflex vomiting (B) ; the Syrup of 
the Phosphates of Iron, Quinine, and Strychnine. Squill, in chronic forms 
with tenacious sputa, but not when fever or acute inflammation (R) ; the Pil. 



BRONCHORRHCEA. 



595 



Ipecac, cum Scilla, of the Br. Ph. in io-grain doses night and morning, is a 
most useful remedy (Br). Tar, diminishes the secretion and allays the cough 
(P) ; gr. ij in pill every 3 or 4 hours in chronic paroxysmal winter cough (R). 
Digitalis, when interstitial pneumonia and general anasarca (B). Eucalyptus, 
valuable in chronic cases of broncho-pulmonary catarrh (B). Apomorphine, 
by the mouth, as an expectorant, alone or along with morphine (Br). Seepage 
368. Chekan, a fluid extract of the leaves is highly efficient (M). Carbonic 
Acid, diluted, may be inhaled with benefit (P). Formalin, in dilute solution, as 
spray. [See page 287.] Nuclein, has been administered with benefit, as a gen- 
eral tonic. Gallic Acid, is useful in some forms of chronic broncho-pulmonary 
catarrh (B). Iron, with free expectoration, Mistura Ferri Composita ; or better, 
the Phosphate of Iron, Quinine, and Strychnine (B); to check profuse bron- 
chial secretion (R). Myrtol, in fetid bronchitis, of great value (Gubler). Co- 
paiba, when purulent secretion (R); for profuse secretion, the best of all expec- 
torants, but nauseous (B). Cubeb, when profuse expectoration, has similar 
remedial influence (B). [See Bronchorrhcea, for formula.] Terpin Hydrate, 
gave immediate and curative results in cases of long-standing and obstinate 
bronchitis, which had resisted all other treatment; gr. xlviij, in Glycerin, q. s. 
ut. ft. solutio, Syr. Lactucarii, q. s. ad ^ij, of which a teasp. every three hours 
(Boyland). Terebene, is proving very valuable ; requires an equal weight of 
light magnesium carbonate to suspend it. Koomiss-cure, possesses great value 
(B). Cod-liver Oil, a teaspoonful ter die, after meals, of great service, if con- 
tinued (B); to control expectoration (R). Poultices, made large, of hot linseed 
meal, to cover the chest, when congestion of lungs. Olive Oil, inunctions to 
chest, has soothing and strengthening effects. Diet, nutritious, and stimulants 
necessary when great prostration ; Koomiss is an excellent article of diet. 
[Compare Cough, Emphysema.] 



Prescriptions. 



R-. Ext. Eucalypti Fl., . . ^j. 
Ammonii Chloridi, . . 3J. 
Ext. Glycyrrhizse, . . . 3 ij. 
Syrupi Tolutani, . . . 3 iij. 
M. Sig. — A teasp. 4 to 6 times daily. 



li . Syrupi Scillae, . . . 
Tinct. Opii Camph. , 
Ammoniaci. . . 

Syrupi Tolutani, . . 
M. Sig. — A teasp. p. r. n. 



,l ss - 

3 SS - 

2x. 



R 



R. 



M 



Tinct. Sanguinarise, 
Ammonii Chloridi, 
Syrupi Tolutani, . 
Spt. Etheris Nitrosi, 

Aquae, 

Sig. — Tablesp. p. 



3J- 

3 ss. 
* iijss. 



Ammonii Chloridi, . . ^iij. 

Syrupi Picis Liquidae, . ^vj. 

M. Sig. — A tablesp. 4 times daily. 



M 



Ammonii Carbonat., . . gr. xl. 
Infusi Serpentarioe, . . ^ iv. 
Sig. — A tablesp. every 3 hours. 



Bronchorrhcea. 

Ammonium Iodide, often improves the condition, especially if used with 
Arsenic (B). Eucalyptus, the oil of great utility (B); rr\jj ter die on sugar, or 
see formula above. Sulphurous Acid Gas, as inhalations, or in solution as 
spray, sometimes improves (B). Lead Acetate, as astringent to restrain secre- 
tion (B); gr. j-ij every 2 hours. Petroleum, crude, in capsules, has been ad- 
ministered with rapid amelioration as the result (Blache). Grindelia, an 
efficient remedy (B). Iodine, as liniment, over front and back of chest (R). 
Spinal Ice-bag, to restrain excessive secretion (R). Quinine, and the Phos- 
phates, also Cod-liver Oil, as restoratives (Wa). Copaiba, the most serviceable 
expectorant, but nauseous (B); when copious secretion of pus (R). Cubeb, 
has remedial effect in chronic bronchial affections with profuse expectoration 
(B). Asafetida, is of great benefit (B). Turpentine, an excellent remedy when 
fetid expectoration ; may be used internally (n\,v) or by inhalation from ato- 



5 9 6 



BRUISES BUBO BUNION. 



mizer. Terpin Hydrate, seems to be even more efficient than turpentine, in 
doses of gr. x-xx daily. Carbolic Acid, internally (n\j), and by spray (gr. v 
ad £j aquae), often of great utility (Da C). Benzoin, by inhalation, for its local 
influence. Myrtol, is largely eliminated by the lungs, and is a most valuable 
agent in bronchorrhcea and fetid bronchitis, acting as a stimulant and antisep- 
tic (Gubler); dose, rr\jj in capsules (Br). [Compare Cough.] 



Prescriptions. 



R. Copaibae, 

Syrupi Tolutani, . .aa^ss. 

Spt. Etheris Nitrosi, . . £j. 

Aquae Menth. Pip. , . . 3 ij. 

M. Sig. — A teasp. every 4 hours. 



R 



M. Sig. — Tablesp. bis vel ter in die. 



Cop£ 

Bals 


libae, 
Tolutan., 






Pulv 


. Acaciae, . . 


• aa 3 


ss 


Ac. 


Sulph. Aromat., 


• • 7> 


ss 


Aquae Destillat., 


■ ■ 3 


V J. 



r£. Ammonii Chloridi, . . ^j. 
Emulsi Asafcetidae, . . ^ iv. 
Misce. Sig. — Tablesp. as required. 



R. 



M 



Potassi Iodidi, , . . . %]. 
Ac. Nitrici Dil., . . . ^iij. 
Tinct. Belladonnae, . . 7,). 
Ac. Salicylici, . . . . 3jj. 
Aquae Camphorae, q.s. ad £ iv. 
Sig. — Dessertsp. in water 3 or 4 



times daily, for fetid bronchitis. 



Bruises. 

Arnica, the infusion very useful as an external application for bruises and 
cuts ; also an excellent internal remedy for internal bruises, shake, falls, blows, 
or shock ; tt\,v-x every 2 or 3 hours (P) ; in bruises, sprains, etc. (Wa). Aconite, 
the liniment locally to painful sprains and bruises (Wa). Capsicum, a strong 
tincture applied with gum, said to act like a charm on discolored bruises (R). 
Sulphurous Acid, a solution constantly applied (R). Oil of Bay, as stimulating 
liniment (P). Opium, the tincture with Linimentum Saponis (3j to ^j) diligently 
rubbed in two or three times a day, affords great relief (Wa). 



Bubo. 

Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord) ; 
Calomel locally applied for indolent buboes refusing to heal after opening (H). 
Nitric Acid, indolent and broken bubo (R). Sulphides, are less useful in ma- 
turating buboes than in the case of ordinary boils or abscesses (R) ; to check 
suppuration (St). Iodoform, locally, has proved useful (Wa). Iodine, applied 
to produce vesication around a bubo, relieves inflammation (R) ; freely every 
day, with rest and compression, to cause absorption (St). Silver Nitrate, lightly 
to surface, to stimulate indolent buboes (Wa). Potassio-tartrate of Iron, 30 
parts to 250 aquae destil., three tablesp. daily, also as lotion to sore (Ricord); 
in phagedena (St). Tartar Emetic, gr. j every two hours, reduces inflammation 
in many cases (Wa). Ice, greatly relieves (B). Surgical, open freely with a 
bistoury when suppurating; if pus is virulent, the open bubo is a chancroid, 
and must be treated as such (Keyes). Pressure, by compressed sponge under 
a spica bandage, or a shot bag, the best local treatment for indolent bubo 
(Keyes) ; in all cases cleanliness, rest in recumbent posture, emollient poultices. 
Diet, should be generous, with cod-liver oil, in phagedenic bubo. Treatment 
of syphilitic bubo is that of general syphilis ; local measures are useless, and 
no treatment is called for until the general eruption appears (Keyes). [Compare 
Chancroid, Syphilis.] 

Bunion. 

Iodine, as paint, or Emplastrum Hydrargyri, for indolent form, thick but not 
tender (D). Rest, fomentations, and anti-arthritic remedies for thickened 
bunion ; burst it by pressure if recent and sac thin (D). [Compare Bursitis.] 



BURNS BURSITIS CACHEXIA. 597 

Burns and Scalds. 

Carbolic Acid, 1 part to 30 of Linim. Calcis, or 1 part to 6 of Olive Oil ; the 
latter speedily relieves pain, and promotes healing without suppuration (Wa) ; 
1 part to 10 of Olive Oil, applied on layers of cotton batting, the best applica- 
tion for burns of all degrees. Boracic Acid, a saturated watery solution, used 
with great success (Lister). Lead Carbonate, as white lead paint, an excellent 
application to burns of small extent (B). Salicylic Acid, oj to ^viij 01. Olivae, 
is an efficient local application (B). Collodion, flexible, to burns of first degree 
(R). Phytolacca, relieves pain (B). Lime, as Lime-water and Oil, equal parts 
(R) ; or Lime-water with Linseed Oil (the celebrated Carron Oil) or better still 
with Olive Oil, a favorite and efficient application (P). Acetanilid, powdered 
and dusted over the surface, is an excellent application. Rhus Toxicodendron, 
the tincture externally, £j to the pint of water, in superficial but extensive 
burns (P). Cantharis, the tincture diluted with 40 of water and applied on 
rags, is a most excellent application. Sodium Carbonate in solution as lotion, 
immediately relieves pain and promotes rapid healing. Turpentine, in dan- 
gerous cases, where great constitutional depression (P) ; as wash to severe 
burns, then locally Basilicon Ointment mixed with Turpentine (B). Cotton- 
wool, to allay pain and exclude air (P). Warm Bath, immerse for some days 
(R) ; exclusion of air the main indication (H). Pinus Canadensis, the con- 
centrated extract, painted on freely, relieves the pain effectually. 

Prescriptions, 

Lime and Linseed. j R. Iodoformi, gj. 

Cftfirpi 5 1 

R. Olei Lini, ?vii. -^ , r ,' .'. ". , ' / / ^ J " , 

a f i • % ••■ Ext. Conn Alcohol., . . gr. xl. 

,, %. . \ \ ' 3 J' \ Acidi Carbolici, . . . gtt. x. 

M. big. — Apply on sheet lint, and : at c- b 1 v * j ^ 

..£ •-, j -ji M. big. — bpread on lint and cover the 

cover with oiled silk. . ,-, to ... r 

parts therewith. 



R. Sodii Carbonatis, . . . !fvj. 
Aquae, Oiij. 



R. Pulv. Carbonis Ligni, . jfviij. 



M. Sig. — Apply freely for 3 days on Sig. — To be dusted thickly over the 

old cloths or lint. ! burned parts. 



Bursitis. 

Iodine, painted on outside, after removal of fluid from aspirator (D) ; after 
blistering (Wa). Blisters, in rheumatic enlargement of bursas, are almost in- 
dispensable for a rapid cure (Wa). Fomentations, with rest, to relieve pain 
and swelling ; if unavailing, a crucial incision into the bursa, care being taken 
not to open the capsule of the knee (D). Excision, when chronic, tumor hard, 
resisting other measures (C). 

Cachexias. 

Calcium Phosphate, in scrofulous affections and anaemia (Wa) ; in phthisis, 
and affections marked by mal-nutrition (B). Iron, in splenic, syphilitic, and 
strumous, and especially in all anaemic states ; also in the malarial and phthis- 
ical ; chalybeate waters (B) ; the Ammonio-citrate is the best tonic in the 
cachexia of gastric ulcers, especially in chlorotic females (Wa). Arsenic, a 
prompt remedy in the malarial cachexia ; also of real value in the cancerous 
(Wa). Hydrastine, in paludal and splenic cachexias, stands in high esteem 
(B). Nitric Acid, is adapted to the cachexia following acute diseases or intem- 
perance ; also as alterative after a long course of Mercury (Wa). Potassium 
Iodide, in constitutional syphilis, and resulting affections of bones and skin 
(Wa). Mercury, in the syphilitic, but its utility much questioned (Wa). Aurum, 
in cancerous, mercurial, and syphilitic cachexias, especially when bones, 



59 8 



CALCULI. 



glands, and oculo-nasal mucous membrane affected. Phosphates, in bone 
diseases, wasting, bronchitic, leucorrhceic, etc. (B). Arnica, in very developed 
cachexiae, has excitant action on the nervous system (Wa). Eucalyptus, a 
serviceable tonic and stimulant in cachectic states generally (B). Manganese, 
the Syrup of Ferrous and Manganese Iodide, in anaemic, syphilitic, strumous, 
malarial, cancerous, etc. (B). Grape-cure, often modifies most happily many 
conditions (P). Air, in good condition, an important element (B). Water, 
the Turkish bath and wet pack as aids to remedial action, in plumbic, mer- 
curial and paludal (B). Oils and Fats, to promote constructive metamorphosis 
in many cachexias, especially cod-liver oil (B) ; the latter a most valuable 
remedy in scrofula, phthisis, atrophy, tubercular and jail cachexiae, anaemia, 
etc. (Wa). Massage, has been productive of remarkable results in many 
forms of cachexiae (B). Aliment, of prime importance (B.) [Compare the 
titles Anemia, Scrofula, Syphilis, etc., and the Formulae for Tonics, on 
pages 572 and 577.] 

Calculi, Biliary. 

Chloroform, in 20- to 60-drop doses every 3 or 4 hours, is by some supposed 
to act as a solvent of gall-stones ; it cannot so act but undoubtedly affords some 
relief (B) ; as an inhalation it may be used to relieve the pain of the paroxysm 
(Br). Ether and Turpentine, equal parts of each, Z) once daily for a year, is 
Durande's solvent remedy ; is not solvent, and as an anodyne is inferior to 
morphine or chloral (B). Morphine, gr. ^ w i tn Atropine, gr. y^-, hypodermic- 
ally, the best anodyne for the pain and vomiting during the paroxysm (Br). 
Chloral sometimes relieves the pain (R). Counter-irritants, as mustard poul- 
tices to relieve the pain during the paroxysm (Br). Olive Oil, §ij at night, fol- 
lowed next morning by 3 or 4 seidlitz powders an hour apart, efficient in facili- 
tating the expulsion of accumulated gall-stones ; this treatment is based on 
rational principles, as gall-stones placed in Olive Oil undergo solution, losing 
nearly 70 per cent, of their weight in 10 days (Brockbank) ; ^iv-viij per diem 
between the attacks the best prophylactic (Id). Sapo Animalis, of the Br. Ph., 
is still more efficient for their solution and breaking up (Id). Nitro-muriatic 
Acid, as bath, found useful in India to relieve the pain and promote expulsion 
of the calculus, ^iij of the acid to a gallon of water (Scott). Sodium Phos- 
phate, in 3-dose before each meal for several months, to prevent recurrence 
(B) ; should be given in plenty of water (B). Sodium Salicylate, increases the 
secretion of bile and renders it more watery ; it is therefore indicated in cases 
where there is a tendency to the formation of gall-stones (Br). Succinate of 
the Peroxide of Iron, hydrated, contains a large proportion of nascent oxygen, 
and is given in teaspoonful doses after meals for several months, and resumed 
at intervals afterwards to prevent reformation of the calculi (Buckler). Diet, is 
important ; withhold all starches, sugars, and fats, also malt liquors and spirits ; 
moderate exercise out of doors, lean meats, eggs, fish, fruits, and succulent 
vegetables to be used freely. Mineral Waters, the alkaline are useful, especi- 
ally Vichy, which is deemed of great benefit. [Compare Colic, Jaundice.] 



Prescriptions. 



U . Ferri Peroxidi Succinat. 

Hydrat., ,^j ss - 

Aquae, ^ vjss. 

M. Sig. — Teasp. after each meal for 
several months. 



& . Spt. Etheris Comp., . . £ij. 

Liq. Magendie, .... tr^xxx. 

Syr. Zingiberis, q. s. ad £]. 
M. Sig. — Teasp. doses, an hour apart, 
until pain is relieved. 



Calculi, Renal and Vesical. 

Alkalies, especially Potassium salts, if long continued will effect solution of 
uric acid calculi (R) ; Sodium salts should not be used (B). Calcium Carbon- 
ate, an old and efficient remedy, also Limewater has been used with benefit, 



CANCER. 599 

and may be injected into the bladder (P). Potassium Citrate, in large doses 
for bloody urine containing uric acid crystals (R) ; the Citrate and Carbonate 
are the most desirable solvents for uric acid gravel (Sir H. Thompson). Potas- 
sium Tartra-borate, if long used, is very efficient as a solvent for uric acid cal- 
culi (B). Potassium Salts, are much more efficient than those of Lithium as 
solvents for uric acid (Rogers). Alkaline Mineral Waters, those rich in Potas- 
sium preferred, especially Vichy (B). Ammonium Benzoate, long-continued, 
will dissolve phosphatic calculi (B). Ammonium Biborate, will prevent attacks 
of colic where uric acid calculi, in 20-grain doses every two hours until free 
urination, then gr. xv thrice daily in a glass of flaxseed tea. Magnesium Boro- 
citrate is a good solvent of uric acid calculi (Madsen). Lithium Citrate, to pro- 
mote oxidation (Da C). Piperazin, as a solvent for uric acid and urate concre- 
tions, is far superior to other agents. Olive Oil, internally, is of excellent ser- 
vice in renal as well as in hepatic calculi, controlling the crises of the disorder 
with undoubted effect (Aussilloux). Hydrangea, in decoction, used by the 
Cherokees in all calculous affections with uniform success (Butler). Lead 
Acetate, gr. l / 2 to the ^ of distilled water, injected into the bladder to prevent 
formation of phosphatic calculi, or a solution of Dilute HC1 Acid, nxij-iij to 
the 3 (Sir H. Thompson). Nitric Acid, very dilute, as injection for phosphatic 
calculi (R) ; gtt. j to the ^, as injection into the bladder in chronic cystitis and 
phosphatic deposits (B). Cotton-root, in decoction, as a demulcent for strang- 
ury and gravel (P). Castor Oil, of value as a purgative (P). Calumba, to 
relieve the vomiting (P). Counter-irritants, as mustard-poultices, or turpentine 
stupes, to relieve the pain of the paroxysm (R). Anaesthetics, for the same 
purpose (B). Morphine, hypodermically, as an anodyne and to relieve the 
vomiting (B). Hot Fomentations, to alleviate spasm and pain while calculus 
is passing. Diet. Restrict the use of sugar in any form or combination, also 
fats and alcoholic beverages. Fresh, green vegetables may be used freely, 
also skimmed milk or buttermilk. Mineral waters, preferably Vichy, Fried- 
richshall, and Carlsbad. Frequent abstinence from animal food. Lemon-juice 
and soft water in large draughts, are useful. Surgical Measures. Lithotomy 
or Lithotrity for removal of a stone from bladder. Solvents are of no use 
except for a very small calculus, and even then a considerable time must be 
occupied in the process. No operation in surgery more certainly safe, rapid, 
and successful than lithotrity (Sir H. Thompson). [Compare Colic, Lithiasis, 
Oxaluria, etc.] 

Prescriptions. 

Potassium Tartra -borate. 



Magnesium Boro-citrate. 

R. Magnesii Carbonat. , . . gj. 
Sodii Biborat. , 
Acidi Citrici, .... aa zij. 
Aquae Bullientis, 3 viij. 



R- . Potassii Bitartratis, . . . partes iv. 

Ac. Borici, partem j. 

Aquae, . partes x. 

By heating the above together, the salt is 
M. Sig. — Tablespoonful 3 or 4 times obtained as a powder, of which gr. xx in a 
daily. (B.) j large draught of water 3 or 4 times daily. 



Cancer. 

Opium, stands first in the list of palliatives, allaying pain and quieting irri- 
tation (Wa) ; as powder applied to cancerous sores ; also Morphine, dissolved 
in glycerin, and spread on lint, very useful where there is much pain ; Opium 
is also used in cancer of the stomach (R). Codeine (gr. -^ to y 1 ^), a good hyp- 
notic (P). Arsenic, in cancer of the stomach, diminishes pain and checks 
vomiting ; also in scirrhus of stomach and epithelioma. Arsenous Acid, pure 
or with starch, as a caustic ; enough should be used to set up active inflam- 
mation (R) ; may cause arsenical poisoning by absorption. Belladonna, 
locally and internally (ttLv-x), of great benefit as palliative in severe pains of 
cancer (P). Conium, as poultice, and internally to relieve pain (R) ; is par- 
ticularly applicable to pain of cancer (P) ; as palliative (Wa). Hydrastis, has 



600 CANCRUM ORIS — CARBUNCLE. 

a renewed interest (Pf). Carbolic Acid, undiluted, to sore, and injected be- 
neath it, limits and retards (B) ; pure, as anaesthetic, before applying caustics ; 
with glycerin, as application to fetid cancers (R). Mercuric Chloride, in small 
doses, long-continued, will retard the growth of gastric cancer (Da C). Citric 
Acid, 3j to ^viij aquae, useful in allaying pain of cancerous ulcerations (Wa). 
Acetic Acid, i to 3 aquae ; rrvxxx injected into the tumor, has been used with 
varying success (Wa). Chloral, in 10-grain doses, 3 times a day, has relieved 
the most severe pain of cancer (R). Chloroform, as vapor to raw surface (R). 
Pyoctanin (Methyl Violet) in solution, by injection into the neoplasm, to bring 
about the shrivelling up and final disappearance of carcinoma (Mosetig). Hy- 
oscyamus, bruised leaves, locally (P). Bismuth, relieves pain and vomiting 
of gastric cancer (B). Aurum, the Arsenate was extensively employed internally 
by Massart with benefit (see page 176). Iodoform, applied to diseased surface, 
relieves pain and removes fetid odor (P). Resorcin, 15 parts to 20 of Vaselin 
as an ointment twice daily after washing with a solution of Pot. Permanganate, 
has successfully stopped epithelioma (Antonio). Potassium Chlorate, in im- 
palpable powder, dusted on epithelioma, said to be curative (B). Pepsin, in- 
jections into tumor (B). Salicylic Acid, pure, applied in powder (B). Zinc 
Chloride, the most efficient and safe escharotic ; parts j-ij to v of flour, as 
"caustic arrows " inserted at base of tumor (B). Potassa Fusa, as escharotic 
(B). Zinc Sulphate, dusted over, dry ; an excellent caustic ; remove the eschar 
by poultice (B). Bromine, for destruction of uterine cancer, is preferred by 
some (B). Chromic Acid, a powerful escharotic (B). Calcium Carbonate, as 
calcined oyster-shell, very efficient in arresting growth of cancerous tumors, 
and in alleviating the pain thereof (Hood). Rumex Acetosa, an excellent 
local application ; has a popular reputation. Iron and Manganese, the Syrup 
of the Iodide, for resulting cachectic state (B). Toxins, the erysipelas and 
prodigiosus toxins have proved more efficient in sarcoma than in carcinoma 
(see page 477). Ozone, locally applied as antiseptic and anodyne in cancer 
of the tongue and throat, is highly efficient ; was used on Sir John Millais 
with great benefit during the last three months of his life, kept him comfortable 
without narcotics. Poultices, of starch, applied cold (R) ; or poultices of bread, 
sprinkled with charcoal or freshly ground coffee, as deodorizers to open can- 
cers. Water Enemata, to relieve pain and straining in intestinal cancer (R). 
Electrolysis, has been of great service in many cases, relieving the pain, and 
diminishing the tumor. In a case of sarcoma of the thigh, in which amputa- 
tion was the only possible resource, after one application of the needles by Mr. 
Annandale, the pain was relieved and the tumor diminished (Duncan). It 
seems proved that there is a less frequent return of cancerous growths removed 
by electrolysis than by the ordinary procedures; the evidence in its favor has 
recently accumulated (Tibbits). In any case in which operative interference is 
necessary, electrolysis is the preferable method, and in others is advisable 
(Butler). In 18 cases of epithelioma treated by electrolysis, 13 were cured, 2 
improved, in 2 there were no results, and 1 ended fatally (Groh). [Compare 
Uterine Cancer.] 

Cancrum Oris. 

Arsenic, in medicinal doses (R). Nitric Acid, to surface (R) ; strong Nitric 
Acid the best caustic for worst forms of the disease (Wa). Potassium Chlorate, 
gr. xx-xl in 24 hours, has been strongly recommended (D). Quinine, made 
into a syrup, or as enema, to support the strength (Wa). [Compare Aphthae,. 
Stomatitis.] 

Carbuncle. 

Boric Acid, administered internally and externally as for Boils (which see) ; 
equally efficacious in carbuncle, diminishing pain, redness and hardness ; nu- 
merous apertures rapidly form for the elimination of the core ; the fever falls, 
excitation and insomnia abate, and the carbuncle heals, in the majority of 



CARIES. 60 1 

cases, without surgical interference (Alison). Mercury, Corrosive Sublimate, 
injected into tumor at several points, in doses of 2 drachms of a -^ per cent, 
solution dividedly, has produced good results; these injections were often 
repeated, in broken doses likewise, on the following days (Casson). Bella- 
donna, with Glycerin, as local application to relieve pain (P). Ammonium 
Acetate, to support the system (Cezard). Carbolic Acid, on lint, with 
Glycerin or Oil, into discharging sinuses (R) ; or hypodermically into the 
sloughing tissues. Iodine, to produce vesication around carbuncle ; reduces 
inflammation (R) ; part j of the tincture to iij aquas, locally, has most striking 
effect (Wa) ; may be used with benefit internally or hypodermically (Cezard). 
Calcium Sulphide, gr. -^ hourly, or every two hours, of great service (R). 
Opium, a thick extract, locally (R). Potassium Chlorate, highly recommended, 
also Quinine and Iron, freely to support the system and counteract the carbun- 
cular poison. Poultices, the inflamed surface having been previously smeared 
with Belladonna and Glycerin (R) ; long-continued poulticing is thought to 
create a tendency to a fresh crop. Strapping-, with plaster, concentrically from 
border inwards, leaving the centre free, will sometimes arrest extension (R). 
Collodion, as protective covering (P) ; as zone around base, leaving the centre 
exposed (Wa); Collodium cum Cantharide in a broad zone painted around the 
carbuncle, to relieve the tension (Ag). Ice, or Ice-bags or iced water on cloths 
in early stage, changing to warm fomentations as soon as suppuration has 
begun (Hebra). Galbanum and Opium as plaster to relieve pain, the separa- 
tion of the core then proceeding painlessly (Hill). Crucial Incisions are not so 
frequently made now as formerly ; they relieve tension but often give rise to 
severe hemorrhage. Diet should be very supporting, and stimulants may be 
used freely when the patient is debilitated; Saline purges occasionally (Hill). 
Cauterization, with fuming Nitric or Carbolic Acid, on top of a free crucial inci- 
sion, followed by dressing with Carbolized Oil, is the course to pursue in malig- 
nant pustule. Caustic Potash, applied before an opening occurs, or small 
pieces inserted into openings made by scalpel, to cause the rapid separation of 
the slough. The resulting ulcer should be treated on general principles. [Com- 
pare Anthrax, Boils.] 

Prescriptions. 

R. Calcis Sulphurat., . . . gr. iij. | JR. Tinct. Ferri Chloridi, . ^j. 
Sacchari Lactis, . . . . q. s. Potass. Chlorat., . . . giij- 

Triturat. et div. in chart, xxx. Liq. Ammonii Acetat., . 3 iij. 

Sig. — One powder every 2 hours, to be Syrupi et Aquae, q. s. ad !§ viij. 

taken dry on the tongue. M. Sig. — Dessertsp. every 2 hours. 



Caries. 

Aurum, in syphiloma of bones (B). Calcium Chloride, where strumous 
cachexia (B). Phosphoric Acid, with 8 parts water, locally applied, has been 
of benefit (Wa). Phosphates, the best is Syrup of Calcium Lacto-phosphate, 
or Parrish's phosphates (R). Villate's Solution, injected through the sinuses 
to dissolve the carious bone, has cured many cases (B). [See formula below.] 
Sarsaparilla, a very useful medicine (P). Iodine, locally, with Iron or Cod- 
liver Oil internally (Wa). [See Boxe.] Potassium Iodide, in syphilitic caries, 
holds the first place (Wa). Cod-liver Oil, to promote constructive metamor- 
phosis (R). Mechanical Contrivances, are necessary in most cases ; Sayre's 
plaster jacket, Agnew's jacket of leather and steel, Taylor's apparatus, etc., are 
used in spinal caries to separate the diseased bones, and extend the spinal 
column. [Compare Necrosis.] 

Prescriptions. 
R. Cupri Sulphat., I R- . Syrupi Calcii Lacto-phos- 

Zinci Sulphat., aa partes xv. phatis (U. S. P.), . . ^ viij. 

Liq. Plumbi Subacetat., p. xxx. Sig. — A dessertsp. to a tablespoonful 3 

Aceti, ....... p. cc. ; or 4 times daily. 

( Vitiate' s Solution.) 



602 CATALEPSY CATARACT CATARRH. 



Catalepsy. 

Turpentine, in enemas, and embrocations along the spine, affords the best 
chance of stopping the paroxysms (Wa). Treatment must be essentially tonic 
and restorative (H) ; no constant line can be stated (A) ; external stimulation to 
arouse consciousness, by Ammonia, cold douches, Faradism, etc. Apomor- 
phine, gr. ^ to T ^, in the paroxysm ; with the onset of nausea, consciousness 
returns and spasm ceases; in the intervals between the attacks the treatment 
should be that of hysteria (Gowers). 



Cataract. 

Phosphorus, with Oil, by frictions toth^e forehead, and instillation of the same 
into the eye, may cause absorption of the lens or capsule (Wa). Codeine, in 
diabetic cases (Br). Sodium Sulphate, a solution suggested as injection into 
anterior chamber, in hope to dissolve the nebula (Wa). Galvanism, has been 
successfully employed in incipient stage (Wa). Mydriatics, Atropine, Duboi- 
sine, etc., to secure full dilatation of pupil, as a means of ascertaining when the 
operation should be made, which is when the cataract is mature, there being 
no vision even with dilated pupil (Wa). Diet and Regimen, may do much to 
retard degeneration of the lens, in cases due to diabetes, or to malassimilation 
in gouty or rheumatic persons (C). Iridectomy, made early and effectually may 
postpone the progress of lenticular opacity, if due to increased intraocular ten- 
sion (C) ; in partial cataracts, which have become stationary, iridectomy for 
artificial pupil may be done to expose the clear portion of the lens (Roosa). 
Medicine, accomplishes nothing except to improve the general health and so 
delay the progress of the opacity. Removal may be performed by one of 
several operations (Roosa). 



Catarrh, Acute Nasal. 

Menthol, I or 2 parts dissolved in 20 of chloroform, of which a few drops 
in the hollow of the hand, the hands then rubbed together and placed before 
the face, the remedy being inhaled alternately through the nose and the 
mouth, will arrest the progress of a cold in its initial stage (Wunsche). Chlo- 
roform, by inhalation in small quantities, is an excellent nasal antiseptic, and 
is of great value in acute nasal catarrh. Sodium Salicylate, to abort a cold 
(see page 428). Aconite, in severe coryza with much chilliness, aching limbs, 
hot and dry skin, and quick pulse; also in catarrhs of children and that 
accompanying measles (R) ; in acute coryza (P) ; with Belladonna in ordinary 
colds with sore throat and high fever (B) ; in doses of n^ every }4 hour, very 
useful for a commencing cold in the head (Smith). Belladonna, in acute 
nasal catarrh with profuse watery secretion, vr^ v of tincture, then rr\J each 
hour (B). Nux Vomica, has great effect upon a dry cold in the head (P). 
Euphrasia, is of decided utility in coryza (P). Pulsatilla, a warm lotion, 3j-ij 
in ^iv aquas, syringed into the nasal passages in subacute coryza with muco- 
purulent secretion (P) ; acts similarly to Aconite, but is contraindicated if 
much gastric or intestinal irritation exists (B). Iodine, by inhalation in daily 
attacks with itching nose (R) ; 3>ij of the tincture with 3j of Carbolic Acid 
inhaled from sponge in the bottom of a wide-mouthed bottle placed in hot 
water (B). Iodides, are unquestionably serviceable, their action being local 
and substitutive ; Ammonium Iodide, gr. j every two hours, the best mode of 
using them (B). Sodium Iodide, gr. x ter die, with Pil Ferri Iodidi, in catarrhs 
of specific origin (B). Potassium Iodide, gr. x at bedtime at the onset, to cut 
short an acute cold in the head ; also useful in chronic colds (R). Arsenic 
Iodide is very efficient as a remedy for an acute cold, coryza, and similar 
affections, especially when accompanied by a sore throat resembling that of 
diphtheria ; gr. iij triturated with gr. xx of sugar of milk, one-halfof which 



CATARRH, ACUTE NASAL. 



603 



may be dissolved in ^iv of water, and a teasp. given every hour or so. Ar- 
senic, when sneezing, itching of nostrils and frontal headache (R) ; as cigar- 
ettes (B). [See under Asthma, for formula.] Veratrum Viride, if Arsenic 
fails (R). Potassium Bichromate, in small doses, gr. y^yin trituration, is very 
efficient, especially when the nasal discharge is thick, stringy, and glutinous. 
Potassium Chlorate, in doses of eight or ten lozenges a day, will abort many 
a cold (R) ; a very good remedy in ordinary catarrh (P). Quinine, gr. x, with 
Morphine, gr. ye, at incipiency, will often abort an acute coryza (B). Opium, 
at night, if taken early in the case, will often abort an attack of coryza ; a glass 
of hot grog assists its action (R) ; Dover's powder in a full dose at the onset 
may abort (B). Codeine, is useful in common colds, as a palliative (B). Am- 
monia, may be inhaled in the early stage (R). Camphor, as inhalation, the 
spirit in form of vapor (R) ; with Opium and Ammonium Carbonate as pow- 
der (see formula below), to break up or modify a cold (Beard). Tartar Emetic, 
gr. 2V to T ^ in the first stage (B) ; in acute catarrh of children often accom- 
panied by vomiting and diarrhoea (R). Ipecacuanha, for acute nasal and 
bronchial catarrh, and ordinary colds in children (B). Cimicifuga, when head- 
ache, stiff muscles, dull aches, bone-pains, etc. (R) ; an excellent expectorant 
(B) ; rheumatic colds ; neuralgic pains in jaw (P). Jaborandi, the fluid extract 
in doses of n\,x to xxx, every half hour until profuse diaphoresis sets in, is one 
of the best modes of aborting a cold ; or Pilocarpine Hydrochlorate, gr. l /e in 
water at bed-time, will give prompt relief, and cure in a few days (Wyss). 
Cocaine, a 4 or 5 per cent, solution locally as spray, to empty the engorged 
venous sinuses of the nasal mucous membrane, by their contraction, which it 
induces ; the fluid extract of Coca diluted with water is equally efficient if 
enough be used (Cohen). Resorcin, the best of all applications. (See Ca- 
tarrh, Chronic.) Chloral, 20 grains in %} of Castor Oil, applied with a 
soft mop, when the Schneiderian membrane is very irritable, checks the secre- 
tion of mucus and lulls the irritation and the head pains (Brodnax). Ammo- 
nium Chloride or Cubeb, in the dry, congestive stage of a cold in the head ; 
Cubeb cigarettes may be smoked as a temporary palliative with great relief. 
Sulphurous Acid, in coryza, by inhalation, spray, or fumigation, is very effi- 
cient (R). Oil Inunctions, daily to the whole body, in cases of undue suscep- 
tibility to taking cold, will prevent the frequency of the attack (B). Baths, a 
warm foot-bath before going to bed ; Turkish bath, at onset in coryza, may 
prove abortive, also useful later on ; cold sponge-bath in cases of extreme sus- 
ceptibility, supplemented by occasional Turkish baths (R). [Compare Cough, 
Hay-Fever, Influenza.] 



Quininae Sulphatis, . . gr. xvii 
Liq. Arsenicalis (B. P.), n\xij. 
Liq. Atropine (B. P.), . rr\j. 
Ext. Gentianse, . . . . gr. xx. 
Pulv. Acacire, . . . . q. s. 
Ft. pil. no. xij. Sig. — One every 



Prescriptions. 

R 



4. 



or 6 hours, for acute colds. 



R 



( Wkalen. 



rr.l. 



Camphors, .... 

yEtheris, q. s. 

Dissolve to creamy consistence, 
then add — 

Ammonii Carbonat., . gr. xl. 

Pulv. Opii, gr. x. 

Divide into thirty papers. 
One or two powders, according to age, 
twice or thrice daily. [Beard.) 



M 



Acidi Carbolici, .... gr. lxxx. 

Alcoholis, ^ ss - 

Aq. Ammonire, .... rr\Jxxx. 

Aquae, 3^ ijss. 

Sig. — A few drops as an inhalation 



from a cone of blotting paper. [Brand.) 



Zh 



R. Morph. Acetatis, . . . 
Bism. Subnitrat., 
Pulv. Talci, . . . aa 
Ft. Chartulas no. xxx. 
Sig. — Use as snuff in acute rhinitis. 

[Sajous.) 

R . Codeince, gr. ij. 

Syrupi Tolutani, 

Syr. Scillae Comp., . aa ^j. 
M. Sig. — Teaspoonful occasionally for 
a common cold. (B.) 



604 CATARRH, CHRONIC NASAL. 



R . Tinct. Aconiti, .... n\x. 
Tinct. Belladonnas, . . ^ss. 
Syrupi Zingiberis, q. s., 
ad 3*1- 



Ferrier 's Snuff. 

R- . Morph. Hydrochlor. , . gr. i 

Bismuthi Subnit., . . . ^vj. 

Pulv. Acacise, . . . . ^ij. 



M. Sig.— Half to one teasp. according j M Sig.— Use as snuff, % to ]/ z the 
to age, every hour. | above in 24 hours _ 



Catarrh, Chronic Nasal. 

Sanguinaria, the tincture in io-drop doses thrice daily, or gr. ^ of the alka- 
loid, internally, and the powder in small quantity locally to the mucous mem- 
brane, is successful treatment for chronic nasal catarrh (B). Glycozone, fre- 
quently applied, is of benefit (Edson). Hydrastis, is of value in chronic coryza, 
also in ulceration of the septum or any other part of the nasal fossae, gtt. v of 
the tincture thrice daily internally, and Z) to ^viij of water locally by syringe 
(P). Pulsatilla, is excellent in subacute inflammation of nasal passages, with 
offensive muco-purulent discharge, 3j-ij to ^iv of water, as wash (P). Potas- 
sium Bichromate, is an excellent local application in a solution of gr. j-x to ^iv 
water (B) ; small doses, gr. -j-^y in trituration, internally, a most efficient remedy, 
especially when the discharge is tough and stringy, and the nose tender. 
Cocaine, is much used, but is only of temporary benefit; many of the proprie- 
tary snuffs and powders for chronic catarrh contain this drug, their use fre- 
quently inducing the cocaine habit. Resorcin, the best of all applications, in 
acute and chronic catarrh ; after cleansing the nose with a Boracic Acid solu- 
tion, or Dobell's, use a 2 to 10 per cent, ointment (in Vaselin), also a spray 
every other day, of a 2 to 4 per cent, solution : it gives the same results as 
Cocaine, but is slower in action and more lasting, and does not suppress the 
normal function of the mucous membrane, as the latter does. Eucalyptus, has 
been employed with benefit (Wa). Bismuth, in powder with Acacia, as in 
Ferrier's snuff (see above), or with Tannin, Calomel, Iodoform, etc., used by 
insufflation daily (Robinson). Iodoform and Tannin, 1 of the former to 2 or 3 
of the latter, carefully triturated, and applied by an insufflator every other day 
only, is the very best of all applications (B). Sodium Chloride or Phosphate, a 
teasp. to the pint of warm water as cleansing solution, or the Bicarbonate, in the 
same proportion ; a sea-water gargle in the naso-phary ngeal space, has been used 
with success (Mosler) ; Wei de Meyer's Catarrh Cure is simple Sodium Bicar- 
bonate and a little pink coloring matter (Robinson). Potassium Permangan- 
ate, gr. j-x to the pint of warm water, as a deodorant solution when necessary. 
Ammonia, by inhalation, when painful inflammation of nasal mucous mem- 
brane and frontal bones (R). Carbolic Acid, a 1 per cent, solution as spray, 
or inhalations of the vapor with that of Iodine from a bottle in hot water, or 
vaporized by the warmth of the hand (B). Salicylic Acid, in weak solution, 1 
to 500 of water, as a disinfectant and astringent injection, used with a retro- 
pharyngeal syringe, and followed by applications of powdered Calomel, 
through a speculum, upon the ulcerated parts of the mucous membrane 
(Massei). Cubeb, finely powdered and blown into the nares by an insufflator 
(B), has proven very useful (P) ; may be smoked, and administered internally 
in teasp. doses (Wa) ; in freshly ground powder as a confection, (see below for 
formula), very efficient in follicular disease of the naso-pharyngeal space (Rob- 
inson). Ammoniacum, in the same condition, very small doses, ,gr. j-iij, with 
Ipecac or Ammonium Carbonate, will greatly lessen the amount of secretion 
(Robinson). Aurum Chloride, in mercurialized and syphilitic subjects, with 
offensive discharge, depressed spirits, and soreness of the nasal bones. Iodides, 
of Iron and Sodium, in catarrh of specific origin (B). Silver Nitrate, in pow- 
der, as alterative application, gr. x-xv to the % of menstruum, is often a useful 
adjunct to treatment, used once every 4 or 5 days (Robinson). Cod-liver Oil 
should be used in strumous subjects (R). Alum, in powder, dusted over the 
affected surface, is a useful application (B). Bromine, the vapor may greatly 
benefit, but must be used with caution (B). Senega has been found service- 



CEREBRAL ANAEMIA. 



605 



able (Wa). Douche is dangerous, being likely to cause extension of the catarrh 
to the Eustachian tube and the middle ear ; it has been very generally aban- 
doned. Sprays by hand-ball atomizers, or compressed air apparatus, of warm 
watery solutions, Vaselin, etc., are used with considerable success (Cohen); 
the Hank's atomizing tubes, with a 2-ball rubber syringe, are very serviceable 
for office use, and for the application of Rumbold's hot Vaselin spray. [See 
formula below.] Sulphur Waters, internally, of great benefit in follicular dis- 
ease (Robinson). [Compare Oz^ena.] 



Prescriptions. 



R . Acidi Carbolici, . . . . n\ x. 

Glycerini, 3 v j- 

Vaselini, 3 i j . 

M. Sig. — Warm and use as a spray 
every 4 hours. (Rumbold.) 



R. Pulv. Argenti Nitrat., . gr. vij. 
Pulv. Acaciae, . . . ^j. 
Bismuthi Subnitrat, . . giij. 
Triturat. Sig. — Apply with insufflator 
once in 4 or 5 days. (Robinson.) 



R 



. Acidi Carbolici, . . . T1\xl. 

Sodii Boratis, 

Sodii Bicarbonat, . . aa gij. 

Glycerini, 3 v ij- 

Aquae, . . . . q. s. ad 5viij. 
M. Sig. — Use daily as spray. 

(Dobell.) 

Bismuthi Subcarb., , 

Pulv. Acaciae, . . . aa ^ss. 
Zinci Sulphat. , . . . . gr. x. 
Morph. Sulphat., . . . gr. ij. 
M. Sig. — Snuff, to be used thrice daily. 
(Saj'ous.) 



R. Bismuthi Subcarb., . . ^vj. 

Morph. Muriatis, . . . gr. ij. 

Pulv. Amyli, ^ij. 

Triturat. Sig. — Burness' modification 
of Ferrier's snuff. 



R. Sodii Boro-benzoatis, . ?j. 
Ext. Hydrastis FL, . . gj. 

Glycerini, gj. 

Ac. Carbolici, . . . . TT\, xx. 
Aquae Camphorae, . . . 5 vj . 
Aquae, . . . . q. s. ad ^xij. 
M. Sig. — Use with syringe or atomizer 



thrice daily. 



(Chamberlain.') 



M 



Acidi Carbolici, . . . 
Extr. Hydrastis FL, . . 
Sodii Bicarb., 
Sodii Biborat., . . . aa 

Glycerini, X). 

Aquae Camphorae, q.s. ad £ viij 
Sig. — Use with posterior 



gtt. xv 
3i- 



nasal 



sprayer. 



R 



Sodii Salicylatis, . . . gij. 

Sodii Boratis, . . . . giij. 

Glycerini, £ss. 

Aquae, . . . . q. s. ad 3yj. 
M. Sig. — A dessertspoonful into a pint 
of warm water, and snuff it from the hol- 
low of the hand thrice daily. (Sajous.) 



R. Ext. Pini Canaden, . . n\xx. 

Glycerini, TT^xxx. 

Aquae, Oj. 

M. Sig. — Use with post-nasal syringe. 



Cerebral Anaemia. 

Iron, the tincture of the Chloride, or mild chalybeate waters, in chronic 
cases from general anaemia (B). Amyl Nitrite, in vaso-motor spasm ; affords 
relief in sudden attacks (B). Chloral, in small doses with stimulants and warm 
baths (Ros). Camphor, or other cerebral excitants, as Asafcetida, Valerian, 
Serpentaria (B) ; the Mono-bromide in one- to five-grain doses (Hammond). 
Glonoinum, tt\J of a I percent, solution (P). Phosphorus, supplies the needed 
material for healthy brain action (B). Strychnine, stimulates the circulation 
generally ; with Iron preparations as a tonic. Galvanism, a mild current 
transversely through the head, gives excellent results in the confusion of mind, 
vertigo, etc., due to imperfect nutrition of the brain from atheroma of the cere- 
bral vessels (B). Arsenic, is highly efficient in some hypochondriacal cases 
(B). Aurum, is of great utility in vertigo, melancholia, etc., when due to or 
accompanied by cerebral anaemia (B). [Compare Insomnia.] 



606 CEREBRAL CONCUSSION CHANCRE. 



Cerebral Concussion, 



Arnica, when from a fall, cannot be too highly spoken of (P). Warmth, 
to extremities, rest, expectant treatment, will suffice in mild cases (Ag). The 
indications are : (i) to recover from insensibility and collapse ; (2) to prevent 
inflammation; (3) to restore impaired faculties (D). Stimulants or Venesec- 
tion, cannot be too strongly reprobated (Ag). 



Cerebral Congestion. 

Aconite, in active form, renders important service (B) ; is much the best 
remedy in this condition (P). Belladonna, one of the best remedies in all 
hyperaemic conditions of the brain or spinal cord (P). Gelsemium, n\,v of the 
fluid extract every two hours, very useful (B). Bromides, are very useful (B) ; 
must be used in full doses. Colocynth, as counter-irritant, appears to act well 
(P). Cathartics, lessen blood- pressure (B). Colchicum, in plethoric subjects 
(B). Galvanism, of the brain and cervical sympathetic (B). Chloral, when 
temperature high (B). Arsenic, sluggish venous circulation, torpor (B). Hy- 
drocyanic Acid, TT\jj-v of Scheele's dilute acid (B). Venesection, will prevent 
injury to brain ; not to be adopted as a matter of course ; is contraindicated 
when anaemia, aortic valvular disease, or in cases commencing with syncope 
(A). Water, cold douche to head, feet in warm water ; ice and hot water 
alternately to head and nape of neck, often more affective than ice alone (B) ; 
hot water to head on flannels ; mustard and hot water packing for 20 to 30 
minutes, around legs, when active congestion ; protect bowels well (R). Diet, 
should be low, but not too low, until all fear of relapse is past ; full animal 
diet should be avoided, also undiluted wines (A). [Compare Apoplexy, 
Coma.] 



Cerebral Softening. 

Venesection, and antiphlogistic treatment generally, are most beneficial in 
red softening, the result of inflammation ; require wise discretion, and should be 
used early ; not to be thought of in the yellow form, arising from want of nutri- 
tion, wherein restoratives and food are needed, perhaps wine (A). Phosphor- 
us, in threatened softening of the brain ; is the only drug which affects the 
nerve centers (W). 



Chancre. 

Mercury, small doses steadily, but ptyalism must not be induced ; Black- 
wash (Calomel gr. viij, Aq. Calcis ^j), or yellow-wash (Hydr. Chlor. Corr. gr. j, 
Aq. Calcis ^j) on lint, to erosions and ulcerated indurations (B) ; Calomel 
alone as dry dressing : the internal use of Mercury is best postponed until sec- 
ondary symptoms appear (St). Carbolic Acid, as wet dressing, gr. ij of crys- 
tals to ^iv aquae ter die (St). Iodoform, heads the list of dry dressings ; with 
Lycopodium, equal parts, or 1 to 2 of Zinc Oxide ; 2 to 1 of Calomel (St). 
Hydrogen Dioxide, said to destroy the specific character ; wash lesions thrice 
daily, and apply lint soaked in it (R). Caustics, should never be used unless 
chancre is attacked by phagedena (St). Caustic Alkalies, to hard edges (R). 
Bromine, Chromic Acid, are the best escharotics (B). Dressings, are effective 
as far as the local trouble is concerned, in the majority of cases ; sometimes a 
piece of lint on the erosion will suffice ; never cauterize an initial lesion unless 
it is attacked by phagedena (St). Cleanliness, of great importance ; tepid 
water locally frequently suffices for the local treatment of infecting chancre. 
[Compare Syphilis.] 



CHANCROID CHILBLAINS. 607 

Chancroid. 

Mercury, the Acid Nitrate one of the best caustics ; apply with a glass rod 
(B). Nitric Acid, fuming, as caustic (R) ; Z) to ^viij aquae is an excellent 
dressing (St). Carbolic Acid, injected into sore (B) ; 3'j-v to Oj aquas locally 
in phagedena (St). Ferri et Potassii Tartras, the born enemy of phagedena 
(Ricord) ; Jj to ^vj aquae, internally, teasp. doses thrice daily ; also locally 
(St). Ferrous Iodide, in sloughing phagedena, or simple chancroid in debili- 
tated constitutions (B). Iodoform, powdered and dusted over the sore, allays 
pain, changes morbid action, and is antiseptic (R) ; 1 part to 2 of Lycopodium, 
or one of Tannic Acid ; as stimulant and alterative (St) ; does no good except 
to relieve pain (Gross). Potassium Chlorate, in impalpable powder, is better 
than Iodoform (B). Chloral, gr. iij ad £j aquae, the best local application to 
relieve pain (Gross). Caustics, in severe cases, the white-hot iron, strong Sul- 
phuric Acid, pure Nitric Acid, pure Carbolic Acid, are effective in the order 
named (St). [Compare Bubo.] 



Chapped Hands and Lips. 

Sulphurous Acid, as solution, or by fumigation, will speedily cure (R). 
Glycerin, diluted, or better still, Glycerite of Starch, or with ]/ 2 the quantity of 
Eau de Cologne (R). Benzoin, the comp. tinct. 1 part to 4 of Glycerin ; an 
admirable application (P). Hydrastis, on compress as lotion (P). Collodion 
is usefully employed (P). Carbolic Acid, 1 to 2 of Glycerin, locally ; one appli- 
cation is generally sufficient. Unguentum Aquae Rosas alone, is often efficient ; 
may be combined with Zinc Oxide. Menthol, with Salol, etc. (see below), is 
said to alleviate the pain of chapped hands on the first application. 

Prescriptions. 

R. Mentholi, gr. xv. I R. Cetacei, £j. 

Saloli, gr. xxx. Glycerini, gij. 

01. Olivse, Z ss. Cerae Albae, gr. xv. 

Lanolini, 3J SS - 01. Amygd. Amarse, . . rri^iij. 

M. Ft. unguentum. M. Ft. unguentum. 



Chest-pains. 

Belladonna, as ointment, when tenderness is in the skin (pleurodynia) (R). 
Iodine, as oint. when pain in muscles (myalgia) of chest, they being tender on 
pressure, while the skin may be pinched without pain (R). Strychnine, affords 
relief in functional irritability of the nervous system, manifested by wandering 
neuralgic pains (B). Arnica, for a stitch in the side. Bryonia, when painful 
catching of breath. Cimicifuga, for intercostal rheumatism and pains under the 
breasts in women. [Compare Myalgia, Neuralgia, Pleuritis, Pleurodynia, 
Pneumonia.] 

Chilblains. 

Digitalis, internally and locally, to improve the circulation, and combat the 
arterial hypo-tension and peripheral vaso-dilatation which are always present in 
those subject to chilblains (Pilatte). Caffeine and Kola may sometimes be sub- 
stituted for Digitalis. Iodine, as ointment, the best application (R) ; the tincture 
lightly painted over the surface every 3 or 4 days, is particularly serviceable 
for the itching. Arnica, is a useful application (Wa). Carbolic Acid, with 
Iodine, as ointment, is a very efficient application for chilblains. Benzoin, the 
tincture in Glycerin, applied after thorough washing in soap and water and 
drying, the best application. Sulphurous Acid, an efficient application ; 3j to 



6o8 



CHLOROSIS CHOKING. 



£>iij each of water and glycerin (B) ; as solution or fumigation (D). Balsam of 
Peru, in ointment for broken chilblains (R). Capsicum, the tincture painted 
over unbroken chilblains (R). Cajuput Qil, applied locally (R). Turpentine, 
as wash, then apply Basilicon Ointment, mixed with Turpentine (B). Ichthyol, 
as oint. has been of service. Thiol, the dry form, as a dusting powder, is 
used efficiently. Alcohol, as Eau de Cologne, or camphorated, with friction, 
after careful drying of the hands and feet. Vaselin, and other fatty substances, 
should never be applied (Pilatte). 



R . Tinct. Digitalis, . . . . gjss. 
Thymol i (cryst. ), . . . gr. xlv. 
Alcoholis (70 C), 

Glycerini, aagxv. 

M. Sig. — For local use. {Pilatte 



Prescriptions. 

I R- 



Acidi Carbolici, 
Tincturae Iodi, 
Acidi Tannici, 
Cerat. Simplicis, 



3J- 

si- 

3 IV. 



Misce bene, ft. unguentum. {Morrow.} 



Chlorosis. 

Iron, combined with Arsenic or Strychnine, also occasional purgation and 
active exercise (R) ; the Iodide, when much torpor of the system, is often 
speedily efficacious (Wa) ; Iron is not a specific in chlorosis, and acts best in 
the purest types (Tr.). Manganese, the saccharated carbonate of iron and 
manganese (B) ; Pepto-mangan is a good preparation. Arsenic, if Iron fails 
or disagrees (B). Aurum Arsenate, has rendered good service. Ergot, in 
chlorotic amenorrhcea (P). Nux Vomica, stimulates the blood-making organs, 
and may be combined with Iron ; a very generally useful preparation is the 
syrup or elixir of Iron, Quinine, and Strychnine (B). Cocculus Indicus, when 
amenorrhcea and exhausting leucorrhcea (P). Hypophosphites, of Calcium or 
Sodium (R). Benzoin, has been used with advantage (P). Pepsin, benefits, 
especially where digestive derangement (B). Sulphur, of great benefit in cases 
where Iron is of no effect ; also to prepare the system for benefit from Iron 
(Schulz). Bone Marrow, has been used with benefit. Thymus Extract, has 
apparently been of service. Nuclein, is employed with success in some cases. 
Purgation, is very important, to prevent auto-infection from putrid intestinal 
decomposition, which is the true cause of this disease (Duclos) ; absorption of 
such products tending to impoverish the blood, and produce a "fecal anaemia " 
(Sir A. Clark). Oils and Fats, as inunctions, after baths, of great benefit (B). 
Galvanization, central, will aid the action of the remedies (B). [Compare 
Anemia, Amenorrhcea.] 



Prescriptions. 



R . Ferri Arsenatis, . 
Extracti Cinchonae, 
Fiant pil. xij. Sig.- 
meal. 



U- 



R.. Pulv. Aloes Socot., 



gr. v. 



. . gr.xij. 
-One after each 
(B.) 



R . Ferri Sulph. Exsiccat., . gr. xl. 
Quininae Sulphatis, . . gr. xx. 
Strychninae Sulphat., . gr. ss. 
Ft. pil. xx. Sig. — One thrice daily. 



Ferri Sulph. Exsiccat., . gr. xv. 
01. Tanaceti, vel 

01. Sabinae, gtt. xxx. 

Croci, 
Myrrhae, 

Cantharidis, . . . . aa gr. xxx. 
Ft. pil. lx. Sig. — Two thrice daily, 



gradually increased to foui 



( Wallace. 



Choking. 

Potassium Bromide, benefits a curious affection, sometimes found in children 
who from their birth can swallow solids with ease, but choke at drinks (B). Oil 
of Cajuput, in one case of persistent " choking " sensation in the throat, a few 
doses removed the symptoms, which had lasted several weeks (Hale). 



CHOLERA. 609 

Cholera Asiatica. 

Camphor, a drop or two of the saturated tincture, or gtt. v-x of the spirit with 
a little Opium every half-hour (B) ; gtt. iv-vj of strong spirit every ten minutes 
until symptoms abate, then hourly (R) ; the combination of camphor, opium, 
etc., known as Squibb 's Cholera Mixture (see below for formula) is a very effi- 
cient remedy at the inception. Morphine, gr. }£ to }4 hypodermically in pre- 
liminary diarrhoea (P) ; y% to % gr. of the greatest value even in collapse (R) ; 
dangerous if kidney complications exist (P) : Morphine is the principal ingre- 
dient in Chlorodyne (see page 227) a remedy which is commonly used in India. 
Chloroform, a few drops frequently repeated, or 10 to 30 drops of chlorodyne, 
of great value (B). Chloral, with Morphine, by hypodermic injection, is the 
most effective treatment known (see below for formula) ; it causes pain and in- 
duration but not suppuration (B). Arsenic, in epidemic cholera ; some cases 
of arsenic poisoning are not distinguishable from cholera (B) ; for the vomiting 
and in collapse (R). Copper salts have been given (R). Turpentine, tt^x-xx 
every two hours, promises to be a remedy of value (Wa). Lead, the Acetate 
in early stages (R). Carbolic Acid, with Iodine, has given good results (B). 
Salol, has done excellent service. Sulphuric Acid, the aromatic, with Opium, 
is very effective (B) ; two parts of the former with one of Laudanum, of this 5 
to 30 drops as per age, is one of the best prophylactics (McClellan). Strych- 
nine, as prophylactic during the preliminary diarrhoea, and in epidemic form 
when nearing collapse (B). Alcohol, small doses of iced brandy for vomiting 
(B). Spinal Ice-bag, for cramps (R). Saline Injections, into the veins, have 
been successful in the collapse (B). Transfusion, of milk, in the collapse (B). 
Absolute Rest, recumbent posture, no food, ice ad libitum ; enemata of warm 
milk ; fresh air, friction, and heat to abdomen, legs and feet ; stimulants worse 
than useless. Cholera Toxin, as inoculated by Dr. Haff kine, has been highly 
efficient as a prophylactic (see page 478). 



Prescriptions. 



R 



M. 



Chloroformi, . 




Zi- 


Tinct. Opii, 
Spt. Camphora?, 
Tinct. Capsici, 
Alcoholis, . . . 


. . aa 

q.s. ad 




Sig- 


— 30 to 60 

[Squibb' 


drops ir 
j- Chole) 


l water. 
■a Mix tin 


Acidi 


Carbolici. 




gr. viij. 


Bismuthi Subnit 




Z% 



R . 01. Mentha? Piperita.', . . partem j. 

Tinct. Opii, partes iv. 

Ac. Hydrochlor. Dil., . partes ij. 
Quininae Hydrochlor., . partes iv. 
Tinct. Cinchona? Comp., 
Spt. ^Etheris Comp., aa partes xv. 
M. Sig. — 15 drops every 2 hours. 

(Bot kin's Cholera Drops. 



B 

R. Chloralis Hydrat., . . . ^iij. 
Mucil. Acacia?, Morphina? Sulph., . . gr. iv. 

Aqua? Laurocerasi, . aa 3jj. Aqua? Laurocerasi, . ■ %)■ 

M. Sig. — Teasp. every hour or two, for j M. Sig. — Fifteen to twenty drops as 
vomiting and diarrhoea. I injection hypodermically. (B.) 



Cholera Infantum. 

Bismuth Subnitrate, in hourly doses of 3 to 6 grains, is regarded by many 
as almost a specific. Ipecacuanha, greenish stools with mucus and often 
blood (B). Arsenic, for vomiting and collapse (R). Mercury, gr. l /e of 
gray powder hourly of great service in infantile cholera with incessant sickness, 
profuse, almost continous diarrhoea, offensive and nearly colorless stools; a 
Starch injection, with a minute quantity of Laudanum, assists the gray pow- 
der, and should be given in urgent cases (R). Zinc Oxide, with Bismuth and 
Pepsin, is very useful (B). Camphor, <5j to ^iv of milk, very serviceable (B); 
an admirable remedy for summer and choleraic diarrhoea (R). Opium is gen- 
erally necessary ; enemata of Starch and Laudanum (see above under Mer- 

39 



6io 



CHOLERA SIMPLEX. 



cury). Morphine, hypodermically, in doses of gr. ^q to -^ according to age, 
the latter dose for a child of one year, with 5 or 6 drops of Ether, to be repeated 
in an hour, the most efficient treatment (E. Smith). Copper Sulphate is often very- 
successful (B). Carbolic Acid, with Bismuth, may arrest the disorder promptly 
(Br). Lead Acetate, is one of the most useful astringents in this complaint (Br). 
Potassium Bromide, when due to nervous irritation or cerebral congestion 
(B). Silver Nitrate, is beneficial after the acute symptoms have passed (B). 
Caffeine, when due to nervous irritation (R). Coto Bark, the tinct. gtt. j-iij, 
is highly recommended by Rohrer for choleraic diarrhoea in children. Alco- 
hol, in grave cases, with tendency to collapse, gtt. x-xx of brandy with milk 
every 30 to 60 minutes. Diet, farinaceous food a common cause ; cow's milk 
0% with sacch. lactis ^j to Oj( aquae-bul., or cold milk with Lime-water (R); 
milk, animal broths ; no starches or fats (B). Drinks, as water, weak tea, etc., 
freely, to keep vessels filled and prevent paralysis of the heart (Meinert). Spice 
Poultice, to abdomen, composed of Cloves l Ginger and Cinnamon, mixed with 
brandy or whiskey. Mustard Bath, in stage of collapse, with mustard over 
the heart, and Ether hypodermically (Smith). Lactic Acid, a 2 per cent, solu- 
tion in drachm doses, 5 to 8 times in 24 hours, in epidemic diarrhoea of infants 
with green discharges, with local antisepsis as to linen and diapers, on the 
theory of abacillary origin for the disease (Hayem). Peptenzyme, is excellent 
in cholera infantum and the summer diarrhoea of children. 



Prescriptions. 



& . Cupri Sulphat. 



g r - J- 



Tinct. Opii Deod., . . gtt. viij. 
Aquse Destil., . . . . ^iv. 
M. Sig. — Teasp. every 2, 3, or 4 hours 
for a child of one to two years old. (B.) 



Acidi Carbolici, . . 
Spt. Vini Gallici, . 
Aquae Menth. Pip., 
Mucil. Acacise, . . 
Syr. Papaveris, . . 
Tinct. Opii Deod. 



gr. xxiv. 
gtt. xxiv. 
|jss. 

3 V J- 
3 V J- 

gtt. X. 



M. Sig. — A teasp. every 2 hoi 



R. Hydrarg. Chlor. Mitis, . gr. T L. 
Bismuthi Subnitrat., . . gr. ij-v. 
In powder every half hour for the vomit- 
ing and purging. 



R 



M 



Acidi Carbolici, . . . . 
Bismuthi Submit., . . . 
Mucil. Acaciae, . . . . 
Aqua; Menth. Pip., . . 
Sig. — Teasp. every 2, 3 



R 



. Plumbi Acetat., . . . 

Pulv. Opii, 

Pulv. C amphorae, . . 

Sacch. Lactis., . . . 
Triturat. et div. in chart. 
Sig. — One every hour. 




R- . Hydrarg. Chlor. Mitis, . gr. \. 
Plumbi Acetatis, . . . gr. \. 

OP"* • • g r - Wo- 

Ft. pulv. no. j. Repeat every half-hour 
or hour for the acute gastric symptoms. 



Cholera Simplex. 

Camphor, an admirable remedy (R). Salol, is highly efficient. Salophen, 
is equally so. Veratrum Album, for the vomiting (R). Copper Salts, have 
been given (R). Arsenic, for vomiting ; also for collapse in latter stages (R). 
Chloral, hypodermically with Morphine, is the most efficient treatment (B). 
[See C. Asiatica for formula] ; for the cramps Chloral ^j in Linim. Saponis 
|;iv to vj, applied to the abdomen with friction (Da C). Opium, l /e to yi gr. 
every 2, 4 or 6 hours, in the early stage (P). Morphine, yi to y z gr. hypoder- 
mically, is very useful (B). Carbolic Acid, with Bismuth (see under Cholera 
Infantum for formula) is very effective (B). Lead, the Acetate in the early 
stages (R). Calumba, as anti-emetic, of great value (P). Ipecacuanha, has 
been used with much advantage (Wa). Sumbul, said to have proved success- 
ful (P). Mustard, as an emetic in collapse, to stimulate a failing heart (P). 
Cajuput Oil, much used in India for choleraic affections (P). Alcohol, as 



CHORDEE CHOREA. 6l I 

iced brandy in small doses for vomiting (B) ; the value of stimulants is justly 
doubted; if given, should be largely diluted (Wa). [Compare Cholera 
Asiatica and Infantum.] 

Chordee. 

Aconite, gtt. j, of the tincture hourly, will relieve (R). Belladonna, com- 
bined with Camphor or Opium, gives the best results of remedies administered 
internally (St). Camphor, 3j doses of the spirit will relieve (R). Cantharis, 
gtt. j of tinct. ter die, will prevent (R). Cannabis Indica or Cannabis Sativa 
(P). Lupulin, valuable (P) ; said to prevent (B). Morphine, hypodermically, 
the one sure remedy ; should be injected into the perineum at bedtime (St). 
Cocaine, a few drops of a 4 per cent, solution, locally to the glans ; or injected 
into the urethra, promptly relieves chordee. Diet, should be plain, even low, 
no stimulants ; copious draughts of barley-water, or linseed tea. 

Prescriptions. 

R. Liq. Morph. Magendie, giv. R. Pulv. Opii, . . ... gr. xij. 

Atropinae Sulphat., . . . gr. j. Pulv. Camphorae, . . . gr. xxiv. 

Acidi Acetici, . . . . q. s. Sacch. Alb., q. s. 

Aquae Destillat. , q. s. ad^\. Fiant capsular xij. 

M. Sig. — TIT, v-viij hypodermically at Sig. — One at bedtime, to be repeated in 

bedtime. (Sturgis.) | 2 hours if required. (Sturgis.) 



Chorea. 

Antipyrin, is the only medicine from which cures may confidently be antici- 
pated (McCall Anderson) ; is successfully used to combat excitability of the 
motor nerve centres (W) ; may be given in 2 grain doses every 3 hours to very 
young children (Whitla). Acetanilid has been used with benefit, both in mild 
and grave forms of chorea (Id). Exalgin, with Citrate of Iron and Quinine af- 
ter meals (Dana) ; is believed by many to have specific power over chorea, 
given in doses of 2 grains thrice daily and gradually increased to 3 grains five 
times a day. Arsenic, is one of the most certain remedies, but large doses are 
required and are well borne (B) ; vr\j\j of Fowler's solution thrice daily for a 
child of 7 years, gradually increased to rr^x thrice daily, and may be continued 
for several weeks (Whitla) ; is very successful in uncomplicated cases (R). 
Zinc Sulphate, in doses of 2 or 3 grains gradually increased to 8 grains, is next 
in value to Arsenic (Whitla) ; in large and increasing doses is very useful (R) ; 
has action similar to that of Arsenic, but is inferior (B). Hyoscyamine, ^^ 
grain thrice daily, gradually increased, has cured cases which resisted all other 
remedies (Da C). Duboisine is equally efficient; the Solanaceae are very suit- 
able for nervous, delicate children. Hyoscyamus may be tried. Quinine, as 
a stimulant to the inhibitory centre which controls motor discharge from the 
spinal cells, and which is weakened in chorea to a greater degree than the dis- 
charge power (W). Aurum Bromide, in daily doses of gr. -|- to ^, continued 
until its characteristic headache is produced (Goubert) : the Bromides in full 
doses have proved useful. Chloral, contributes to cure by inducing quiet sleep 
(R): in gradually increasing doses is of the greatest service, as it has an almost 
absolute power to suspend or control spasm during its deep hypnotic action 
(Gairdner). Chloralamid, may be pushed with greater safety, and excellent 
results have followed its use (Whitla). Physostigma, is recommended (R) ; is 
of doubtful benefit (B) ; cures the disease in 5 or 6 days with doses of T \) grain 
of Physostigmine twice daily hypodermically (Reiss). Calcium Chloride, has 
done good in strumous subjects (B). Cocaine, is of the highest value, and has 
cured cases repeatedly in which all the ordinary remedies had been used in 
vain (B) ; the whole amount given daily has rarely exceeded }4 grain (Id). 
Cimicifuga, is a very valuable remedy in cases due to menstrual derangement 
(P); when there is a rheumatic history (R). Strychnine, in doses gradually 



6l2 CHOROIDITIS CHYLURIA. 

increasing to the toxic (Tr) ; minute doses, gr. -g^ to -fa, have been highly use- 
ful when chorea is due to fright or commencing puberty (B). Cuprum Ammo- 
'niatum, has been used successfully (B). Iron, large doses of the Subcarbonate 
in anaemic cases, about the time of puberty (B). Chalybeate waters often re- 
lieve or cure. Arsenic generally better, unless anaemia coexists (R). Vera- 
trum Viride, has been employed (R). Cocculus, or Picrotoxin, large doses (P). 
Conium, in large doses, to quiet muscular agitation (B) ; is only palliative (R) ; 
evidence contradictory as to its value (P). Valerian, said to restrain the move- 
ments (R) ; useful when from worms (P). Chloroform, inhalations, often of 
great service in severe cases (R). Morphine, with Chloral, hypodermically in 
large doses for severe cases (Tr) ; when the movements prevent sleep (R). 
Musk, has been given (R). Cod-liver Oil, when nutrition is low (R). Water, 
by cold affusion to head and spine, and cold baths are important (B) ; tepid water 
first, cold should not be used if rheumatism or fever or pain in the joints (R). 
Electricity, static, is useful in some forms (B) ; the constant current used in 20 
cases, all recovering (Benedict) ; a galvanic chain around the neck and down 
the back, is reported serviceable. 

Prescriptions. 

R. Chloralis Hydratis, . . ziv. R- Tinct. Ferri Chloridi, . 5J. 

Tinct. Hyoscyami, . . ^j. Liq. Acidi Arsenosi, . . £ij. 

Syr. Limonis, . . . . 5j. Syr. Limonis, .... Sjss. 

Aquse Cinnamomi, . . giv. Aquas, . . . . q. s. ad.£vi\j. 

M. Sig. — A teasp. 3 or 4 times daily, M. Sig. — A teasp. thrice daily after 

according to age. meals, gradually increased and effects 

watched. 



R. Zinci Oxidi, ..... gr. iij-vj. R. Acidi Arsenosi, . . . . gr. -£$- ^. 

Sacchari Albi, .... gr. lxxv. Ferri Reducti, .... gr. j-iij. 

M. et div. in pulv. no. vj. Quininte Sulph., , . . gr. ij-v. 

Sig. — One powder thrice daily. In pill or capsule, thrice daily. 

(Bambej-ger.) [Sachs.) 



Choroiditis. 

Mercury, as in iritis ; cannot be borne to the same extent as in the latter dis- 
ease (A). Opiates, necessary externally and internally to overcome pain (A). 
Treatment, is generally the same as in corresponding forms of iritis, but when 
atrophic spots appear on the choroid, no treatment can repair the damage 
(A) ; rest of eyes and protection from light by blue glasses ; in suppurative 
form (panophthalmitis) use Atropine, in strong solution, with ice compresses 
and leeches in early stage ; Paracentesis repeatedly to relieve tension and 
give .exit to pus ; Canthoplasty of outer canthus to relieve the pressure of the 
lids (Roosa). 

Chyluria. 

Thymol, in doses of 1 grain, gradually increased to 5 grains, cured two cases 
of chyluria due to filariae in the blood (Laurie). .Hypophosphites, the syrup in 
emulsion with Cod-liver Oil, caused the entire disappearance of the chyluria in 
a lady who had been a life-long sufferer therefrom (Barnes). Sodium Benzo- 
ate, in doses of 3j, thrice daily, gave promising results, but the after-history of 
the cases was not obtained (Mackenzie). Potassium Iodide, in large doses, 
has checked the discharge for a time in several cases (Lewis). Gallic Acid, in 
doses of 5j-ij» always affords some benefit (Id). Ferric Chloride, large doses 
of the tincture do some good (Id). Treatment, is unsatisfactory ; no remedy 
appears to possess any constant effect (Whitla). 



CLIMACTERIC DISORDERS COLIC. 613 

Climacteric Disorders. 

Aconite, for nervous palpitations, and restlessness or " fidgets ; " gtt. j hourly 
(R). Cimicifuga, for distressing headache (R). Amyl Nitrite, in small doses 
when the "heats" predominate, followed by cold, clammy, pale skin (R). 
Ergot, for the flooding, gr. ij. of Squibb's extract, in fresh pill every hour until 
relieved; Cannabis Indica may be well combined with it. Cannabis Indica, 
is used in the headaches of the menopause with uniformly good results. [See 
Headache, for formula.] Nux Vomica, Opium, and Belladonna, when 
symptoms described under Iron are limited to head and face (R). Iron, for 
flutterings of the heart, with fullness of head, heat and weight on the vertex, 
frequent flushings, and hot and cold perspirations ; large doses of the Chloride 
ter die (R). Ammonia, Raspail's sedative lotion to painful part of the head in 
climacteric headaches (R). Potassium Bromide, for the despondency, with 
sleeplessness and irritability, often also with heats, flushings, perspirations (R). 
Physostigma, the extract, gr. ■£$ every )4 hour for 7 or 8 doses for flatulence 
and a sensation of fluttering at the pit of the stomach (Smith). Camphor, 
for drowsiness and headache; Eau-de-cologne, saturated with Camphor, 
rubbed to the head (R). Zinc Valerianate, hysterical symptoms (R). Change 
of air and scene, where other treatment only partially successful (R). Warm 
Bath, to promote free perspiration ; at 90 to 95 F. for an hour, once a week, 
will correct many of the symptoms (R). [Compare Metrorrhagia.] 



Coccyodynia. 

Chloroform, injected as deeply as possible about seat of greatest pain (B). 
Electricity, has cured one severe case of 12 years' standing, and helped others. 
Surgical treatment the only resource in rebellious and painful cases (Ros). 
Nott extirpated the coccyx ; Simpson performed subcutaneous section of mus- 
cles and ligaments ; Goodell removes the bone, after first treating the case as 
the local expression of a general neurosis. 



Coldness. 

Strychnine, for cold hands and feet (R). Cold Baths, with friction to the 
skin, nightly for cold feet (R). Chloral, in small doses daily, will counteract 
the coldness of the feet and hands in certain cases of anaemia, hysteria, etc. 
(Cherchevsky). Spinal Ice-bag, is often efficiently employed in general cold- 
ness of the surface, and persistent coldness of the hands and feet (R). Co- 
caine or Atropine, will raise the body-temperature. (See page 51.) 



Colic, Intestinal. 

Nux Vomica, quickly subdues abdominal cramps and spasms (P). Bella- 
donna, especially in children (R). Chamomile Oil, TT\, iv-vj, in colicky attacks 
of hysterical women (P). Cocculus, of great value, especially during preg- 
nancy (P). Chloral, sometimes relieves (R). Chloroform, effective in flatu- 
lent colic ; also useful in hepatic and saturnine (B) ; often used combined with 
Opium (D). Potassium Bromide, in a peculiar form of colic in young children 
(R) ; given in Anise- or Peppermint-water is of greater efficacy for the colic 
of infants than the opium preparations in general use, and perfectly safe (B). 
Asafcetida, no better remedy in flatulent colic of infants ; teasp. doses of the 
Emulsum Asafcetidae (B). Dioscorea, is used successfully in so-called bilious 
colic, rr^xv-xxx of the fluid extract. Morphine, gr. )/%-%. hypodermically, 
repeated in 15 minutes, gives more relief than any other remedy in all forms 
of colic (B) ; frequent small doses (P). Arsenic, will cure in a surprising 
manner when enteralgia is idiopathic (B). Essential Oils, especially those of 



614 



COLIC. 



Cloves and Cinnamon (R) ; of Anise, Cardamom, etc.; Oil of Rue in flatulent 
colic of children (P). Magnesium, the Carbonate with Opium and Asafetida, 
as in Dewees's Carminative (see page 168), the dose being- Tt^xx for an infant 
of 2 to 4 weeks old. Tobacco, as enema, dangerous ! (B); as clyster, or by- 
stomach (R). Ammonia, in spasm of intestinal canal and in colic of children 
or infants from bad feeding (R). Lime Water, for young children who eject 
milk in lumpy masses, with colic and flatulence (R). Water, hot fomentations 
to ease pain (R) ; a copious enema of warm water often gives immediate 
relief. 

Prescriptions. 
R . Spiritus Chloroformi, I R . Ext. Gentianae, 

Tinct. Cardamomi Co., . aa^ij. Pulv. Rhei, aagj. 

M Sig. — Teasp. in water every ^ Ft. pil. xx. Sig. — One or two pills 

hour. (B.) thrice daily for tendency to colic. 



R- . Atropinae Sulphatis, . 


• gr- j- 


Zinci Sulphatis, . . . 


. gr. xxx. 


Aquae Destil., . . . 


• SJ- 


M. Sig.— 3 to 5 drops 


two or three 


times daily. 


(B.) 



B 



. Pulv. Camphoras, 

Pulv. Capsici, 

Pulv. Zingiberis, . . . aa gr. ij. 
Ft. pil. xij. Sig. — One pill as required. 



Colic, Lead. 

Alum, singularly, is the best remedy (B) ; gr. x hourly (R) ; converts the 
poisonous salt of lead in the system into a comparatively innocuous sulphate ; 
3jss-ij daily with TTLxl-1 Tinct. Opii, and an occasional dose of Castor or 
Croton Oil to procure one or two motions daily (Wa). Opium, gives more 
relief than any other remedy, gr. )/% to % °f Morphine hypodermically (B) ; 
gr. ij-iv of Opium, with a moderate dose of Castor Oil (P). Sulphuric Acid, 
diluted well, as a prophylactic, and is useful in the treatment of the disease (B); 
considered remarkably efficient when used in association with repeated Sulphur 
baths (Wa). Calomel, a full dose, with or without Opium, followed in a few hours 
by Castor Oil and a Turpentine enema, often affords speedy and marked relief 
(Wa). Tobacco, may control, but is dangerous (B). Croton Oil, in half-drop 
doses, with sufficient Opium to relieve the pain, repeated every 3 or 4 hours 
until free evacuations are produced ; proves effectual when other remedies fail 
(Wa). Magnesium Sulphate, for the constipation, and to remove the poison 
from the system ; should be combined with Potassium Iodide, Z) of the 
former thrice daily and about two hours after having given gr. v-x of the Iodide; 
this treatment dissolves the lead in the tissues, causes its elimination by the 
intestinal mucus, renders it insoluble after it has entered the intestinal canal, 
and quickly removes it from the body (Br). Atropine, gr. t ^q, with Potassium 
Iodide, gr. v, gives excellent results in the treatment of lead poisoning, the 
former relieving the colic and pain in the head in the most rapid manner, 
keeping the bowels open freely, assisting in the return of the bodily powers, 
and aiding in the removal of the lead by the Iodide (Humphreys). [Compare 
the Treatment of Lead-poisoning in the Appendix.] 



R 



Prescriptions. 



Aluminis, .... 
Ac. Sulphurici Dil., 
Syr. Limonis, . . 

Aquae, ^iij. 

M. Sig. — Tablesp. every hour or two 
for lead colic. (B.) 



3*J 



R. Magnesii Sulphatis, . . ^j. 

Ac. Sulphurici Dil., . . %\. 

Aquae, J iv. 

M. Sig. — Tablesp. every 3 hours (B) ; 
or thrice daily, each time preceded by a 5- 
to io-grain dose of Potassium Iodide. (Br.) 



Colic, Renal and Hepatic. 

Ether, inhaled in paroxysms of hepatic colic (R). Chloroform, by inhalation 
in renal and biliary colic, inferior only to Morphine injection, superior to 



COLLAPSE COMA CONDYLOMATA. OI5 

Opium, warm baths, etc.; two or three administrations will be required (R). 
[See also Colic, Intestinal.] Counter-irritation, flying blisters for renal 
colic (R). Opium, small doses with Spt. Chloroformi every five or ten minutes 
until the pain gives way, or Morphine hypodermically (R). Turpentine, has 
been given with benefit in biliary colic (R). Olive Oil, in full dose during an 
attack of colic, frequently gives relief (Brockbank) ; stops the spasm of the 
ureters, and acts in nephritic colic precisely as it does in hepatic colic (Aussil- 
loux). Water, warm baths to ease the pain (R). Aliment, withhold all starches 
and fats ; Alkaline mineral waters are useful (B). [Compare Calculi.] 

Collapse. 

Camphor, 3j of a 10 per cent, solution in oil, hypodermically into each fore- 
arm, in the collapse of pneumonia (Schilling); hypodermic injections of cam- 
phor are used for purposes of excitation in collapse. Ether, by mouth, inhala- 
tion, or hypodermically, is of great service. Ammonia, the liquor diluted, by 
intravenous injection, in cases of fracture and laceration accompanied with 
collapse (P) ; in desperate cases when the hypodermic method is the only avail- 
able route (Whitla). Brandy, or other alcoholic stimulant, by mouth if the 
patient can swallow, if not then by the bowel or hypodermically (Id). Digitalis, 
the tincture as a cardiac stimulant, but being slow of action it should be pre- 
ceded by Ammonia or Alcohol. Strychnine, or Nux Vomica, for impending 
cardiac failure, is very efficient. (See page 356, also Heart Affections and 
Syncope.) Electricity applied to the phrenic nerve, or an interrupted current 
through the upper extremities (Whitla). Beef Extract, Liebig's in large doses 
with hot water, is a rapidly acting stimulant (Id). Transfusion, or a warm 
saline solution by subcutaneous injection, when collapse is associated with 
extensive hemorrhage; or an Esmarch bandage to the limbs, or a tourniquet 
to the femoral artery, to keep the blood out of the lower extremities (Id). Heat 
to the surface and over the cardiac region. Counter-irritation, by mustard to 
the spine, nape of the neck, and calves of the legs. Affusion, of cold water 
alternating with hot (P). [Compare Exhaustion, Shock, Syncope.] 

Coma. 

Croton Oil, as a purgative, ni, % or y^ every hour, mixed with a little butter 
or lard and conveyed to the back of the tongue (R). Oxygen, by inhalation, 
is generally applicable in coma. Potassium Bitartrate, free purging therewith, 
often removes coma, convulsions, and other symptoms due to poisoned blood 
(R). Blisters, in the comatose condition, large blisters or mustard poultices 
should be applied in quick succession to different parts of the body — chest, 
abdomen, thighs, and calves ; often very valuable in the critical condition near 
the end of an acute illness (R). Cold Douche, for stupor of drunkenness or of 
opium poisoning ; may have to be repeated if relapses occur ; it should be kept 
up for a long time if pulse and breathing improve, or are no worse (R). Mus- 
tard, as poultice to the feet and ankles in the coma of narcotic poisoning (P). 
Exercise, in coma from poisoning the patient should be persistently walked 
about. [Compare Cerebral Congestion, Uraemia, and the Treatment of 
Narcotic Poisoning, in the Appendix.] 

Condylomata. 

Nitric Acid, ^j to Oj aquas, as wash, frequently used (R). Thuja, locally a 
strong tincture, also Tt\,v internally, night and morning, for warts with narrow 
base and pendulous body; warts about anus or pudenda of either sex, whether 
syphilitic or not, are often rapidly cured by Thuja (P) ; in non-syphilitic warts 
of penis or vulva, I have employed it with satisfaction (Pf). Mercury, Calomel 
dusted over, after washing with a solution of Chlorinated Soda (Ricord) ; the 
Nitrate locally, or a 20 per cent, oleate (R). Zinc, the Chloride, Iodide or 



6l6 CONJUNCTIVITIS, CATARRHAL. 

Nitrate as local applications (R). Arsenous Acid, as a caustic (R). Carbolic 
Acid, as a mild escharotic (B). Chromic Acid, gr. c to %] aquae dest. ; a good 
local application (B). [Compare Syphilis, Warts.] 

Conjunctivitis, Catarrhal. 

Zinc, a weak solution of the sulphate or acetate as astringent collyrium (B); 
gr. j-ij in ^j aquas destil. as mild astringent lotion every few hours, with ice 
locally in the earlier stage (Roosa). Sodium Borate, gr. v in gj aquae dest. a 
good and mild astringent for ordinary cases. Boric Acid, gr. vj in Jj each of 
aquae camph. and aq. destil., as collyrium (Fox). Boro-glyceride, in dilute 
solution, 3ss to the ^, is an efficient application. Mercury, Calomel finely levi- 
gated and dusted from a camel's-hair brush over the palpebral conjunctiva in 
severe cases (B) ; is a most efficient application in the conjunctivitis of children 
showing minute ulcers ; the Oleate of Mercury and Morphine applied to the 
outside of the lids in palpebral conjunctivitis (R) ; the Red Oxide as ointment, 
10 grains to the ^ of Vaselin (Bader) ; the Yellow Oxide, 8 to 10 grains to the 
^ of Vaselin (Seely) ; ^ grain in £ij of Vaselin is strong enough. Carbolic 
Acid, a 5 per cent, solution applied every two hours by spray of steam atomizer, 
which dilutes it one-half, an extremely efficient application, relieving the pain 
and contracting the vessels. Cocaine, the Hydrochlorate, in 3 to 5 per cent, 
solution or oleate, applied to the palpebral conjunctiva, is a very efficient pal- 
liative, especially where much pain and photophobia (Roller). Alum, Potassa 
Alum after acute symptoms subside (Br) ; gr. iij-v ad ^ij aq. destil. brushed 
over the conjunctiva twice daily. Pulsatilla, 3j-ij of tincture to ^iv aquae, as 
wash several times daily, also n\j-x internally every 3 or 4 hours (P). Opium, 
the wine dropped into the eye relieves pain and improves the condition of the 
conjunctiva (R) ; Morphine, gr. j-ij ad 3J, is often used in collyria with Zinc 
Salts or Alum, but is irritant. Cadmium, as collyrium, gr. ij of the sulphate to 
^j aquae rosae (B). Tannin, in Glycerin, Z) ad ^j, every second day in chronic 
catarrhal conjunctivitis, presenting diffused injection of vessels with oedema 
(Hansell). Silver Nitrate, solutions of gr. j-iv to the ^, applied by physician 
to conjunctiva (R); should not be given to patient; Zinc and Copper Salts are 
preferred (B). Copper, the Sulphate crystal in chronic cases where great swell- 
ing or hypertrophy of the papillary layer ; is too irritating to be entrusted to the 
patient. Lead salts should never be used lest deposits occur in slight abra- 
sions or ulcerations of the cornea. Sulphates, of Zinc, Copper, and Iron, with 
Alum aa, gr. j to ^j of aq. destil. as collyria, extremely efficient; in severe 
cases may be used in saturated solution by the physician (Holmes). Castor 
Oil, a drop placed in the eye often allays the pain and photophobia caused by 
an irritant (R). Belladonna, locally and internally (B). Atropine in strong 
solution, gr. iv to the 3, is one of the best local applications where mydriasis 
is not objectionable. Euphrasia, as a mild astringent (P). Blisters, behind 
the ears in bad cases (R). Ergot, the fluid extract locally gives excellent re- 
sults in acute conjunctivitis (B). Staphisagria, especially in tarsal ophthalmia 
(P). Colchicum, when gouty diathesis (A). Spigelia, in rheumatic form (P). 



Hydrarg. Oxidi Rub., . gr. x. 

Atropinae Sulph., . . . gr. j. 

Vaselini, ^j. 

Sig. - A minute portion as an oint- 
M. Sig. — Eye- water. ment for the eye. [Badei-.) 







Pr 


escr, 


i prions. 


Zinci Sulphatis, 








R. 


Morphinae Sulph., . aa 


■ g r - j- 








Atropinae Sulph., . . , 


. gr. ss. 








Aquae Rosae, . . . . . 


• l\- 






M, 


Sig. — Eye- water. 








ment 



R. Liq. Plumbi Subacetat., . gj. R. Ung. Hydrarg. Nitrat., . gr. xx. 

Aquae Destillatae, . . . ^iij. Cocainae Hydrochlorat., gr. v. 

M. Sig. — For local use. To be brushed | Vaselini Albi, . . . . £ij. 

over conjunctiva of everted lids by the sur- i Use a fresh ointment, triturate thor- 

geon and washed off with water. {Buller ) I oughly, and label " Ointment for the eye." 



CONJUNCTIVITIS. 617 



Conjunctivitis, Diphtheritic. 

Zinc Chloride, gr. ij--iv to the ^, as collyrium, has succeeded admirably (Wa). 
Atropine, locally throughout the disease ; not very effectual (Roosa) ; is, for 
severe cases, powerless ; cornea sure to be attacked and liable to slough 
(Noyes). Boric Acid, a 4 per cent, solution, as antiseptic, the best application, 
with Quinine internally in full doses (Noyes). Iron, the Pyrophosphate for 
children, S) in Hjiij of simple syrup, of which a teasp. thrice daily after meals, 
with Quinine in 1- to 3-grain doses thrice daily, and good food (Derby). Cold 
by compresses, as in purulent ophthalmia, in early stages. Silver Nitrate, in 
10 grains to the ^ solution locally, or the mitigated stick in the second stage. 
Tannin, gr. xx to the ^ of Glycerin, later on, applied every day, with hot water 
lotions if corneal complications are present. 



Conjunctivitis, Gonorrhceal. 

Zinc Chloride, gr. j-ij ad Hjj aquae, as collyrium, used with marked benefit 
(Wa). Silver Nitrate, a 2-grain to the ^ solution, after syringing out the eye 
with warm water, followed by ice compresses, in hope to abort the attack, if seen 
early (Roosa). Cold, by ice or wet compresses, essential in the early stages 
(C). Atropine, may be used from the beginning, as corneal complications 
begin very early. Treatment, is generally the same as for Purulent Conjunc- 
tivitis ; isolation and cleanliness are of prime importance. 



Conjunctivitis, Granular. 

Silver Nitrate, the diluted stick applied lightly and quickly (C) ; strong solu- 
tions to granular lids, gr. xx to the % cautiously when corneal ulcers exist (B) ; 
mild solutions better, gr. v to the % daily in the papillary form ; in miliary tra- 
choma it should not be stronger than gr. ij to the ^ (Noyes) ; applications lose 
their effect after a time, and should be changed (Roosa). Copper Sulphate, 
the solid crystal lightly touched to the membrane once a day, the favorite 
astringent and caustic in all forms of trachoma (Roosa) ; when the membrane 
is torpid to other stimulation and when lymphoid substance is predominant ; as 
ointment gr. v-x to the ^ of. Vaselin, when for use by patient (Noyes). Alum, 
a smooth crystal is a useful daily application (Noyes). Tannin, gr. x-xxx to the 
^ of Glycerin, an application to change to from others (Roosa). Bismuth is one 
of the numerous applications in chronic conjunctivitis and granular lids (B). 
Phytolacca internally, is undoubtedly efficient in granular conjunctivitis (W). 
Jequirity, to excite substitutive inflammation (see page 65). Atropine, gr. ij to 
the ^, thrice daily, is often advisable, where moderate irritation and haziness 
of the cornea (Noyes). Hygienic Measures, are of great value ; protection by 
blue or smoked glasses ; rest of eyes, best secured by using Atropine collyria ; 
hot or cold water as local bath frequently. Tobacco, must be avoided, also all 
locations contaminated by impure air. Canthoplasty, of outer commissure 
when the lids press on the globe. 



Conjunctivitis, Phlyctenular. 

Mercury, Calomel finely levigated and dusted from a camel's-hair pencil 
over the membrane in phlyctenular ophthalmia, an excellent application, but 
should never be used when Iodine is being taken; in more obstinate cases a 
small bit of Pagenstecker's ointment, the size of a pin-head (Hydrarg. Oxidi 
Flav. gr. j-iij, Vaselini 3j), placed between the lids (Noyes). Ergot, the fluid 
extract applied undiluted gives excellent results in the phlyctenular ophthalmia 
of children (B). Antimony, Tartar Emetic gr. ^ to ^g- 3 or 4 times daily in 
strumous ophthalmia, with sharp purgation at the outset (R). Belladonna, or 



6l8 CONJUNCTIVITIS CONSTIPATION. 

Atropine, locally in strumous ophthalmia, of great service in relieving pain ; 
constitutional treatment also required (Wa). Arsenic, invaluable in inveterate 
cases of strumous ophthalmia, especially when complicated with cutaneous 
eruptions (Wa). Tannin, finely powdered and dusted over the everted lid, 
gives remarkably good results in this and other forms of conjunctivitis, causing 
very little pain and no inflammatory reaction (B). Carbonic Acid Gas, applied 
to the eye is said to relieve the pain and photophobia of strumous ophthalmia 
(R). Hydrastis, as lotion, is serviceable when Meibomain follicles are impli- 
cated, causing adhesion of lids in the morning (P). Physostigmine, locally, 
to reduce the pupil and shut out the light (P). Iodine, is employed locally in 
strumous ophthalmia, for its alterative stimulation (W). Zinc Chloride, gr. 
ij-iv to the ^, as collyrium, has succeeded admirably in pustular ophthalmia 
(Wa). Zinc Sulphate, gr. j-iv to the %, is very serviceable; the addition of 
Liquor Plumbi improves its efficacy (Wa). Rhubarb, the Mistura Rhei et Sodse 
where much disturbance of digestion present. Tonics, may be given later, 
preparations of Cinchona and Iron. Cod-liver Oil, in strumous subjects, tends 
to remove the manifestations of the disease (R). 



Conjunctivitis, Purulent. 

Alum, gr. ij ad ^j aquae, a sufficient astringent application in ophthalmia 
neonatorum (Roosa) ; gr. viij ad ^j aquas, applied every % or y 2 hour in the 
purulent ophthalmia of children, its success depending on the frequency of the 
application (R). Copper Sulphate, gr. j ad ^j aquae camph. as collyrium in 
purulent ophthalmia of infants (Wa). Silver Nitrate, gr. iij-x ad ^j aquae 
destil., rarely so strong as gr. x to the S§, applied by brush once daily to 
everted lids in purulent ophthalmia of infants (Noyes) ; solution gr. ^ to the ^ 
twice daily under lids (Meigs) ; by many considered needless and injurious 
(Roosa). Boric Acid, a 4 per cent, solution, as antiseptic, is all that is neces- 
sary in mild cases ; in others it is the proper fluid for cleansing the eye 
(Noyes). Atropine, when the cornea becomes invaded, and shows haziness, a 
solution gr. ij to the g must be instilled every 3 hours (R). Cold, by ice or wet 
compresses, essential in the early stages of acute purulent ophthalmia (C). 
Cleanliness, a matter of great importance ; as the discharge is infectious the 
patient should be isolated and care taken to prevent inoculation of the other 
eye. 

Prescriptions. 

\ R . Sodii Boratis, gr. iij. 

R. Sodii Boratis, . . . . gr. xij. Aquas Rosse, 

Zinci Sulphatis, . . . . gr. j. Aquae, aa ^j- 

Aqua? Camph., .... zj. M. Sig. — Apply beneath lids three or 

Aquae Destillat., . . . 3J. four times daily after cleansing. 

M. Sig. — Apply to lids 2 or 3 times 

daily in ophthalmia neonatorum, with solu- 1 R. Atropinae Sulph., . . . gr. j. 

tion of Silver Nitrate, gr. 3^ to the ^ in- j Glycerini, ^ss. Aquae, . ^ij. 

jected under lids twice daily. {Meigs.') M. Sig. — Two drops into the eye. 



Constipation. 

Nux Vomica, gtt. j-ij of tincture twice or thrice daily (R) ; gtt. v-x in a glass 
of cold water before breakfast and dinner, often overcomes the most obstinate 
constipation (P) ; especially useful when great fecal accumulations from torpor 
of bowel (B). Sulphur, gr. x with Confectio Sennae, often succeeds after other 
remedies fail (R) ; sulphurous mineral waters (B); or Sulphates in purgative 
waters; frequent small doses (R). Podophyllum, the most generally used 
cathartic when secretion deficient (B) ; gr. T ^ to \ night and morning when 
constipation with nervous and bilious headaches (P). Senna, as in the Pulvis 



CONSTIPATION. 



619 



Glycyrrhizae Compos., which may be taken in doses of a teasp. to a tablesp. as 
required, and kept up for months (Goodell). Mercury, Calomel or gray pow- 
der as a cathartic (R). Hydrastis, very valuable, when constipation is refer- 
able to a sluggish liver (P). Magnesium, the Bicarbonate, a useful and mild 
aperient (R). Alum, a cheap and serviceable laxative (B). Aloes, in minute 
doses, in pill with Ferrous Sulphate, as the official Pil. Aloes et Ferri, is one of 
the best agents in the management of chronic cases ; purgation should not be 
aimed at. Chloral, is an efficient laxative in rebellious chronic constipation, 
particularly that of neuropathic cases (De Holstein). Ipecacuanha, gr. j every 
morning, fasting, when great torpor of bowel (R). Cocculus, flatus, hard 
lumpy motions (P). Turpentine, in purely atonic constipation, with gaseous 
distention of colon, has triumphed when all other remedies failed (P). Physo- 
stigma, very effective in intestinal torpor (B). Stillingia, rt^x of fluid extract 
in habitual constipation (B). Castor Oil, a mild efficient cathartic (B). Am- 
monium Chloride, in the so-called bilious state, with constipation (B). Arsenic, 
rr\jj of Fowler's solution often overcome constipation (R). Belladonna, gr. ]/ z 
of the extract at night, in habitual constipation (B) ; gr. /4>-)4 once a day, espe- 
cially when dyspepsia (R) ; acts directly on the bowel as a stimulant (P). 
Croton Oil, the most efficient cathartic, when simple impaction without inflam- 
mation ; gtt. j-ij (B) ; when evacuations of blackened feces (R). Cascara Sagrada, 
the fluid extract in doses of 3j> produces large, soft evacuations without grip- 
ing, and leaves behind it a laxative influence. Frangula, in similar doses, is 
equally efficient, but if from a fresh bark may produce griping. Cathartics, 
especially Confectio Sennse, Pil. Rhei Compos., Pil. Aloes, the Comp. Cathar- 
tic Pill, as well as those above (B) ; purgation as usual practiced was de- 
nounced by the editor of the Lancet, October 1, 1870. Saline Waters, are use- 
ful (B) ; Pullna, Friedrichshall, or Hunyadi, the first two with milk, are good 
for children (R). Enemata, of soap-suds and salt, or a pint of cold water (B) ; 
or Turpentine, Castor Oil, aa ^ss to Oss-j of gruel (P); the habitual use of 
warm enemata increases torpor of the bowels (R). Tamar-Indien, a favorite 
mild aperient, is proprietary, and supposed to contain Cocculus, Glauber's salt, 
etc. Aliment, important in habitual constipation ; corn bread, cracked wheat, 
oatmeal, bread of unbolted flour, fruits, green corn, tomatoes, and celery ; yi 
dozen each of almonds and raisins daily. Water, a glass of cold water before 
breakfast may overcome habitual constipation (B) ; drinking largely of water 
is a most beneficial measure in cases of chronic constipation. Smoking a 
cigar or a pipe after breakfast (R) ; tobacco smokers rarely suffer from consti- 
pation. [Compare Intestinal Obstruction.] 



Ext. 


Colocynth Co., 


• • gr- xij 


Ext. 


Belladonna. . . 


• g r - ! J- 


Ext. 


Gentianse, . . 


. gr. vj. 


Olei 


Cari, ... 


. gtt. iij 



Prescriptions. 



R 



Ft. pil. vj. Sig. — One pill at bedtime. 



Podophylli Resinae, 


. . gr. ij. 


Quininse Sulpbatis, 




Ext. Aloes, . . . . 


. aagr. vnj. 


Fellis Bovini, . . . 


. . gr. xvj. 


Ft. pil. no. xvj. Sig.- 


— One or two at 


dtime. 


[Goodell.) 



R . Ext. Rhamn. Pursh., Fl.,gj. 
Ext. Belladonnae Fl., . . 3J. 
Tinct. Nucis Vom., . . zij. 
Syrupi et Aquae, . . aa ad^ iv. 
M. Sig. — Teasp. thrice daily in obsti- 



Castor Oil Emulsion . 



nate constipation. 



[Clarke.) 



01. Ricini, 

Glycerini, aa 3J- 

Tinct. Aurantii, .... lr^xx. 

Tinct. Senegae, .... rr^v. 

Aq. Cinnamomi, q. s. ad £ss. 

M. ft. emulsum. Sig. — One dose, 

be taken in the morning. 



R 



M. 



Artificial Hunyadi 


Water. 


Magnesii Sulphatis, 




Sodii Sulphatis, . . 


aa^ss. 


Potas. Sulpbatis, 


• g r - U- 


Sodii Bicarbonatis, 


• gr- V »J- 


Sodii Chloridi, . . 


. gr. xx. 


Aquae, . . . . q. s 


ad£ viij. 



Sig. — A winegl. before breakfast. 



620 CONVALESCENCE CONVULSIONS. 



Convalescence. 

Lime, as Lime-water, or the Carbonate, in convalescence from serious dis- 
ease (R). Quinine or Hydrastine, to promote digestion and appetite (B). 
Fats, especially Cod-liver Oil (R). Alcohol, before or during meals (R). 
Koumiss, possesses great value (B). Bitters, especially Gentian and Calumba 
(B) ; the latter especially when stomach weak (R). Eucalyptus, a serviceable 
tonic (B). Coca, 3ss— ij of the fluid extract as a dose (B). Guarana, gr. xv-^j 
may be given (B). Opium, as Laudanum, injected per rectum, for insomnia of 
convalescents (R). Sea-Baths, valuable in many cases (R). Nuclein, is used 
with benefit. Orchitic Extract, has been employed with good results. Bone 
Marrow, gives great satisfaction in anaemic cases. Diet, requires the most 
careful attention ; the prevalent error of giving food of difficult digestion too 
early must be guarded against, especially in intestinal and gastric disorders ; 
the strictest moderation should be enjoined. The symptoms must be watched 
closely, and combated by appropriate medication. [Compare Adynamia for 
Tonic Prescriptions, also Anemia.] 



Convulsions. 

General Directions. — In all cases a horizontal posture, fresh air, clothing 
loose ; a plug of soft wood, or a cork, between the teeth, to prevent biting the 
tongue; sprinkle the face and chest with cold water. Epileptic. — The general 
directions above will usually suffice. Hysterical. — The diagnostic peculiarities 
are : pupils not dilated, but are sensitive to light ; no wounding of tongue ; 
face not livid ; pulse usually normal. Infantile. — Administer some anti- 
spasmodic, as Ether, alone or combined with Musk or Belladonna ; then search 
for any mechanical cause, as a pin in a dress, etc.; lance the gums if dentition 
the cause (A). Solanum Carolinense, has a good reputation in the southern 
states for epilepsy and other convulsive affections, and has rendered excellent 
service in my hands (Napier) ; a tincture is prepared by bruising the berries 
and steeping them in whiskey, of which the dose is 3j, repeated until drowsi- 
ness is produced. [Compare Albuminuria, Epilepsy, Hysteria, Puerperal 
Convulsions, Uraemia.] 



Convulsions, Infantile. 

Belladonna is of the highest value in certain congestive forms, as in fits due 
to the irritation of teething, or those referable to whooping cough (P). Ignatia, 
is efficient in convulsions of children from intestinal irritation, no cerebral con- 
gestion being present (P). Valerian, has been successfully used in convulsions 
from worms to which it is fatal (P). Potassium Bromide in all forms of con- 
vulsions in children (R) ; children bear it in large doses, gr. v thrice daily or 
oftener for a child a year old in convulsions from teething (Br). Chloral, in 
large doses, gr. v, by mouth or rectum (Br) ; best used as a suppository rather 
than by liquid injection, and ofter very useful (R) ; it gives better results than 
any other agent. Chloroform, inhalations of great service (R) ; useful in all 
forms (B) ; should be used to arrest the convulsion and prevent recurrence 
(Smith). Alcohol, has remarkable power in arresting convulsions of dentition ; 
small closes of wine or brandy (W). Asafetida, in the convulsions of teething, 
a small portion in enema, appears to mitigate them (Wa). Opium, efficient, 
but dangerous in young children. Veratrum Viride has been employed suc- 
cessfully (R). Amyl Nitrite, gtt. v. with gr. % of Morphine, used in one 
case as a last resort, after five hours' convulsions in a child of 18 months, 
which resulted in producing quiet sleep (Engel). Hot Baths, are important, 
with cold affusions or ice to the head (B). Spinal Ice-bag, may be very 
efficient (R). 



CORNEAL OPACITIES CORNS COUGH. 62 I 



]£ . Chloralis Hydratis, . . gr. v. 

Lactis, gj. 

M. Sig. — As rectal injection. Or the 
dose may be made into a suppository 



Prescriptions. 

R . Sodii Bromidi, 



Chloralis Hydratis, 

Sodii Bicarb, . . . . aa gr. 

A q uas > Si- 



with cacao-butter and inserted well up into I M. Sig. — A teaspoonful every hour to 
the rectum. j a child under four months old. 



Corneal Opacities. 

Cadmium, is said to promote their absorption ; gr. ij of the Sulphate to Jj of 
rose-water, as collyrium (R, Wa). Mercury, Calomel by insufflation, or the red 
Iodide gr. ij, Cerate gr. xl, Olive Oil gtt. xx, as ointment, successfully used 
(Wa) ; weak solutions of the Bichloride, or ointments of the Oxides, gr. }( to 
the 5, as remedies, among many others, to hasten their absorption in recent 
cases (Arlt). Oils, Eel-liver and Cod-liver Oils, Ox-gall, Juniper Oil, Oil of 
Turpentine combined with Olive Oil, and others, dropped into the eye once or 
twice daily for the same purpose (Arlt). Opium, the wine at first, then insuf- 
flations of Calomel and Red Precipitate or Yellow Oxide ointment, frequently 
used by me in recent cases (Arlt). Potassium Iodide, as ointment with Potas- 
sium Carbonate after Cod-liver Oil or Oil of Turpentine with Olive Oil, in cases 
of longer standing (Arlt). Silver Nitrate, gr. v-x ad sjj aquae, as lotion (C). 
Iodine, internally and as collyria.has been efficacious, especially in strumous 
cases (Wa). Sodium Chloride, gr. x ad gj aquse destil., of which TT\,v-x in- 
jected subconjunctivally, to hasten disappearance of turbidity (C). Operative 
Measures, only in case of incrustations (as of lead and lime) situated superfi- 
cially, by removal of epithelium and anterior elastic layer ; deeper interference 
may lead to suppurative keratitis. Excision of opaque cornea and transplant- 
ing of one from an animal's or a recently enucleated human eye (keratoplasty), 
has always failed. Artificial pupil by iridectomy, for central opacities which 
are unremovable. Tattooing to relieve . deformity of disfiguring leucomata 
(Arlt). Pannus and leucoma are best let alone (D). Stenopaic Spectacles, 
for semi-transparent opacities in pupillary region (bonders). [Compare Ker- 
atitis.] 

Corns. 

Salicylic Acid, in strong solution, removes excess of epidermis, warts, and 
corns; is the essential ingredient of all "corn-cures." Silver Nitrate, solid, 
after soaking and paring (Wa) ; the best application for soft corns, and very 
irritable ones (D). Acetic Acid, strong, to remove corns (Wa). Mercury, 
Corrosive Sublimate in alcoholic solution locally to remove corns (Wa). 
Iodine, gr. xl ad ^j Alcoholis, locally (Wa). Poultices, are useful ; or a plaster 
of soft material with hole in centre (D). Water, hot and cold, alternately 
applied to inflamed corns. Keep a corn thin by frequent washing and paring ; 
in performing the latter the knife should work downwards to the apex of the 
corn, so as to remove the central pressure on the subjacent tissue. 

Prescription. 

R . Acidi Salicylici, . . . . gr. xv. 

Extr. Cannabis Ind., . . gr. vijss. Mix, and keep in closely-corked vial. 

Alcoholis, 90 , .... TTlxv. Paint the corn every other day for a week, 

^Etheris, 62 , TTLxxxvij. | then it can be easily squeezed out. 

Collodii Flexilis, . . . TTiJxxv. {Vigier.} 

Cough. 

Opium, in some form, is much used in cough-mixtures ; Morphine and Gly- 
cerin applied to fauces (B) ; moderate doses are useful in irritative affections 



622 COUGH. 

of the air-passages to allay irritation and hypersecretion, but it may do even 
fatal mischief in cases where secretion is copious and expulsory power feeble 
(P) ; opiates inadmissible when with copious expectoration there is any indica- 
tion of bronchial congestion (Wa) ; very useful in violent and frequent cough 
with little rhonchus and no signs of obstructed oxidation ; also, when cough is 
due to red, inflamed and ulcerated throat ; Opium or Morphine given so as to 
cling for some time in contact with the pharyngeal structures (R). Codeine, is 
often efficient in cough (Br) ; of particular value in ^ gr. doses ; is slightly 
expectorant, also laxative, does not nauseate nor cause vomiting, nor affect the 
appetite ; is far the best agent for the cough of phthisis, when morphine is not 
well borne (Kobler). Nux Vomica, in laryngeal cough of neurotic origin, drop 
doses of the tincture every five minutes ; is promptly efficient (Macfarlan) ; has 
specific action on the pneumogastric, and is one of the most efficient remedies 
in cough of any kind, whether from bronchitis, pneumonia, phthisis or emphy- 
sema, but especially in nervous coughs and periodic coughs which come on in 
the evening and stay all night {Jour, de Med.). Pulsatilla, as Anemonine, % 
gr. and gr. doses, very useful in irritative cough, asthma, whooping-cough (P). 
Iodine, by inhalation for children in hoarse, hollow cough, wheezing (R) ; the 
tincture, 5-10 drops, inhaled from boiling water, for five minutes at bedtime, 
often gives most signal relief in the irritating cough of phthisis. Apomorphine 
Hydrochlorate, very valuable in cough where there is persistent hacking with- 
out expectoration, or with difficult expectoration ; the dose is only gr. ^ to ^ 
in the 24 hours ; solution rapidly alters unless a few drops of Hydrochloric 
Acid are added (Stocquardt). Terpin Hydrate, in bronchial cough, and night- 
cough from habit, is very efficient in a 2-grain dose at bedtime, repeated earlv 
in the morning (Boyland). [See under Bronchitis, Chronic, for formula.] 
Aconite, irritable, tickling throat-cough ; short, dry cough of asthmatics, with 
anxious look and full, strong pulse (P). Belladonna, often useful; no indica- 
tions (R) ; internally and externally as plaster to the chest, very serviceable in 
spasmodic and nervous coughs (Wa). Hyoscyamus, very useful in spasmodic 
tickling night coughs (P). 

Hydrocyanic Acid, for nervous, irritable cough, and cough of phthisis and 
mother's sympathetic cough (B) ; no more certain palliative for simple, ner- 
vous cough due to irritable state of the system (S) ; a valuable adjunct to ordi- 
nary remedies in cough of phthisis (Wa). Potassium Cyanide, is equally 
useful, gr. iij with ^j each of Ext. Grindelias FL, Syr. Scillae and Syr. Tolutan., 
makes a good non-opiate cough mixture, of which the dose is 3j every 4 hours 
(Waugh). Prunus Virginiana, has some influence, due to its Hydrocyanic 
Acid ; is much used in cough mixtures (P). Laurocerasus, used as a substi- 
tute for Hydrocyanic Acid in spasmodic coughs (B). Conium, supposed to be 
useful (R) ; is very useful in spasmodic cough ( Wa). Ipecacuanha, the fid. 
extr. for troublesome night-cough (B) ; in obstinate winter-cough, with wheez- 
ing, the wine as spray to fauces, efficacious (R) ; in coughs of childhood Ipecac 
is one of the most generally serviceable expectorants we can use (Wa). 
Lobelia, dry cough, continued tickling sensation, even in sleep (P). San- 
guinaria, combined with Hyoscyamus, in nervous, spasmodic cough (P). 
Senega, as a stimulant expectorant in the cough of chronic bronchitis and 
subacute chest affections. Gelsemium, excessive irritability of the respiratory 
centre (R) ; often remarkably relieves convulsive or spasmodic, reflex and ner- 
vous coughs (B). Alum, internally in spasmodic cough ; gr. x to ^j aquae as 
spray, in chronic cough also (R). Drosera, the fluid extr. in )4 teasp. dose to 
an adult every 2 or 3 hours, of high value when spasm predominates. [See 
page 271.] Potassium Bromide, serviceable in various reflex coughs (uterine, 
renal, etc ), and in cough of phthisis it is occasionally ameliorative as a gargle 
(B). Cubeb, 3ss-j of the tinct. in half-glass of Linseed tea thrice daily, often 
cures like a charm the coughs of chronic catarrh, of emphysema, or acute 
catarrh, or following an attack of influenza (R). Asafoetida, its value due to 
the sulphur in it (Garrod) ; very serviceable in after-cough from habit, and in 
mother's sympathetic whooping-cough (B). Carbolic Acid, as spray, a 5 per 
cent, solution in a steam atomizer will often prevent as well as cure a cough from 



COXALGIA. 



623 



cold. Valerian, in asthmatical and hysterical coughs (P). Chloroform, with 
Morphine and molasses in paroxysmal dry cough ; may be painted on throat 
also (R) ; in irritable reflex cough, the vapor of a teaspoonful of the spirit may 
be inhaled from the surface of hot water, and repeated every five minutes for 
four or five times (B) ; the inhalation of small quantities of chloroform gives 
the greatest possible relief in the irritable cough of phthisis (Spencer Wells). 
Chloral, in convulsive coughs, ameliorates symptoms after hypnotic effect 
(Wa). Camphor, equal parts of Camphor and Chloral triturated together are 
said to allay spasmodic cough when painted over larynx (B). Glycerite of 
Tannin, applied to throat when chronically inflamed and so producing cough ; 
often the case with children (R). Grindelia, used in cough of habit and spas- 
modic cough (B). Squill, in catarrhal cough, should not be employed until 
active inflammation has subsided (Wa) ; the syrup or vinegar of Squill is the 
best preparation for cough with tickling in the throat (P). Cod-liver Oil, in 
chronic coughs (R). Lactucarium, the syrup as vehicle in cough-mixtures (B). 
Chamomile Oil, gtt. ij-viij, in coughs due to heightened reflex irritability, 
especially in hysterical women (P). Pix, Tar-water, in winter cough, especially 
when paroxysmal (R) ; allays the cough of bronchitis and phthisis (P) ; the 
Plaster as rubefacient and counter-irritant in chronic coughs (Wa). The fre- 
quency and violence of nervous coughs may be controlled by a determined 
effort of the patient's will. [Compare Bronchitis, Pertussis, Phthisis.] 



Prescriptions for Cough Mixtures. 



R. Spiritus Etheris Nitrosi, Zij. 

Vini Ipecac, 3 SS - 

Tinct. Opii Deodorat., . Z). 
Syrupi Tolutani, q. s. ad Jij. 
M. Sig. — A teaspoonful twice or thrice 

daily. {Boxvditch.) 



R 



Liq. Magendie, 

Spt. Limonis, . . . aa £j. 

Syr. Ipecac. , 

Spt. Lavand. Comp., aa giv. 

Syr. Scillae Comp. , 

Syr. Tolutani, . . aa 5j. 

Syr. Pruni Virgin, q. s. ad 3VJ. 
M. Sig. — A teasp. as required. 
Each dose has of Morph. Sulph. gr. J f 



iij. 



R . Codeinae Sulphatis, . . 
Liq. Atropin. Sulph. (1 

P- c -)> "l xi J- 

Liq. Strychninae (I 

P- c -)> 3J- 

Syr. Tolutani, .... ^jss. 
Infusi Rosae Acidi (B. 

p-), «*3tj. 

M. Sig. — A tablesp. in a winegl. of 
water every 4 to 6 hours. 



R . Mist. Glycyrrh. Co. , . . ^ ij. 
Syr. Pruni Virginian., 
Syr. Tolutan, . . . aa ^j. 
M. Sig. — Half teaspoonful 3 or 4 times 
daily for infants, teaspoonful doses at 1 to 
2 years, larger doses for older children. 

{Potter.) 



R. Tinct. Opii Deodorat., 

Vini Antimonii, . . aa ^ss. 

Ext. Valerianae Fl. , 

Syr. Simplicis, . . . aa zij. 

Aquae, ^jss. 

M. Sig. — A teaspoonful every hour or 
two until cough controlled. For those of 
4 years and upwards. 

[Meigs 6° Pepper.) 



R . Tinct. Sanguinariae, 

Tinct. Lobelia% . . aa ^jss. 

Vini Ipecac, . . . . 3 iij. 

Tinct. Opii Camphorat., 

Syr. Scillae, . . . . aa ,^jss. 

Aquaa Cinnamomi, . ad ^vj. 
M. Sig. — gj every three hours in the 
cough of bronchitis. {Potter.) 



Coxalgia. 

Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, 
is thought to be most valuable in scrofulous diseases of the joints (Wa). Sul- 
phuric Acid, Z] ad 3J Adipis, as ointment, persevered in, has resulted in great 
benefit; a powerful irritant (Wa). Counter-irritation, by blisters around the 
hip, with perfect rest in the straight posture, Cod-liver Oil, etc. (D). Ferrous 



624 



CROUP. 



Iodide, in scrofulous disease of the joints, with Cod-liver Oil and nutritious 
diet (Wa). Iodoform, very successfully used by many continental practition- 
ers in scrofulous diseases of the joints (Wa). Cod-liver Oil, the remedy on 
which most reliance is to be placed (R). [Compare Abscess, Caries, Suppu- 
ration, Synovitis.] 

Croup, Catarrhal. 

Aconite, valuable (R) ; has been employed with the best results (P) ; gtt. y z 
to j every half hour, until an impression is made on the fever movement, 
then every hour or two (B). Hot Water, applications beneath the chin and 
along the whole course of the larynx (Wa). Hot fomentations or turpentine 
stupe to throat (El) ; hot bath (95°-io2°) in the paroxysm, a good method 
(M & P). Potassium Bromide, locally, a solution, by atomization, has proved 
highly efficient in spasmodic croup (Wa). Lobelia, has been used with occa- 
sional success (P). Ipecacuanha, the syrup or fluid extract as an emetic at the 
outset (El) ; is a slower emetic than Tartar Emetic (P) ; the syrup to vomiting 
during the paroxysm, and rr^v-x every 2 or 3 hours next day (M & P). [Com- 
pare Laryngismus Stridulus.] 



Prescriptions. 



R. 



Potassii Citratis, 

Syr. Ipecac. , . . 

Tr. Opii Deodorat. 

Syr. Simplicis, . 

Aquae, .... 
M. Sig. — Teaspoonful every two hours 
at 2 years of age. In severe form of spas- 
modic laryngitis. (M. dr 3 P.) 



3J- 

gtt. xij. 

gjj. 

3jss. 



R. 



M. Sig. — Teaspoonful every 2 or 3 
hours at 6 months old when cough fre- 
quent and harassing. (M. &° P. ) 



Tinct. Belladon., . . 


• gtt. w 


Tinct. Opii Camph., . 


• gtt- L 


Pulv. Aluminis, . . . 


• gr. vj 


Syr. Acaciee, . . . . 


. |ss. 


Aquae, 


. 3JSS. 



Croup, Membranous. • 

Mercury, a remedy of established value, gr. ss-j of Calomel, with gr. yi-% 
of Ipecac, according to age, every 2 hours, with local and other general meas- 
ures, especially the use of a hot (70°-75°) and moist atmosphere (Wa) ; the 
Sub-sulphate, given early, is the best emetic, gr. iij-v ; Calomel is strongly 
urged as a laryngeal sedative and aplastic agent, allaying laryngeal spasm and 
preventing formation of membrane (B). Alum, one of the best emetics in this 
disease, a teasp. in honey or syrup, repeated every ten or fifteen minutes until 
it operates (M & P) ; a very useful and non-depressant emetic (B). Sanguinaria, 
by many considered specific, is undoubtedly the best emetic for this disease 
(P) ; is too harsh and too uncertain in action (B). Tartar Emetic, as an 
emetic, has established value in croup (Wa) ; is injurious, too depressant (B). 
Potassium Chlorate, as alkali, after emetics, the most reliable internal remedy, 
gr. ij-iij every 2 hours to a child of 4 years (M & P). Ferric Chloride, may 
be combined with the preceding, in doses of 3-5 drops of the tincture, at the 
same age (M & P). Emetics, besides the above, are : Copper Sulphate, in 
small frequent doses (R); Ipecacuanha, inferior to Mercury (B) ; in severe 
cases vomiting should be caused 2 or 3 times a day, and should be commenced 
early (R) ; Apomorphine, effective, but highly dangerous (B). Senega, is con- 
sidered a valuable auxiliary (P) ; has been employed (R). Quinine, in full doses 
is highly useful (B). Sulphurous Acid-, as spray, hourly or more frequently 
(R). Tannin, a 5 per cent, spray, several times a day for 15 or 20 minutes 
at a time (R). Hydrogen Dioxide, the solution, 1 to 4 of water, copiously 
sprayed over the nose, throat, mouth, etc., to destroy the membranes and pre- 
vent their reproduction ; then Glycozone, a teasp. in a winegl. of water thrice 
daily internally, prevents any disturbance of the stomach and regulates the 
bowels (Edson). Lactic Acid, as solvent of membrane (B). Iodine, the tinc- 
ture, externally, affords great relief, and tends to prevent formation of false 



CYANOSIS CYSTITIS. 625 

membranes (Wa). Water, warm bath, hot fomentations or compresses to 
throat; watery vapor in room. Steam inhalations, with a few drops of Iodine 
or Bromine. Diet, water only in small quantities during attack ; supporting 
diet may be required afterward. Lime-water, by vaporization, or inhalations 
of the vapor of slaking lime for a few minutes in every hour, or some other 
alkaline solution during the whole treatment (M & P). Tracheotomy, fully 
justifiable, 1\% percent, recovered, out of 1024 operations; should be done 
when paroxysms become very frequent, and dyspnoea is rather persistent than 
paroxysmal (M & P). [Compare Laryngitis, Diphtheria.] 



Prescriptions. 


gr. xx. 


R. 


gr. v. 





R. Pulv. Sanguinarise, . . gr. xx. R. Acidi Lactic i, 3ilJ ss - 

Pulv. Ipecac, . . . . gr. v. Aq. Destillat., . . . . |x. 

Syr. Ipecac.,. ... ^ij. M. Sig. — To be used as a spray, or ap- 

M. Sig. — A teasp. every l hour until plied by a mop. 

emesis, then ]/ z teasp. every hour. (P.) {London Throat Hospital.') 



Cyanosis. 

Amyl Nitrite, by inhalation, often gives marked relief (P). Quebracho, in 
that from asthmatic attacks of consumptives, lessened the cyanosis or entirely 
relieved it (Rohrer). Oxygen, by inhalation in the cyanosis of asphyxia from 
toxic gases or due to opium and chloroform narcosis. Leeching is of service, 
in a manner not easily understood (P). Treatment must depend on the nature 
of the lesion or disease giving rise to the cyanotic condition (A). [Compare 
Asphyxia, Asthma, Dyspncea, Heart Affections.] 



Cystitis, Acute. 

Belladonna, is a good remedy in almost every form of vesical irritation (G) ; 
when the vesical mucous membrane is irritable (B) ; very useful in recent 
catarrh from chill, with pain (P). Cantharis, in large doses causes inflamma- 
tion of the urinary tract, but gtt. j of the tincture every hour will often relieve 
vesical catarrh (Smith) ; in small doses continued, very efficient (B) ; gtt. j-v 
of the tincture thrice daily, when bladder is irritable, its sphincter weak, and 
pain along the urethra (P) ; may be employed in cystitis with benefit (R) ; 
in small doses, the best remedy for acute cystitis. Aconite, for febrile symp- 
toms (P). Quinine, often useful for acute symptoms (B). Iodoform, in sup- 
pository for painful cystitis (R). Opium, a rectal injection of Starch and Lau- 
danum will subdue pain and prevent the frequent micturition (R) ; Opium is 
dangerous if the kidneys are diseased (P). Alkalies, the Citrates and Bicar- 
bonates if urine is highly acid ; stop when it becomes alkaline (R) ; Liquor 
Potassae in barley-water or in a decoction of Trnicum repens, preferred to all 
other alkalies; urine must be maintained at a neutral or very slightly acid re- 
action (Thompson). Cannabis Indica, an excellent anodyne in all bladder 
cases, having specific effect on that organ. Rest in horizontal posture, muci- 
laginous drinks, hot fomentations and hip-baths, from 100 to no°, laxatives 
for the bowels, light food ; Milk-diet often necessary, especially in children. 
[Compare Bladder Irritable, Calculus, Dysuria, Enuresis, Hema- 



turia.] 



Prescriptions. 



R. Atropinae Sulphati-. . . gr. j. R. Pulv. Opii gr. xij. 

Acidi Acetici gtt. xx. Camphors. gr. xxx. 

Alcoholis, Ext. Belladonnas, . . . gr. iij. 

Aquae, aa ^ ss. 01. Theobrom., . . . . q. s. 

M. Sig. — Pour drops in a winegl. of M. et div. in supposit. no vj. 

water before each meal. (G.) Sig. — One to be used at bed-time. 

40 



626 CYSTITIS. 

Cystitis, Chronic. 

Benzoic Acid, and the Benzoates, in chronic cystitis, from any cause, when 
urine is alkaline (B) ; has some balsamic character, and is useful in some cases 
of chronic cystitis; gr. xxiv in the day, at least, in pills made with Glycerin 
(Thompson). Sodii Benzoas, 3j m Tinct. Gekemii 3»ij-iij, and water to ^vj, 
makes an excellent wash for painful cystitis of old men with enlarged prostate; 
a fluidounce should be warmed and injected, and retained 20 to 30 minutes 
(Copeland). Alkalies, when urine is acid; the Liquor Potassas, with Hyoscya- 
mus as an anodyne, preferred notwithstanding its chemical incompatibility, to 
control painful and frequent micturition (Thompson) ; Bicarbonates or Citrates 
better, as the strong reaction of liq. potassse unfits it to be given in doses suffi- 
ciently large to affect in any great degree the reaction of the urine (R). 
Triticum, is very efficient as an internal remedy, ^ij-iv of the rhizome boiled 
in a quart of water until reduced to a pint, this strained to be taken in four doses 
in the 24 hours (Thompson); a very useful remedy (Pancoast). Buchu, is 
probably the most efficient of the urino-genital remedies, the fluid extract in 
doses of n\,x-3j (B) ; the best drug in chronic cystitis, especially when the 
catarrh implicates the ureters or the kidneys themselves, producing consider- 
able muco-purulent discharge (P). Uva Ursi, is decidedly effective (P) ; is less 
so than Buchu (B). Stigmata Maydis, an infusion, 3 i j to the pint, a wine- 
glassful every 3 or 4 hours, has been used internally with considerable success 
(Dessein). Pareira, considered superior to Uva Ursi (Brodie) ; often very suc- 
cessful (P). Chimaphila, is often very efficient, but is more actively diuretic 
than the above-named remedies (B) ; by many practitioners it is considered 
the best remedy for chronic cystitis. Copaiba, is very useful by virtue of its 
local action on the mucous membrane, but objectionable for its nauseous taste 
and resulting gastric disturbance (B). Cubeb, is often useful from its stimu- 
lating effect (P). Turpentine, has been useful in many cases (R) ; when cys- 
titis is due to urethral inflammation or prostatic disease (B). Juniper, the oil 
is indicated under the same conditions as is Turpentine (B). Eucalyptus, there 
is no more efficient remedy in chronic cystitis than this (B) ; the oxygenated oil 
of Merck is best, in doses of 3 drops on sugar every 6 or 8 hours. Myrtol, has 
been used with excellent results in the Paris Hospital. Salicylic Acid, in large 
doses, either internally or by injection into the bladder, is most efficient (B) ; 
the acid or Salicylates often useful to prevent decomposition (P). Salol, proves 
an efficient disinfectant, as its constituents are excreted with the urine; solu- 
tions of 5 to 10 per cent, in Retinol, gave gratifying results in subacute cases 
of obstinate character, where other agents were of no avail ; this solution 
remains in the bladder, in diminishing quantity of course, after 6 or 8 urina- 
tions (Desnos). Camphoric Acid, in ]/ 2 to 3 per cent, solution in hot water, as 
injection, has cured several cases. Carbolic Acid, and Sulpho-carbolates to 
preserve the urine sweet (R). Sulphites will accomplish the same object (B). 
Silver Nitrate, by intravesical injection, gr. j in ^iv to begin with, increased 
gradually to gr. % to the % at most (Thompson) ; stronger solutions are advo- 
cated by Professor Richardson of New Orleans, and Professor Gardiner of 
McGill College, Montreal ; in the writer's experience a solution of gr. v to the 
25 used as a vesical wash, has been promptly efficient in curing many cases 
which resisted other treatment for months, — it sometimes produces serious 
symptoms, and it is therefore well to have a neutralizing solution of Sodium 
Chloride on hand for use if required. Other Injections, which may be used to 
wash out the bladder are — Lead Acetate, gr. j to ^iv of warm water, once 
daily ; Nitric Acid, dilute, Tr\J— ij to the ^j of water; Tannic Acid, gr. j to ^j ; 
Borax, ^j in §ij of Glycerin and ^ij of water, of which ^ss to Jiv of warm 
water for one injection ; Quinine, gr. j-ij to the ^j of water, with a drop of 
Acetic Acid. All injections must be used with great care, not more than ^ij 
forced in at once and that very slowly ; use flexible catheter, warm solutions, 
and a rubber injecting-bottle with a long nozzle and stop-cock (Thompson) ; 
washing the bladder is of great value (R). Evacuation of the urine, some of 
which is often retained in the bladder, is a matter of great importance. Ergotin, 



CYSTS DEAFNESS. 



627 



hypodermically, increases the contractile power of the bladder, and enables 
it to empty itself more perfectly (Langenbeck). Pichi, the fluid extract, rr\,xx 
to xxx four times daily, gave excellent results in bad cases of long standing, 
urine being alkaline, ammoniacal, ropy and purulent (Delamere). [Compare 
Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.] 



R 



Uvae Ursi Fol., 
Pareirae Radicis, . . aa §j-ij. 
Sig. — Boil in 3 pints of water until re- 
duced to a quart, then strain, and take I or 
2 wineglassfuls 3 or 4 times daily. 

{Thompson. ) 



Prescriptions. 

& . Quinince Sulphati 



R . Ext. Tritici Repentis Fluidi, 
Syr. Amygdalae, . . aa ^ ij . 
M. Sig. — A dessertsp. in water 5 or 6 
times daily. {Pancoast.) 



ft. 01. Terebinth., .... §ss. 

Camphorse, gr. xv. 

Extr. Hyoscyami, . . . gr. ss. 
Fiat massa. Sig. — Take a piece the size 
of a cherry-stone morning and evening. 
( Chanvel. ) 



• 3 SS - 
Acaciae, . . . . . gij. 

Morphinse Sulphatis, . gr. jss. 

Aquae, ... q. s. ad §iij. 

M. Sig. — A tablesp. to 3^ ounces of 

warm water, which inject in 3 parts, daily. 



R. 



5J- 



Sodii Boratis, . . 
Glycerini, 

Aquae, aa "£ ij. 

M. Sig. — Tablesp. in four ounces 
warm water as an injection. 



of 



R. 



gr. vij 
I "jss- 



Argenti Nitratis, 
Aquae Destillat., 
M. Sig. — Injection every third or 
fourth day after washing the bladder out 
with warm water. (Picord.) 



Cysts. 

Iodine, by injection very effective in cysts of the neck, and sometimes in 
unilocular ovarian cysts (B) ; Jx after tapping (R). Silver Nitrate, gtt. v-x of 
a strong solution (gr. xx ad gij), as injection into cystic tumors (wens), after 
allowing the contents to escape, will cure by setting up adhesive inflammation 
(B). Galvano-puncture, will permanently occlude cysts of the neck (B). Aurum 
Chloride, may sometimes cure ovarian dropsy (B). Remedies, internally, have 
all proved worthless (E). [Compare Ovaritis.] 



Deafness. 

Quinine, cures some forms, and often causes deafness (Brown-Sequard). 
Glycerin, for dryness of meatus; also to form a film to ruptured tympanum 
(R); either alone or in combination with Olive Oil (P) ; effects are temporary 
(Wa). Tannin, the glycerite as application for throat deafness (R). Gelse- 
mium, the tincture, n\xv-xx, repeated 2 or 3 times a day, is often useful in the 
treatment of nervous deafness, and seems to have an influence on the organ of 
hearing similar to that of Nux Vomica on the organ of sight. Colchicum, 
when from gout in ear (A). Cantharides, as ointment; gr. xxx ad ^j Adipis, 
below and behind the ear bis die, with alterative mercurial treatment, in deaf- 
ness from thickened tympanum (Wa). Collodion, contractile, applied to the 
membrana tympani, in deafness from relaxation of the membrane, has exerted 
a permanently beneficial influence, even in cases of long standing (Wa). 
Turpentine, gtt. xl in ^ss Glycerin, a few drops into the meatus in deafness 
depending on deficient secretion of cerumen, results in much benefit (Wa). 
Morphine, gr. ss sprinkled on surface behind the ear denuded by a small blis- 
ter, has proved curative in chronic deafness, after all other remedies had failed 
(Wa). Gargles, in throat-deafness, are of great value ; of Potassium Nitrate, 
Borax, etc., in sthenic cases ; tincture of Capsicum added in nervous forms ; 
of Hydrargyrum Bichloride, when from secondary syphilis (Wa). Water, 



628 DELIRIUM DELIRIUM TREMENS. 

washing in warm water, in deafness from general debility (Toynbee). Faradi- 
zation, of the ear in nervous deafness, in which slight results only to be expected 
from the treatment (R) ; demands the utmost caution (Wa). Inflation, by the 
Politzer bag, or eustachian catheter, in throat deafness. Remove wax from 
external canal. 

Delirium. 

Belladonna, in delirium of typhus and other fevers (R) ; in severe forms of 
delirium (P). Hyoscyamus, in delirium of typhus ; mild, less inflammatory form, 
hallucinations, nervous excitement, little cerebral congestion (P). Stramo- 
nium, in wild and furious delirium of puerperal mania, with general restless- 
ness and suicidal or destructive tendency (Wa) ; no drug deserving of more 
confidence in the greater number of maniacal cases (Cullen). Opium, in 
traumatic delirium, as a rectal injection, combined with Tartar Emetic in fevers, 
or, better still, Morphine hypodermically ; Laudanum in low, muttering deli- 
rium (R) ; is regarded with suspicion (P). Cannabis Indica, the extract in 
doses of gr. %-% in nocturnal delirium occurring in softening of the brain 
(Wa). Potassium Bromide, in delirium resembling delirium tremens (R). 
Camphor Monobromide, useful in rambling delirium (Wa). Camphor, in 20- 
grain doses, every 2 or 3 hours, especially in low, muttering delirium (R). 
Chloral, in violent delirium of fevers (R). Antimony, in delirium of fevers (R). 
[See Fevers.] Water, the cold douche in maniacal delirium ; place patient 
in warm bath during application (R). [Compare Cerebral Congestion, 
Fever, Mania.] 

Delirium Tremens. 

Chloral at outset (R) ; very successful, but dangerous to old drunkards or 
when heart disease exists (B); the experience of inebriate asylum physicians 
does not bear out the teaching that chloral is dangerous to old alcoholic 
cases, being by them commonly given in 30-grain doses every 3 or 4 hours 
until sleep is induced, without apparent danger. Belladonna, of proven effi- 
cacy when congestion of the brain (P); useful for the insomnia when coma 
vigil, cold surface, cyanosis (B). Stramonium can do all that Belladonna can 
do, and is more powerful (Tr). Hyoscyamus, in some forms admirable (P). 
Hyoscine, is a useful drug in delirium tremens, and in other affections in which 
tremor is a marked symptom (Weatherh). Duboisine, is even more sedative 
and hypnotic. Opium, cautiously, if at all (B); as rectal injection, hypodermi- 
cally, or with spirits ; if patient strong, delirium boisterous, and pulse full, add 
Tartar Emetic or Aconite (R). Bromides in the " horrors " preceding the 
delirium, Z) every 4 to 6 hours ; are of less value in the delirium, and in sub- 
sequent attacks (R); Ammonium Bromide has been used with very good 
results (Wa). Chloroform, inhalations to procure sleep (R); anaesthetics are 
dangerous (B). Cannabis Indica, gr. ss-j of extract, one of the least dangerous 
and most useful hypnotics (P). Tartar Emetic, as hypnotic (B) ; combined 
with Opium to control mania and insomnia (R). Capsicum, to induce sleep in 
early stages, gr. xx-xxx in a bolus with honey, repeated after three hours (R); 
in 20-30 gr. doses has remarkable success (P) ; the tincture in 3ss doses every 
three hours of great benefit (Wa). Nux Vomica, or Strychnine, should be 
more freely used than it is in alcoholism, and in delirium tremens may be used 
hypodermically almost to the commencement of tetanic action (Luton). 
Arnica, the tincture is exceptionally serviceable in cases where there is depres- 
sion (B). Coffee, often exceedingly useful (P). Digitalis, 3ss of tincture re- 
peated in 4 to 6 hours (R) ; a tablesp. of the infusion every 4 hours in pale 
subjects, where anaemia of brain, with effusion and oedema (B); has cured 
many cases promptly without producing any unfavorable symptoms; its safety 
and efficacy are alike questionable (Wa). Cimicifuga, an excellent tonic for 
the nervous system, is very successful (P). Quinine, with a mineral acid to 
restore digestion, in the "horrors," and in adynamic states (B) ; gr. j two or 



DEMENTIA PARALYTICA DENGUE DENTITION. 629 

three times daily as a tonic, the best agent to produce nervous tranquillity 
(Anstie). Sumbul, very efficient for insomnia (P). Zinc Phosphide, gr. jss 
daily, in divided doses, for many weeks, is used with decided benefit. Zinc 
Oxide, is of essential benefit as a nerve tonic and sedative, gr. ij-viij, twice 
daily, gradually increased to the higher dose named (Wa). Lupulin, the tinc- 
ture or oleo-resin, useful in mild cases as stomachic tonic and cerebral sedative 
(B). Ammonium Carbonate, when anaemia of brain and feeble heart-action 
(B). Conium, combined with Opium, is useful (P). Alcohol, of undoubted use 
where failure of stomach to appropriate food (B) ; is best omitted entirely from 
the treatment, the experience in inebriate asylums showing that cases recover 
more rapidly and surely without alcohol. Water, about 6o° with ice to head, to 
reduce temperature in the hyperpyrexia (R). Treatment, should tend to nour- 
ishment, and establishing of digestion ; concentrated liquid nourishment, with 
moderate use of stimulants (H). Diet and Hygiene, the immediate source of 
danger is exhaustion, hence animalized and nutritious, digestible diet should be 
used in fluid form, small quantities frequently repeated ; beef- tea, soups, yolk of 
eggs, warm milk, cocoa, cayenne pepper or stimulants in soups; coffee, to still 
nervous excitement ; hot baths and wet pack to eliminate the poison ; a quiet, 
dark room, sleep a necessity, often induced by Belladonna. [Compare Alco- 
holism ; also page 115, for Treatment of Delirium Tremens.] 



Prescriptions. 



R . Tinct. Capsici, 

Ext. Lupulini Fl., . aa 5j. 

Mucil. Acaciae, . . . . ±ss. 

Aquae Cinnamomi, . , 3 jss. 
M. Sig. — Dessertsp. as required for the 
wakefulness and excitement which pre- 



R. Chloralis Hydratis, . . £vj. 
Ext. Conii FL, .... 3 iij. 
Ext. Hyoscyami FL, . ,^iv. 
Mucil. Acaciae, . . . . zij. 
Aquae Menth.Virid., . ad ^\). 
M. Sig. — Teaspoonful in water after 



cedes an attack of delirium tremens. I each meal, to prevent delirium tremens. 

Dementia Paralytica. 

Physostigma, has seemed to retard the progress of the disease in some few 
cases (B). Paraldehyde, in one or two drachm doses as a calmative and hyp- 
notic, is as efficient as Chloral and without danger (B). Tonics, may be used, 
though treatment is only palliative ; Calcium Lacto-phosphate, Cod-liver Oil, 
etc.; no remedies have hitherto been of any avail (B). 

Dengue. 

Emetics and Purgatives are indicated at the outset, also free diaphoresis. 
Quinine, in five-grain doses every four or five hours for the fever (Da C) ; should 
be given more for its tonic than for its antiperiodic effects (Fayrer). Opium, 
in some form for the pains and nocturnal restlessness. Salicylic Acid or Sali- 
cylates, for the pains in joints and muscles. Carbolic Acid, as lotion, a 5 per 
cent, solution, for the itching, or Camphorated Oil. Belladonna, confers great 
relief in this disease, ttLx-xv of the tincture may be given every hour for two or 
three doses (Fayrer), Aconite, with salines and Nitrous Ether, during the 
pyrexia, which may be so high that cold sponging or the cold bath may be re- 
quired. Bitter Tonics, as Gentian or Calumba, with Quinine and a mineral 
acid or Strychnine during convalescence. Treatment, is entirely symptom- 
atic. 

Dentition. 

Belladonna, in convulsions of dentition, rarely fails to relieve (P). Hyoscy- 
amus, to alleviate pain and subdue irritation ; better than Opium for children 
(P). Chamomilla, mj of the tincture every ^ hour, an excellent sedative for 
children (A. A. Smith). Potassium Bromide for irritability and convulsions in 



630 



DIABETES. 



teething (R). Dulcamara, the infusion, in diarrhoea of dentition, quickly 
checks symptoms (F). Calumba, excellent for the accompanying vomiting and 
diarrhoea (P). Hypophosphites, of Calcium or Sodium, as a general tonic, are 
highly recommended (R). Rhubarb, with Soda, internally for the aphthae, with 
perfect cleanliness of the mouth and a wash of Borax or Potassium Chlorate 
in Glycerin, gr. x to the % (E. Smith). Castor Oil, for the diarrhoea of denti- 
tion to clear out the bowels, then a mixture of Chalk and Catechu, or Zinc 
Oxide.gr. j to the dose, with gtt. j of Laudanum if required to reduce peristalsis 
(Id). Lancing the Gums to relieve tension when gum is actually swollen ; 
should not be indulged in indiscriminately. 



Prescriptions. 



b\ . Potassii Bromidi, . . . gj. 

Olei Anisi, TUAJ- 

Mucil. Acaciae, 

Aq. Menth. Pip., . . aa ^j. 
M. Sig. — Teasp. every half-hour until 
the child is relieved. (B.) 



R. 



M 



Sodii Bromidi, Sodii Bicarb., 

Chloralis, aa gr. xx. 

Aq. Menth. Viridis, . . 5jss. 
Syr. Zingiberis, . . . . ^ ss. 

Sig. — Half-teasp. to a dessertsp. 



according to age. 



Diabetes Insipidus. 

Opium, large doses necessary, gr. vj-xij a day (B) ; combined with Gallic 
Acid, the most generally useful remedy (W). Ergot has cured many cases, the 
fluid extract in doses of 3ss-j thrice daily (Da C) ; one of the most efficient 
remedies (B) ; is the most useful remedy (R). Iron and Strychnine are very 
useful for tonic effects (Da C). Valerian restrains the flow of urine but does 
not cure (B). Muscarine has been used with apparent success (R). Potassium 
Iodide is curative in many cases of syphilitic origin (B). Alum has produced 
good results (B). Jaborandi, is used successfully to reduce the quantity of 
urine (B). Valerian, large, increasing doses (R). Krameria lessens the quan- 
tity of urine (P). Diet, a dry diet beneficial (B). 



Prescriptions. 

R. Extr. Ergotse Fl., . . . ^iij. I R. AcidiGalhci, giij. 

Sig. — Half-teasp. thrice daily, gradually Div. in chartulas xij. 

increased to a dessertspoonful. Sig. — One powder thrice daily. 



Diabetes Mellitus. 

Phosphoric Acid, largely diluted, assuages the inordinate thirst ; in one case 
it seemed to act as a curative agent (Wa). Arsenic, when from faulty assimi- 
lation, in diabetes of hepatic origin, and in thin subjects (B) ; the Bromide is 
credited with several cures (see Aurum below) : the Lithiated Arsenical Water 
was used in 70 cases, with cure of 96 per cent. (Martineau). [See infra for 
formula.] Morphine, is very efficient in reducing sugar when used by mouth, 
but is of no value when employed subcutaneously, even in the same case 
(Bruce). Opium in large doses (gr. vj-xij a day), ameliorative. Codeine, is 
especially serviceable (B) ; abates thirst and controls appetite (R) ; its value 
much disputed (P) ; is of great value in many cases (W) ; is one of the best 
remedies in doses of gr. ]i~Yz (Da C). Jambul, has given favorable results 
after abandoning all the usual remedies (Lawrence) ; in 2 severe cases, in 
which 7 and 3 per cent, of glucose were excreted, the urine was brought back 
to normal by preparations of the bark, and kept so for two years (Vix) ; should 
be given after meals, in water or wine sweetened with Saccharin. Sodium 



DIABETES. 63I 

Salicylate has cured when all other drugs have failed (R) ; gr. x-xv in com- 
pound spirit of Lavender, and water, thrice daily, is my favorite remedy (Da C). 
Ergot, is one of the useful drugs (Da C) ; decreases the quantity of sugar and 
the volume of urine. Potassium Bromide, gr. xx ter die, cured two cases insix 
weeks (Begbie) ; useless (Da C). Krameria lessens the quantity of urine (P). 
Phosphates, to avert failure of nutrition (B). Aurum, the Chloride is one of the 
promising remedies (B) ; the Bromide of Gold and Arsenic caused so much im- 
provement in one case that he was accepted as a good risk by one of the fore- 
most life insurance companies (E. A. Wood). Iodoform, in doses of gr. j-ij, 
rapidly reduced the sugar and caused its disappearance in 4 or 5 days, in five 
cases, without any change in diet being made (Moleschott) ; the amount of testi- 
mony for its value in this disease is quite considerable (B). Iodol, can be ad- 
vantageously substituted for Iodoform in all the diseases to which the latter is 
applicable (B). Uranium Nitrate, gr. i-iij, thrice daily has caused decided im- 
provement in several cases' (Hughes). Aloin, for the accompanying constipa- 
tion (Da C). Nux Vomica, or Strychnine, is generally beneficial. Calcium 
Lactophosphate benefits the thin, nervous type of diabetic remarkably (B). 
Antipyrin, affects secretion, and has been used with benefit in this disease. 
Orchitic and Adrenal Extracts have been given with reported success. Alka- 
lies are used on theoretical grounds, but have not produced much benefit; one 
case apparently cured by the diligent use of Ammonium Carbonate (B) ; are 
serviceable (Da C) ; alkaline mineral waters for diabetes of hepatic origin and 
in obese subjects, are extremely useful (B). Alkaline Waters, when of hepatic 
origin and in obese subjects ; tepid drinks for the intense thirst (B). Salines, 
a warm solution of the Phosphate and Chloride of Sodium, by intravenous in- 
jection, in diabetic coma, produced astonishing results in one case (B). Oxy- 
gen as oxygenated water, instead of carbonated water, has been successfully 
used (Le Blond). Glycerin has produced good results (B) ; used in place of 
sugar (W). Diet and Hygiene are of the utmost importance ; avoid amylaceous 
food, and everything containing sugar, especially ordinary bread; use fresh, 
nutritious animal food, with bread of bran or almonds ; warm baths, warm 
climate, flannel underclothing. Peanuts, are an excellent article of food for 
diabetics, being rich in albumen, of which they contain 47 per cent., together 
with 19 per cent, of fat and non-nitrogenous extractive matters (Furbringer). 
Milk-cure, by skimmed milk, very successful, 6 to 10 pints daily; give no other 
food for six weeks, then animal food; — Caution! the urine of patients taking 
Salicylic Acid gives the reaction of sugar with Trommer's test (R). Saccharin, 
as a substitute for sugar, does well for sweetening purposes, but is not a nutrient, 
and has no influence on the disease. Dulcin, is 200 times sweeter than saccha- 
rin, and is harmless in reasonable doses, up to 24 grains in the day (Kobert). 
Levulose, is a saccharine food which can be taken freely and without any in- 
jury by diabetic patients ; it most nearly approaches the ideal carbohydrate 
food indicated in diabetes (Hebra) ; it is assimilated well and nearly all oxid- 
ized by diabetics, who are able to partake freely of it in comparatively large 
quantity (Ebstein) : sugar and sugar-forming food constitute more than half the 
nourishment needed by a healthy person, and it is the imperative duty of the 
physician to furnish a diabetic with a moderate amount thereof, to prevent 
death from inanition, and to lessen the danger of diabetic coma which is in- 
duced by a diet of meat alone (Leyden) ; Levulose, formerly very high in price, 
is now sold at a reasonable rate under the name Diabetin. 



H. . Liq. Potassii Arsenitis, . ^jss. 
Tinct. Opii Deodorati, . 5 v. 
Syrupi Zingiberis, . . . ^j. 
Aquae Cinnamomi, q. s. 

ad g iv. 
M. Sig. — Teasp. thrice daily. 



Prescriptions. 

R . Lithii Carbonatis, . . . gr. xl. 
Sodii Arsenatis, . . . . gr. j. 
Ext. Gentianee, . . . . gr. xx. 
Ft. pil. no. xxv. Sig. — One night and 
morning until sugar disappears. More 
convenient than Martineau's liquid. 

( Vigier. ) 



632 



DIAKRHCEA. 



R • Codeinse, err. viij. 

Syrupi, et Aquae, . .' . ^ij. 
M. Sig. — Half-teasp. thrice daily, grad- 
ually increased up to two teaspoonfuls. 

{Pavy.) 



R . Sodii Arsenatis, . . . . gr. iij. 

Aquae, Oj. 

A tablesp. of this with Lithii Carbonat. 
gr. iij, into a quart siphon filled with car- 
bonated water, which is to be taken freely, 
as daily beverage. (Martineau.) 



Diarrhoea. 

Mercury, in diarrhoea of children with bad digestion, flatulent distention and 
clay-colored, pasty, stinking motions, gr. j of the Bichloride to ^ viij of water 
in doses of Z) every hour, or, still better, Hydrarg. cum Creta, gr. % every hour 
or two, will restore the natural bilious color and limit the number of the stools(R) ; 
Calomel in minute doses, gr. fa to ^ every half hour, is useful in the diarrhoea 
and dysentery (ileo-colitis) of children, when there is much irritability of the 
stomach (B) ; in the acute or chronic diarrhoea of children, characterized by 
slimy stools mixed with blood and accompanied by pain and straining, gr. j of 
the Bichloride to ^x of water, in doses of £j, is very efficient, curing with re- 
markable speed and certainty (R); in mucous diarrhoea, gr. j. of the Bichloride 
to a quart of water, in doses of Z] every hour (A. A. Smith). Antipyrin, in 
doses of gr. l /z to \]/ 2 , has rendered signal service in the diarrhoea of infants and 
children. Aconite, in diarrhoea from chill, with high fever and cutting pains 
in the abdomen (P). Camphor, in summer diarrhoea and the preliminary diar- 
rhoea of Asiatic Cholera (B) ; when from effluvia of drains or exposure to cold 
(R) ; useful in many forms (P). Ipecacuanha, in summer diarrhoea and dysen- 
tery of children with greenish stools (B) ; hourly drop-doses of the wine, espe- 
cially if vomiting (R) ; when from nervous irritation, especially in young chil- 
dren (P). Dulcamara, in diarrhoea of children from damp, or with dentition 
(P). Pulsatilla, dyspeptic diarrhoea, mucous discharges, active piles (P). Qui- 
nine, in periodic diarrhoea, with dysentery and jaundice (B). Veratrum Album, 
in the vomiting and purging of summer diarrhoea (R). Podophyllum, in chronic, 
with high-colored motions and cutting pains, also in morning diarrhoea (R) ; 
gr. fa to fa, with occasional doses of Aconite, for vomiting and diarrhoea of 
gastro-enteritis and prolapse of rectum (P). Chamomile, an infusion in sum- 
mer diarrhoea of adults, or in that of dentition (R) ; the Oil in diarrhoea of chil- 
dren, especially from worms (P). Arsenic, for evacuation of undigested food 
(B) ; gtt. j of Liq. Arsenicalis before meals when diarrhoea excited by food ; also 
in chronic and membranous forms (R). Nux Vomica, a very useful adjunct 
to other remedies (B) ; often of much service in epidemic diarrhoea (P). Sul- 
phuric Acid, in summer and choleraic diarrhoea; small doses in the chronic 
form and in the straining diarrhoea of children (R). Peptenzyme, is excellent 
in cholera infantum and the summer diarrhoea of children. Balsam of Peru, 
is excellent in diarrhoea, with or without tenesmus (Tr). Kola, is useful in 
atonic diarrhoea. Zinc Salts, are very efficient in the summer diarrhoea of 
children (B). Hsematoxylon, is devoid of irritating qualities and is well adapted 
to the diarrhoeas of young children. Calumba, in diarrhoea due to relaxation 
of the mucous membrane and not dependent on inflammation (B). Catechu, 
in atonic diarrhoea and in that following withdrawal of morphine or opium from 
habitues, also in the diarrhoea of children ; in the latter the tincture with Chalk- 
mixture is very serviceable. Kino, in atonic diarrhoea ; the tincture in doses of 
3j for the diarrhoea resulting from the disuse of opium or morphine. Coto, the 
fluid extract, or Cotoin, is one of the new remedies for atonic diarrhoea. Tan- 
nic Acid, is very useful in profuse and chronic diarrhoea (B) ; with milk diet in 
chronic diarrhoea and dysentery (S). Opium, is commonly used, but is best 
when evacuations are very watery, combined with mineral Acids or with Lead 
Acetate (B) ; with Starch as an injection in severe cases (R). Codeine, gr. ss-j 
answers most satisfactorily in the milder forms of diarrhoea and leaves no un- 
pleasant after-effects (Braithwaite). 

Bismuth Subnitrate, is effective, requires large doses; gr. xxx-lx every 3 or 



DIARRHCEA. 



633 



4 hours ; is especially indicated when desire for stool is felt immediately after 
eating (B) ; gr. j hourly with milk, sometimes with gr. 1 of gray powder in vari- 
ous forms of infantile diarrhoea (R). Bismuth and Ammonium Citrate, in diar- 
rhoea without irritation, but rather relaxation of the intestinal mucous membrane. 
Bismuth Salicylate, is highly praised in the diarrhoea of phthisis and in that of 
typhoid. Salol, is very efficient in acute diarrhoea due to action of microbes. 
Resorcin, gives very marked satisfaction in the diarrhoea of children. Thymol, 
gr. xx to 3'j in 24 hours in divided doses for adults, is a very efficient internal 
antiseptic in all cases of diarrhoea, especially that of phthisis, teething children, 
chronic diarrhoea, etc. (Martini). Carbolic Acid, very useful in fermentative 
diarrhoeas, especially combined with Bismuth in cholera nostras and cholera 
infantum (B). Mineral Acids, in painless, watery stools, light color and alka- 
line (B). Alkalies, Mistura Cretae in sour-smelling stools (B) ; Sodium, Potas- 
sium or Magnesium Bicarbonates when acid canal (R). Calcium Carbonate, 
as Chalk-mixture, in the later stages, also in the diarrhoea of typhoid or phthisis 
(R) ; may be combined with Opium and with vegetable astringents. Lead 
Acetate, with Opium as an injection (R) ; is excellent in all forms (B). Rhu- 
barb, in early stages to get rid of irritant, afterward to check the diarrhoea (R) ; 
when torrefied it has no purgative power, but its astringency is retained. Ru- 
mex, in morning diarrhoea (R). Arnica, checks exhausting diarrhoea with great 
certainty (P). Silver Nitrate, in diarrhoea of children, with white, pasty, and 
offensive stools; combined with Opium the most effective remedy for that of 
phthisis and typhoid (B). Saline Purgatives, a teaspoonful of Epsom salts 
(Magnes. Sulph.) in a wineglass of water every three hours when intestinal inflam- 
mation (B). Copper Sulphate, the most effective astringent in chronic diarrhoea 
and that of phthisis (B). Ergot, in persistent, chronic diarrhoea (B). Iodine 
one or two drops of tincture in diarrhoea from atony of mucous membrane (B) 
Castor Oil, in diarrhoea from irritating matter in the intestinal canal, as un 
digested aliment or irritant secretions, no remedy more useful (B). Diet 
should be cool or cold, light, bland food ; gruel, rice, arrowroot, whey, barley 
water, in recent cases; in chronic cases the most digestible but nutritious food 
as fresh fish, game, raw eggs, rice, mucilaginous drinks; Milk and Lime-water 
or Soda-water very useful; also raw meat pulp; avoid beef, pork, veal, and 
much starchy food. In most forms of diarrhoea in children it is wise to cut off 
milk and substitute some artificial food (R). [Compare Dysentery, Cholera.] 



Prescriptions. 



R. Bismuthi Subnit. , . . . gj-ij. 
Pepsini Saccharat., . . gss. 

Zinci Oxidi, gr. vj-xij. 

Trit. et div. in chartulas xij. 
Sig. — One every four hours in summer 
diarrhoea of children. 



. ^ss. 



R . Sodii Bromidi, . 

Mucil. Acacias, 

Aquae Purae, aa q. s. ad ^ij. 
M. Sig. — Teaspoonful every three 
hours in the diarrhoea of dentition, for child 
less than a year old. (A. A. Smith.) 



R . Tinct. Opii Deodorat. , . tt\x. 
Bismuthi Subcarb., . . ^jss. 
Syrupi Zingiberis, . . . £yj. 
Mist. Cretae, . q. s. ad ^ iv. 
M. et fiat emulsum. Sig. — A teaspoon- 
ful every 2 or 3 hours, for a child of one 
year old, when the stools are acid and green. 
( Good hart. ) 



R . Zinci Sulphatis, 

Pulv. Opii, 

Pulv. Ipecac, . . . aa gr. xij. 
M. Fiant pil. no. xij. Sig. — One 3 or 
4 times daily in chronic diarrhoea of adults. 



R. Tinct. Opii Cam ph., 

Tinct. Catechu, . . aa ^iij. 

Mist. Cretae gx. 

M. Sig. — A teaspoonful four or five 

times daily for children. 



R. Tinct. Opii Deodorati, . Z). 
Tinct. Calumbae, q. s. ad 3pj. 
M. Sig. — Teasp. in a winegl. of water 
before meals. 



R. Zinci Oxidi, gr. xvij. 

Sodii Bicarb., gr. viij. 

M. et div. in chartulas iv. 
Sig. — One every 6 hours. 



634 



DIPHTHERIA. 



R . Plumbi Acetat gr. xx. 

Pulv. Opii, . . . . gr. x. 

Fiat massa, et, div. in pil. x. 
Sig. — One twice daily. 



R . Spiritus vEtheris Co., 

Tinct. Opii Camph., . aa Ij. 
Syr. Simplicis, . . . . 3 ij. 
M Sig. — A dessertspoonful after each 

movement. 



R. Ac. Nitrici Diluti, . . . ^ij. 

Tinct. Camphora?, 

Tinct. Opii, . . . . aa gj. 

Syr. Zingiberis, . . . . Ziv. 

Aq. Men thee Pip., q. s. ad g vj. 
M. Sig. — Tablesp. doses to be used 
after a cathartic. (Hope's Mixture as 
modified by Thompson.) 



M. 



Tinct. Opii Camph., 
Syr. Rhei Aromat, . aa ^ss. 
Aquae Calcis, . q. s. ad 31]. 
M. Sig. — A teasp. for children. 



Diphtheria. 

Antitoxin, is eminently successful, particularly when the treatment is com- 
menced eaily in the case. (See page 149.) Mercury, the Corrosive Chloride 
internally, with Ichthyol rubbed into the glands of the neck, employed with 
marvellous success (Davison) ; doses for 24 hours are gr. % in Sjiv of water for 
young children, gr. yi in ^vj for children of 6 or 7 years, gr. ^ in ^viij for 
adults, with Ichthyol (as above) and Antipyrin by enema if much fever (Dale) ; 
the Bichloride has given me most success, with a gargle of Thymol or Boric 
Acid (Da C) ; gr. jss in 31V of glycerin and water, of which 3j every l / 2 hour 
for 6 doses, then every hour night and day, to a child of 4 years (Grant-Bey) ; 
locally very efficient, gr. ij to Oj of water, applied on a cotton swab, which 
should be burned after one using; this hourly night and day (Oatman). 
Hydrargyrum Cyanide, in solution of gr. ^ to the %, of which a teasp. every 
y z hour day and night to older children and adults, with a gargle of the same 
solution (Sellden) ; gr. ^V~¥S"> according to age, every hour or two (Enchsen) ; 
gr. \ in !§iv of water, of which 3j to iv as per age every hour (Schultz) ; used 
by homoeopaths in Berlin almost entirely, sometimes alternated with Apis, but 
most efficacious alone ; table of 484 cases so treated, with 28 deaths. {Brit. 
Jour. Homaeop., 1884, p. 382.) Calomel is next in importance to Quinine and 
Iron, has proved successful in cases where other means failed, gr. ]/%-%. every 
3 hours, with a little Dover's powder (Da C) ; checks plastic exudation, its use 
limited to children of good constitution, with sthenic symptoms ; gr. x / z to j every 
2 or 3 hours, with or without Dover's powder (gr. j) or Ipecac (gr. j) till bowels 
become relaxed, with greenish stools (Wa) ; gr. v repeated boldly every hour to 
3iv, for a child of 3 years, until the stools appear like polyps in water-troughs, 
gelatinous, and of a bright, dark-green hue, — then a dose of Castor Oil if sali- 
vation is feared (Reiter) ; the safest and most efficient germicide with which we 
can saturate the system ; nothing like it in diphtheria, gr. Y^-yi every hour, 
even gr. j every 2 hours has no bad effects, no salivation (Fowler). 

Belladonna, an excellent remedy ; if given early will abort the exudation and 
later is useful to sustain the heart (B) ; especially when throat and tonsils 
acutely inflamed and much swollen (R). Pilocarpine, used in 80 cases without 
a single death; produces free salivary discharge, but is depressant to the heart 
(Guttmann) ; many opinions for and against it; is decidedly injurious in ady- 
namic cases (B). Quinine, in tonic doses recommended from my experience 
(Da C) ; when headache with high temperature, vomiting, and symptoms of 
septic poisoning, then in full doses (Wa) ; is most useful after serious symptoms 
have abated, then with Iron and a mineral acid (Mackenzie). Arsenic, in 
medicinal doses for malignant cases, or when sloughing of throat (R) ; the 
Iodide, in doses of gr. ^ every hour or so, (see under Throat, Sore), an ex- 
cellent remedy for the so-called diphtheritic sore throat. Calcium Chlorate, in 
solution locally as lotion for the mouth ; considered almost specific by some ; 
its chief utility is in removing fetor; may influence germs (R). Potassium 
Chlorate, grain-doses every y z hour (Smith) ; is more largely used than any 
remedy, both internally and locally (B) ; in full doses with Liq. Cinchonas, 



DIPHTHERIA. 635 

seems to be of service in some cases (Wa). Carbolic Acid, as spray, a 5 per 
cent, solution in the atomizer cup ; locally to the fauces, to remove fetor and 
destroy disease-germs (B) ; the strong acid in Glycerin as caustic on a mop or 
brush (W); with Iodine internally to prevent systemic infection (B). Sodium 
Sulpho-carbolate, internally, has been found useful in lieu of Carbolic Acid 
(Wa). Salicylic Acid, locally, and internally, gr. x, has produced good re- 
sults (B). Sulphurous Acid, the gas, recommended by a royal commission in 
Victoria, as a means of arresting the disease; crude sulphur burned in the 
room, all apertures being closed (R) ; in full and frequent doses, causes rapid 
disappearance of the exudation, and improvement in the general condition ; 
3j every yi hour to an adult in severe cases, in ordinary ones every two hours : 
an 8-ounce mixture should have 2 or 3 ounces of syrup, and should be given 
in milk to very young children (Snow). Sodium Sulphite, Z) to ^j aquae, 
locally, an easily managed application (B) ; an injection for nares in nasal 
diphtheria (Da C). [See formula below.] Sodium Hyposulphite, in solution 
of Z) to ^ij of water, of which hourly doses of 3j. to be retained in throat 
several minutes before being swallowed, an excellent local and constitutional 
remedy, which may also be used by a brush or spray to the throat, and by a 
syringe to the nares (Fruitnight). Sodium Benzoate, is highly efficient, 75 to 
100 grains daily, according to age, also used locally (B). 

Lime-water, dissolves false membrane ; the vapor of slaking lime inhaled ; 
or, better, Lime-water by atomizer to back of fauces while patient respires 
deeply (W). Ferric Chloride, as solution painted on or applied by spray to 
the throat (R) ; of no advantage locally, internally may serve by supporting 
the organism (B) ; the tincture, gtt. xx every 2 or 3 hours ; or better the Per- 
chloride, gr. y z to j every 2 hours in syrup and water, is easier to take and 
doesn't hurt the throat (Da C) ; the solution is an ingredient of Loeffler s Solu- 
tion (see formula below) for local use. Thymol, 3j in Glycerin ^j and Water 
§iij, is the best agent for use as a gargle (Da C). Toluene, with Menthol, 
Creolin, etc., as in Loeffler s Solution, which is applied on a swab of cotton 
every 3 hours for 4 or 5 days, after cleansing the surface ; is highly efficient for 
destroying the bacilli and preventing absorption of toxin (Loeffler). Hydrogen 
Dioxide, the solution, as spray or gargle, is a very useful application, and may 
be diluted with 3 to 4 parts of water; is much more powerful against young 
bacilli of diphtheria than against those of two days old, and hence its 
therapeutic value is especially available at the very outset of the disease, and 
as a prophylactic during epidemics thereof (Traugott). Glycozone internally, 
a tablesp. in a winegl. of water every 3 hours, has an excellent effect (Edson). 
Tartaric Acid, locally converts membrane into a gelatinous mass, easily ex- 
pelled (Vidal). Chloral, a dilute solution in glycerin and water makes an excel- 
lent local application for the throat; internally may be used as a symptomatic 
remedy in the early stages, but not when the heart is weak. Papain, by atom- 
ized inhalation, is used to destroy the membrane. Pineapple Juice and Papaya 
Juice, used by sipping and swallowing the juice after chewing the pulp, highly 
efficient in India (Chambers) ; see page 377. Boracic Acid, in solution as gargle, 
ranks next best after Thymol (Da C). Sulphur and Alum, equal parts, pow- 
dered and blown into the throat at the moment of deep inspiration, as often as 
asphyxia is threatened, are efficient (Jones) ; Sulphur is a very old and efficient 
local remedy in diphtheria, the flowers (sublimed sulphur) rubbed up with water 
as a gargle, or blown upon the throat through a quill, was the method of Dr. 
Field, who had a great reputation in England a few years ago for curing this 
disease {Lancet). Trypsin, is a good solvent of the false membrane; of all 
remedies used with the spray-atomizer, it has given me the largest percentage 
of recoveries (Fruitnight). Chinolin, a 5 per cent, solution painted over the 
affected parts with great advantage (Seifert) ; the tartrate in 10-grain doses in- 
ternally (B). Bromine, the vapor by inhalation, is useful (Wa) ; a T i^ solution 
in distilled water, of which gtt. j-iij every %, hour in a teasp. of sweetened 
water, using a glass spoon ; and a saucer full of Bromine Water in the room, 
renewed every 12 hours, has seemed to be extremely efficient in a number of 
cases. Iodine as inhalation frequently ; with use the solution may be increased 



6 3 6 



DIPHTHERIA. 



to 3ss at each inhalation (R). 'Potassium Permanganate, gr. y, in distilled 
water, internally, and also used locally, is of undoubted benefit (B) ; is credited 
with brilliant results even in malignant cases. Sanguinaria, the best emetic, 
and by many is considered specific in this disease (P). Lactic Acid, Siijss to 
£x of distilled water, as gargle, on mop or by spray, to dissolve membrane (B). 
Tannin, a 5 per cent, solution as spray (R). Cubeb, very efficient in the catar- 
rhal forms of diphtheria (Robinson) ; the freshly ground berries in large doses 
in early stages of the disease, a very successful treatment (Trideau). Turpen- 
tine, 3j of the oil thrice daily, with n\,iv of Spiritus ^Etheris as a corrective, at 
the same time using ice-bags, and a gargle of Potassium Chlorate solution, and 
internally ^-ounce doses everv 2 hours of a 2 per cent, solution of Sodium 
Salicylate (Roesse, Baruch). Tar and Turpentine vapor, made by burning in 
the room Coal-tar 7 parts to Oleum Terebinthinae 3 (Delthil). Methylene Blue, 
was used with success after losing cases by other treatment ; even in simple 
non-diphtheritic ulceration of the throat, patients would, after one or two appli- 
cations of the solution express themselves with delight as being cured (Rose). 
Chlorine-water, tablesp. doses internally and as a gargle, highly efficient ; a 
mixture of Chlorine-water 2 parts and Distilled Water 1, of which 3j internally 
every 2 or 3 hours, is by far the best treatment of this disease ; no water should 
be given after the mixture (Schubert) ; as a prophylactic the same may be 
given 2 or 3 times daily (Id). Nuclein, has been used with benefit (see page 
134). Strychnine, hypodermically, for the subsequent paralyses (R). Alcohol, 
is probably as good a local antiseptic as any ; diluted with equal parts of water, 
by hand-ball atomizer every y z hour; is the prince of antiseptics, and the most 
perfect and reliable medicine in diphtheria of which we have any knowledge 
(Hills). Stimulation, freely, the essential part of the treatment; infants are 
not injuriously affected by every teasp. doses of whiskey every y z hour; stimu- 
late for effect and not by dose ; those cases do best which are stimulated freely 
and early (Da C) ; there is more danger from giving too little alcohol than from 
too much ; a three-year-old child can comfortably take Jj-^v of Cognac, or 
gr. xv of Musk or Camphor, or gr. xv-3j of Ammonium Carbonate in 24 hours ; 
in the septic form especially, the intoxicating action of Alcohol is not experi- 
enced, and young children with general sepsis began to improve when their 
^iv of brandy were increased to jfxvj daily (Jacobi). Water, as ice in the 
mouth, and the wet pack to the throat are extremely serviceable (B); Ice 
sucked, especially at commencement, and continued until the disease declines 
(R) ; Ice packed in bladders or thin india-rubber bags, to the throat (W). Ali- 
ment, srood foods, wines or brandy, necessary from the start to maintain the 
patient's strength (R) ; a teasp. of glycerin every 3 or 4 hours, plenty of good 
soup and wine, nutritive enemata, are necessary to sustain the system. Moist 
inhalations. Temp, of room 68° Fah. Removal from the house wherein 
attacked is advisable. Tracheotomy, only in extremis (R) ; is not successful 
in diphtheria, though very much so in membranous croup (Da C). Intubation 
of the Larynx, as an alternative to tracheotomy, is enthusiastically advocated 
by many operators. 

Prescriptions. 

R. Potassii Chloratis, .... gr. xl. 



R. Hydrarg. Chlor. Corros., . gr. jss. 

Glycerini, j|j. 

Aquae Destillatae, .... %\\). 
M. Sig. — A teasp. every y hour for 6 
doses, then every hour night and day to a 
child of four years. Also, — 
R. Ung. Iodoformi (1 in 10), rubbed in 
over swollen glands every 3 hours. 

[Grant- Bey.) 

R. Sodii Sulphitis, giij. 

Glycerini, zij. 

Aquae, q. s. ad 3 iv. 

M. Sig. — Nasal injection. [Du Costa.) 



Solve, et adde — 

Ac. Sulphurici Aromat, 
Tinct. Ferri Chloridi, . aa ^j. 
M. Sig. — Teasp. doses for adults, every 
2 to 4 hours, reduced as improvement ad- 
vances, but kept up throughout disease. 



R 



Ac. Tartarici, t 5j. 

Glycerini, oJ ss - 

Aquae Menth. Pip., q.s. ad £ iv. 

M. Sig. — Gargle frequently. ( VidaK 



DROPSY. 637 

& . Tinct. Ferri Chloridi, . , 3J. Alcoholis, . . . . q. s. ad Cc. 100. 

Syrupi Tolutani, Sig. — To be applied by cotton swab 

Liq. Potassi Citratis, . aa 5 ijss. every 3 hours for 4 or 5 days. 

M. Sig. — Teasp. to dessertsp. accord- \ (Lcejfler's Solution.) 

ing to age, every 3 hours, £j=TTLx of the i 

tincture. {Anderson.) \ . 

r , TT , /-! 1 r- K • Tinct. ferri Chloridi, . . 5j. 

R. Hydrarg. Chlor.Corros, gr.j, may * Potassii Chloratis %ss 

be added to the above formula, which , r . . ,, ' ' ' ' ' ° 

, ,, t , , . . . , ' Misce et adde — 

should then be given in teasp. doses. . _ , ~ ... 

& r Aquae, q s. ad 3 vnj. 

Sig. — Gargle. [Jacobi.) 

R- . Mentholi Gm. 10. For the chemistry of this combination 

Toluene, . . . . q. s. ad Cc. 36. see under Chlorum, ante, page 233. Gly- 

Dein adde- | cerin should not be added, as in Dr. Ja- 

Creolin, Cc. 2. | cobi's original r£ , which makes a mixture 

Liq. Ferri Chloridi, . . . Cc. 4. | which may explode. 



Dropsy. 

Arsenic, in dropsy from feebleness of heart, and in old age (B) ; swelled feet 
from debility (R). Aurum, has an ancient reputation in several forms of 
dropsy (see page 175). Digitalis, one of the best remedies, especially in renal 
dropsy from acute desquamative nephritis; the infusion in doses of ^ss (B) ; 
the fresh infusion best for that of heart disease, especially when tricuspid 
regurgitation (R) ; induces striking effects in cardiac dropsy, when scanty 
urine and venous engorgement; has high rank as a diuretic (P). Apocynum 
Cannabinum, actively diuretic (P). Diuretin has been employed with marked 
benefit in both cardiac and renal dropsy, in hepatic cirrhosis, and in various 
diseases of the heart and kidneys accompanied by oedema: gr. xv several 
times daily, in aqueous solution, avoiding acids or acid vegetable juices. 
Caffeine, the Citrate in 5-grain doses is eminently diuretic; for objections to its 
use see page 198. Cactus, has long had a high reputation in dropsy among 
the natives of its habitat ; is probably of service in cardiac dropsy. Hydrar- 
gyrum, a classical pill in dropsy with dyspnoea from cardiac disease is the 
combination of Dr. Baillie, containing Mercury, Digitalis, and Squill (see 
formula below) ; Calomel in doses of gr. ss-ij is eminently diuretic, especially 
in cardiac dropsy, but by many it is thought to act by aiding the action of 
other diuretics. Bryonia, as a drastic purgative and diuretic; care necessary 
as it depresses the heart ; the infusion best (P). Hellebore, the tincture, in 
doses of gtt. v-xv, every 2 or 3 hours, very successful in diopsical effusions, 
especially in general anasarca after scarlatina (P). Senega, as a diuretic 
when dropsy is dependent on kidney disease; has been praised (P). Chima- 
phila, is useful as a diuretic in renal dropsy especially when loss of appetite 
and debility (P); may be substituted for Scoparius (B). Juniper, largely used 
as a diuretic in cardiac and renal dropsy (B) ; esteemed in post-scarlatinal 
dropsy (R). Iron, purgative chalybeate waters (B) : the Liquor Ferri et Am- 
monii Acetatis (Basham's Mixture), in anaemic dropsy (Da C). Pilocarpus, 
very valuable in renal dropsy when secretion of urine is much reduced or sup- 
pressed (B). Jalap, the compound Jalap powder, gr. xv-xx, with giij of Potas. 
Bitart. and a little Ginger, early in the morning, 2 or 3 times a week ; no hy- 
dragogue superior in dropsy from Bright's disease (Wa). Turpentine, controls 
dropsy with albuminous urine, from non-desquamative renal disease; gtt. ss. 
every 2 to 4 hours (P). Colchicum, as a hydragogue in hepatic and cardiac 
dropsy when patient is vigorous, also in post-scarlatinal dropsy (B). Scopar- 
ius, esteemed by English physicians (B) ; is most useful in cardiac dropsy; 
Cullen found it the most certain diuretic : diluents should be freely used with 
it (P). Squill, in cardiac dropsy ; cautiously if from kidney disease ; if anaemic 
add Iron (R). Taraxacum, is occasionally used as a diuretic, with limited 
utility (B). Copaiba, gives good results, especially in ascites, which see for 
formula (B). Potassium Bitartrate and Acetate, are very certain as diuretics 



6 3 8 



DUODENAL CATARRH. 



when largely diluted with water, as Cream of-tartar lemonade; indicated in 
desquamative nephritis, and in general dropsy from valvular disease of the 
heart (R). Elaterium, of unquestionable value as a derivative in many pas- 
sive forms of dropsy, though many fear it (P). Acupuncture, or better still, 
incisions from ^ to an inch long, one over each external malleolus generally 
sufficient; a hot sponge, moistened with weak Carbolic Acid solution kept to 
incisions (R). Aliment, dry diet is of advantage in dropsy of serous cavities 
(B) ; should be light in acute dropsies; nourishing in chronic. Water not in- 
jurious but beneficial as drink. Warm baths, Holland gin in small doses, 
tapping for alleviation in incurable cases. A moderately warm, dry atmos- 
phere. Skim-milk diet said to be of great value in renal dropsy. [Compare 
Ascites, Hydrocele, Hydrocephalus, Hydrothorax, etc.J 



R . Vini Colchici Seminis, 
Liq. Ammonii Acetat. 
Infusi Petroselini, . . . . -, 
M. Sig. — Teasp. every 4 hours 



Preset 

I ijss. 
v. 
, An 



excellent diuretic, especially adapted to 
the dropsy of scarlatina. (B.) 



R. 





Tinct. Digitalis, . . . 


. ^ i-ii. 


M 


Tinct. Scillae, . . T 
Spt. Juniperi Comp., 
Potassii Acetatis, . . 
Vini Albi, . . . . q. s 
Sig. — A tablesp. 3 or / 


- 3 1V - V J- 
. 3 iv. 
ad'^vj. 
\ times daily 


Ft 


Pulv. Digitalis, . . . . 
Pulv. Scillre, .... 
Hydrarg. c. Creta vel 
Pil. Hydrargyri, . . 
. pil. no. j. Sig. — One 


• gr-j-jss. 

• gr-j- 

• gr-j-iij- 
.hrice daily. 



Pulv. Scilke, 

Pulv. Digitalis, . . . . aa % ss. 

Potassii Nitratis, . . . . 5J. 
M. Fiat massa, et div. in pil. xxx. 
Sig. — One pill thrice daily. 



iptions. 

! R. Elaterini, gr. j. 

Spt. Etheris Nitrosi, . . - 3 ij. 

Tinct. Scillae, 

Tinct. Colchici, . . . aa % ss. 

Syr. Symplicis, ijj. 

M. Sig. — A teaspoonful 3 or 4 times 
daily, for hepatic and cardiac dropsy in 
sthenic subjects. 



R. Potassii Acetatis, .... ^ vss. 
Spt. Etheris Nitrosi, . . . t^ij. 
Aquae, . . . . . q. s. ad ,^viij. 
M. Sig. — Tablesp. every 3 or 4 hours. 

R. Potassii Bitartrat., .... gj. 

Ext. Taraxaci, 3 ss - 

Decocti Taraxaci, .... ,§viij. 
M. Sig. — 1 / 2 wineglassful twice or thrice 

daily. 

R . Aceti Scilloe, ^ ss. 

Infusi Digitalis, . q. s. ad 5iv. 
M. Sig. — A tablesp. 2 or 3 times daily. 

R . Liq. Ferri et Ammonii Ace- 
tatis (U. S. P.), . . . . 3jvj. 
Sig. — Dessertsp. or two three or four 
times daily. (Bas/iam's Mixture.) 



Duodenal Catarrh. 

Salol, is the most efficient remedy. Sodium Phosphate, 3j four times daily, 
extremely efficient in catarrhal conditions of the duodenum and bile-ducts, 
resulting in jaundice, hepatic colic, etc. (B). Vichy Water, in similar condi- 
tions, probably owes its efficacy to the Sodium Phosphate contained in it (B). 
Potassium Bichromate, in doses of gr. ^- \, two or three times a day, is an 
excellent remedy in so-called duodenal dyspepsia, manifested by a bitter taste, 
coated tongue, pale stools, vomiting of glairy fluid and dull pain in right hypo- 
chondrium. Arsenic, has been used with success in jaundice from catarrh of 
bile-ducts after duodenal catarrh (B). Aurum salts will often remove duodenal 
catarrh, and that of the bile-ducts, also the jaundice therefrom (B). Podophyl- 
lum, in catarrhal and malarial duodenitis. Nitro-muriatic Acid, internally in 
mucous duodenitis; also as bath to right hypochondrium (^iij to gall, j), temp, 
of bath 96 (B). Aliment, no starches or fats ; milk, eggs, oysters, beef-broth, 
broiled or raw beefsteak, white-fish (B) ; the diet should be exclusively animal, 
in order to let the stomach deal with it. [Compare Jaundice, Biliousness.] 



DYSENTERY. 639 

Dysentery. 

Mercury, in minute doses for the ileo-colitis of children ; gr. ■£$ to T \ of 
Calomel or Hydrargyrum cum Creta every half hour (B); gr. y^ of the Bi- 
chloride hourly or every 2 hours, in acute or chronic dysentery if stools are 
slimy or bloody (R). Ipecacuanha, is par excellence the remedy for acute 
dysentery of the ordinary type ; large doses ; gr. xxv-xxx (P) ; gr. xv in milk 
(B) ; valuable in acute or epidemic forms, also in summer dysentery of 
children, with greenish stools, mucus and blood, gr. ij-v every 2 hours, in milk 
(B) ; in dysenteric diarrhoea of children, especially with vomiting, which will 
often yield to hourly drop doses of Ipecac wine (R). Hamamelis, when the 
discharges contain much blood (R). . Aconite, when fever and cutting pains 
(P). Nux Vomica, in epidemic dysentery (P) ; prune-juice stools, much gas, 
vital depression (B). Arsenic, Fowler's solution gtt. ij with gtt. v of Opium 
often benefits (B). Quinine, when periodic (B) ; in malarial subjects is as suc- 
cessful as Ipecacuanha in dysentery of the ordinary type (P). Gamboge, gr. 
}( in 24 hours, exceedingly valuable, especially in young persons (P). Castor 
Oil, as a mild cathartic, is very valuable in appropriate cases (Wa) ; gtt. v 
every hour, in water with sugar and gum, is excellent for dysenteric diarrhoea 
of children (Smith). Bismuth Subnitrate, in doses of 1 5 to 20 grains every hour 
or so, is highly efficient ; may also be used in suspension with Starch or Chalk- 
mixture, as a rectal injection. Arnica, is highly extolled for cases where the 
vital powers are depressed (Wa). Salol, is highly efficient. Saline Purgatives, 
Epsom salts the best treatment for acute dysentery, especially when fever, 
pain, tenesmus and stools of mucus and blood (B). Potassium Bitartrate, 
in acute dysentery with scorbutic symptoms, as seen in miners, sailors, etc.; 
a full cathartic dose, ^ss or more, has acted most beneficially as a preliminary 
to other treatment, and in many cases has proven to be the only remedy 
required. Silver Nitrate, in pill. gr. %-], with Opium, in acute dysentery 
after subsidence of acute symptoms; also as enema beyond the sigmoid flexure 
(gr. x-xx ad Oj aquae) ; also as escharotic through speculum to ulcer of rectum 
(B) ; a solution of 1 in 1000, as antiseptic wash daily, up to 60 washes in series, 
entirely successful in many cases of the recurrent form of tropical dysentery, 
having lasted from 1 to 5 years (Gallay, Surgeon-Major for French Colonies). 
Balsam of Peru, 3 grains, with alcohol £>j> syrup of lemons 3'w and water §iij, 
excellent for dysentery (Tr.) Opium, as enema, with starch and milk, alter 
canal is emptied by salines ; indispensable in chronic dysentery (B) ; for the 
purging (R) ; a remedy of great value, and applicable to every stage and every 
form of the disease, allaying pain and vascular excitement, moderating peri- 
stalsis, promoting the cutaneous secretion ; is inferior to Ipecac in acute dysen- 
tery, and is most valuable in the chronic form (Wa). Glycerin, with infusion 
of Linseed (1 to 4), to allay tenesmus (B). Lead Acetate, as enemata, in acute 
and chronic dysentery, to allay tenesmus (B) ; with Ipecac and Opium in pill, 
for acute form (Da C). Sulphuric Acid, with saline purgatives (B). Copper 
Sulphate, useful in acute dysentery ; in chronic the most valuable astringent 
(B) ; gr. x-xx ad Oj aquas (R). Ergot, in chronic, after acute ; and also in the 
acute form (R). Grape-cure, is used successfully in the chronic form (P). Iron 
Pernitrate, sometimes in chronic (army) dysentery (B). Calumba, is of great 
value in chronic dysentery with ulceration of colon (P). Chekan, is used with 
benefit. Injections of mucilaginous enemata (as Linseed) are of great value 
(R). Diet is of prime importance (B). Avoid animal food and stimulants; 
liquid foods best ; all cold (R). [Compare Diarrhoea, Enteritis.] 

Prescriptions. 

R. Magnesii Sulphatis, . . . ^viij. I & . Ergotini, gr. xx. 

Ac. Sulphurici Dil., . . . ^ ss. Ext. Nucis Vom., . . . . gr. v. 

Aquas, ,l v iij- Ext. Opii, gr. x. 

M. Sig. — Tablesp. in a winegl. of water | Fiant pit. no. xx. Sig. — One pill every 

every hour or two until it operates. (B.) ! 6 hours. {King.) 



640 



DYSMENORRHEA. 



R. Plumbi Acetatis, . . . . gr. xxiv. 

Ipecacuanhae, gr. iij. 

Pulv. Opii, . . . . . . . gr. iij. 

Fiant pil. no. xij. Sig. — One every 2 
hours until blood ceases, then at longer in- 
tervals. [Da Costa.) 



R . Morphinae Sulph. , . 

Strychninae Sulph., 

Ac. Sulphurici Dil., 

Aquae Camphorae, . 

M. Sig. — Teasp. well diluted, every 

hour or two. In epidemic dysentery with 

prune-juice stools and marked depression. 



• g rl J- 

• g r - %• 

% njss- 



R. Liq. Ferri Nitratis, 

Ac. Nitrici Dil. , . . , aa 3 ss. 

Syr. Zingiberis, t ^j. 

Aquae, q. s. ad 5 iij. 

M.- Sig. — Teasp. thrice daily for a child 
of 2 years. Tonics to follow palliative 
treatment. [Starr.) \ 



R . Plumbi Acetatis, . . . . gr. iv. 
Morph. Acetatis, . . . . gr. ss. 

Aquae Fervid., ^j. 

M. Sig. — Enema to allay tenesmus. 

R. Bismuthi Subnit., . . . . ^ij. 

Spt. Ammon. Aromat., . 3J. 

Tinct. Opii, gtt. xvj. 

Syrupi Simplicis, . . , . ^ss. 

Misturoe Cretae, 5J SS - 

M. Sig. — Dessertsp. to child over one 
year ; tablesp. or more to an adult, every 2 
or 3 hours, after emptying bowels by a 
laxative. 

R. Ext. Ergotae Fl., .... % iijss. 
Tinct. Opii Deodorati, . . ^ss. 
M. Sig. — Teasp. thrice daily. 

[Andrew .) 

R. Ferri Sulphatis, gr. xl. 

Pulv. Opii, gr. xx. 

Fiant pil. no. xx. Sig. — One pill thrice 
daily, in chronic dysentery. 



Dysmenorrhcea. 

Ammonia, the Aromatic Spirit in doses of Z] every 4 hours or oftener, a 
thoroughly trustworthy remedy, and should be used in place of the alcoholic 
stimulants generally prescribed (Illingworth). Ammonium Acetate, has re- 
markable power over many forms of dysmenorrhcea ; the Liq. Ammonii 
Acetatis, in ^ss doses, with gr. % of Ipecac, every 2 or 3 hours, to keep up the 
action of the skin until the flow is well established (E). Antipyrin, as an anal- 
gesic, is efficient. Acetanilid, is equally efficient for the pain. Cimicifuga, 
relieves the pain in the congestive variety, and is decidedly useful (P) ; is said 
to be very efficient (R) ; is valuable (Wa). Opium, necessary when pain is 
very severe ; one hypodermic of Morphine at each period is often sufficient 
(Wa). Codeine, when Morphine is not well borne, has given very complete 
satisfaction in several cases; gr. % to y z morning and evening (Oliver). 
Gelsemium, relieves pain in the neuralgic form, TT\,v-x of the fluid extract 
every 2 hours (B). Chloroform, as the liniment on a flannel wrung out of hot 
water, or by inhalation as anaesthetic when pains very severe; sometimes 
exerts a permanent influence (Wa). Ergot, given when the molimen begins, 
is useful in the congestive form (B). Amyl Nitrite, may be inhaled with bene- 
fit in the neuralgic variety, especially in chlorotic girls (Wa). Sodium Borate, 
in the membranous form, has been used with great benefit combined with Ext. 
Belladonnas (Wa). Camphor, is my favorite remedy, gr. x in mucilage and 
Cinnamon-water; repeat the dose in an hour or two if necessary (Dewees). 
Guaiacum, is very useful (P) ; drachm doses of the ammoniated tincture in the 
neuralgic or rheumatic forms (B). Caulophyllum, is by many considered the 
best curative remedy for spasmodic dysmenorrhcea, if given in the intervals. 
Viburnum Opulus, the fluid extract, in half-drachm doses, has considerable 
reputation in some sections for uterine pains of various kinds, and is useful in 
the spasmodic variety of this affection ; may be used in combination with Canna- 
bis Indica (Thomas). Arsenic, gtt. iij-x of Fowler's sol. with gtt. x of Tinct. 
Digitalis, ter die between the periods, gives excellent results (Athill) ; indicated 
when copious membranous discharge from bowels and uterus (R). Cannabis 
Indica, is very useful as a palliative in painful menstruation (B) ; gr. ss-j thrice 
daily to relieve the pain (R). Nux Vomica, in neuralgic form ; Syrup or Elixir 
of Iron, Quinine, and Strychnine (B). Apiol, neuralgic form (B) ; as emmena- 



DYSPEPSIA. 



64I 



gogue, night and morning, for several days near the period (Wa). Pulsatilla, 
in the functional form ; is of much benefit when discharge is scanty or profuse, 
black and clotted; should be persevered in for 2 months or more (P) ; gtt. ij 
every hour is most effective when the affection is not of membranous, obstruc- 
tive, or neuralgic character (Smith). Hydrastinine, has been used with benefit. 
[See under Menorrhagia.] Chloralamid, in one dose of gr. xxx, to prevent 
an impending attack, has been of service. Belladonna, in neuralgic or spas- 
modic forms, dark and fetid discharge, crampy pains, and cold chills ; a sup- 
pository or mild injection, together with internal administration, will relieve 
(P) ; in neuralgic dysmenorrhcea it will permanently relieve (B). Aconite, a 
valuable remedy when commenced early (P) ; for the congestive form in ple- 
thoric subjects (B). Aletris, is advertised as a highly efficient agent. Carbonic 
Acid, injected into the vagina (See page 82). Electricity: in neuralgic, a gal- 
vanic current ; in congestive, the inverse current (B). Croton-chloral, in neu- 
ralgic form (R). Iron, if depending on anaemia (B). [See Amenorrhcea for 
formula.] Cajuput Oil, said to relieve the pains (R). Rue and Sumbul, are 
reported useful (P). Emetic of Ipecac, with warm covering in bed, feet in hot 
water, hot ginger tea, Liquor Ammonii Acetatis ; if pain very severe, a sup- 
pository of Morphine and Belladonna per rectum ; best to avoid anodynes (E). 
Accessories, spinal ice-bag, when scanty discharge ; when menorrhagic, hot 
water spinal-bag ; sitz-baths, either hot or cold, or cold alone, during intervals. 



Prescriptions. 



R 



Ext. Cimicifugse Fl., . . . 5pv. 
Ext. Pulsatilla FL, . . . gjss. 
Ext. Eriodyctii FL, . . . £j. 
Syr. Aurantii, . . q. s. ad J§ iv. 
M. Sig. — One or two teasp. every two 
hours, for six doses. 



R 



Ext. Belladonnse, 
Ext. Stramonii, 
Ext. Hyoscyami, . 
Quininse Sulphatis, 
Fiant pil. no. xx. Sig. 



daily, in neuralgic dysmenorrhea. 



. . gr.iv. 
aa gr. v. 
-One pill thrice 



R 



FL 



Ext. Viburni Prunifol. JM., *rj. 

Ext. Senec. Aurei, . . • 51J. 

Tinct. Guaiaci Volat., . . ,^xij. 
Sig. — A teasp. in new milk, thrice daily, 
between attacks, 3J every hour during at- 
tack, and a hot sitz-bath. 



R. Ext. Ergotae Fluidi, . . . ^vij. 

Tinct. Gelsemii, . . . . 3J. 

Tinct. Aconiti, vr^xvj. 

M. Sig. — Teasp. every 2, 3, or 4 hours. 
In congestive dysmenorrhcea. 



R. Ext. Opii, 

Ext. Cannabis Ind., 
Ext. Hyoscyami, . . 
Camphorae, 
M. Fiant. pil. no. x. Sig. 

or three times daily. 



aa gr. x. 
gr. xxv. 
-One pill two 
{McLane.) 



R 



. Ext. Cannabis Ind. FL, . £jss. 

Ext. Viburni Op. FL, . . ^vj. 

Mucil. Acacias, ^iij. 

Aq. Cinnamomi, . q. s. ad^'w. 
M. Sig. — Dessertsp. every 4 to 6 hours. 



Dyspepsia. 

Pepsin, is very beneficial ; Scheffer's or Beale's saccharated pepsin with 
diluted HC1 acid (B) : is especially adapted to gastric indigestion. Pancreatin, 
for intestinal indigestion ; Liquor Pancreaticus to peptonize milk, gruel, soups, 
etc., before administration, in cases of great digestive debility. Peptenzyme, 
is said to be very efficient. Papain (Papoid), acts equally well in gastric and 
intestinal indigestion, and hence is particularly indicated in cases of difficult 
diagnosis as to the location of the trouble ; is used in the various forms of dys- 
pepsia and indigestion with most excellent results : has marked proteolytic 
action in acid, alkaline and neutral solutions, and in the presence of many 
chemicals, antiseptics and therapeutic agents (Chittenden). Ingluvin, also 
promotes digestion (B). Pineapple Juice has the power of digesting proteids 
(Marcano) ; the fresh juice is a very constant and powerful digestant of albu- 
minous matters, its ferment being decidedly active in the presence of either 
41 



642 DYSPEPSIA. 

acids or alkaline carbonates, but most energetic in neutral solution, and be- 
tween 122 and 140 F. (Chittenden). Mineral Acids, Hydrochloric or Lactic 
with Pepsin after meals in atonic dyspepsia ; Hydrochloric after meals for acid 
pyrosis ; Nitro-muriatic for dyspepsia with mental despondency, oxalates in 
urine, offensive gas, sallow complexion (R) ; Phosphoric, dilute, very efficient 
before meals (Da C). Sulphurous Acid, i^iv-^j, well diluted, for acid pyrosis 
(B). Alkaline Mineral Waters, before meals in atonic dyspepsia, and highly 
useful in the dyspepsia of obese subjects (B). Alkalies, shortly before a meal 
increase the gastric juice, and are usually better than acids in atonic dyspepsia ; 
Sodium Bicarbonate is the best (R) ; a full dose (gr. xl-lx) in dyspeptic attacks, 
with flatulence, etc., usually affords speedy relief (Wa) ; Limewater is often 
efficient. Chloroform, gtt. xv-xx in sweetened water, when rapid fermentation 
of food and evolution of gas soon after eating ; is promptly efficient in giving 
relief (Willis) ; a highly efficient remedy in acute dyspepsia. Chloral, is a very 
good remedy in doses of 5 to 10 grains in ^j of cinnamon water; acts as a 
gastric antiseptic and sedative, and is efficient in the nervous dyspepsia of 
neurotic subjects, with severe gastric pain. Arsenic, drop doses of Fowler's 
solution before meals in irritative dyspepsia (B) ; also when diarrhoea is excited 
by food (R). Bryonia, in dyspepsia of liver origin, and bilious headache with 
vomiting (P). Charcoal, when flatulence ; Nux Vomica in 5 rr\, doses before 
meals, better (R). Mercury, Gray powder, gr. j, 3 or 4 times a day, when 
dyspepsia during chronic disease or convalescence ; if constipated, Calomel, 
gr. ss, with Ext. Hyoscyami, gr. iij, in pill for 3 nights (R) ; the Yellow Oxide, 
in doses of gr. ^o - "^- mr dyspepsia septica and kindred disorders of the ali- 
mentary canal ; remarkably efficient in Austrian navy (Schaffer). Ipecacuanha, 
tt^v-x of the wine most valuable in atonic and chronic catarrhal dyspepsia 
(P) ; constipation, depression, food like a heavy weight (R). Hydrastis, gtt. v- 
xv of the tincture before meals, a good stomachic tonic (B) ; in chronic dys- 
pepsia, sluggish liver (P). Pulsatilla, a good remedy when depression with 
fear of death, white-coated tongue, little or greasy taste, nausea, flatulency, 
heartburn ; gtt. v in water every 4 hours (P). Cannabis Indica, often renders 
good service in indigestion. 

Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B) ; when 
flatulence, weight on head, and heartburn (R) ; often of the highest possible 
value in simple atonic form, or in the dyspepsia of drunkards (P). Cinchona, 
with mineral acids in atonic dyspepsia (P). Quinine, especially for town- 
dwellers and elderly people ; checks excessive fermentation in alimentary 
canal (R). Chamomile, rr\jj of oil, very useful in atonic dyspepsia (P). Igna- 
tia, useful in nervous dyspepsia (P). Taraxacum, certainly does good in sim- 
ple atonic dyspepsia (P). Belladonna, gr. l /e to % of the extract, once a day 
when there is constipation (R). Bismuth, mixed with vegetable Charcoal in 
flatulent dyspepsia (R); gr. x with same quantity of Calcined Magnesia, in 
chronic gastric catarrh, where diet cannot be regulated (Rose) ; the Subgallate 
(Dermatol) is said to be an efficient remedy. Aurum, the Chloride is useful in 
nervous dyspepsia (see page 176). Manganese, gr. x-xv of the Black Oxide 
in gastrodynia and pyrosis (B). Sanguinaria, gtt. ij-v of tincture or gr. -^ of 
alkaloid, in atonic dyspepsia promotes secretion and increases the appetite 
(B). Silver Oxide, y 2 -grain doses with same quantity of Ext. Hyoscyami be- 
fore meals in nervous dyspepsia (B). Xanthoxylum, as stomachic tonic, 3j of 
the fl. ext. in atonic dyspepsia (B). Simple Bitters, Calumba is the best ; 
Quassia or Gentian or infusions of them as vehicles for acids and alkalies (B) ; 
Calumba is easily tolerated when the stomach is weak (R) ; Gentian as stom- 
achic and tonic, very useful in atonic dyspepsia and that of gouty subjects ; the 
tinct. in some aromatic water, or in combination with alkalies and sedatives 
(Wa) : Chirata is particularly serviceable in the dyspepsia of gouty subjects. 
Rhamnus Purshiana, in all cases of dyspepsia associated with a torpid liver 
and constipation ; small doses at first, gradually increased (Wa). Salophen, 
is used with decided benefit in intestinal dyspepsia with flatulence. Strontium 
Bromide, is excellent in dyspepsia, also in acetic and lactic fermentations. 
Glycozone, is an excellent remedy for atonic and acid dyspepsias, in which it 



DYSPEPSIA. 



643 



gives very gratifying results (Edson). Aloes, combined with other agents, 
where habitual constipation accompanies dyspepsia (R) ; especially indicated 
in duodenal dyspepsia, gr. ij-iv with Ipecac gr. j-ij, two or three times a week 
(Wa). Water, a dry diet will entirely relieve the ice-water dyspepsia, or that 
due to excessive beer-drinking (B) ; half a tumbler of cold water y z hour be- 
fore breakfast acts to some people as a purgative and removes many dyspeptic 
symptoms, but flatulent dyspepsia is often traceable to excessive water drink- 
ing at meals, especially that of iced beverages (R). Hot Water, l / 2 a pint to a 
pint at iio°-i5o° F. an hour before each meal and x / z an hour before going to 
bed, each draught sipped slowly during 15-30 minutes; as a cure for dyspep- 
sia this is an old and efficient practice (Wa). Milk-cure, has succeeded ad- 
mirably (B) ; fresh Buttermilk a most excellent article for dyspeptics, as also is 
Kumyss. Alcohol, in any form, especially good wines, is useful in the atonic 
dyspepsia of sedentary livers (B) ; when loss of appetite and of digestive power 
from fatigue, a glass of wine or brandy-and-water before eating is very appro- 
priate ; useful also in indigestion of town dwellers, or during convalescence 
from acute disease (R). Diet, avoid tea and hot beverages, over-cooked food, 
over-feeding and iced-water ; masticate all food well, eat slowly, small quan- 
tities and frequently. Active out-of-door habits should be cultivated, and all 
articles of food known to disagree should be strictly avoided. [Compare 
Acidity, Biliousness, Flatulence, Gastralgia, Pyrosis.] 



Prescriptions. 



R. Acidi Hydrochlor. Diluti, . ^jss. 

Glycerini, £ij. 

Syr. Rubi Idaei, .... ^jss. 
Liq. Pepsini (Fairchild), . t ^iij. 
Spt. Chloroformi, . . . . Jss. 
Vini Albi vel Xerici, q. s. ad% xij. 
Sig. — ^ ss thrice daily after meals. 



R. Ac. Hydrochlorici Dil., . gj. 

Tinct. Capsici, 3 ss. 

Tinct. Calumbae, .... Jfjss. 

Vini Pepsini, . . . q. s. adgiv. 
M. Sig. — Dessertsp. after meals. In 
atonic dyspepsia. (Pancoast.) 



R. Tinct. Capsici, l^xvj. 

Tinct. Nucis Vom., . . . zij. 

Tinct. Gentianse Co., q. s. ad£ ij . 

M. Sig. — A teasp. in water thrice daily, 

with gr. A Aloin at bedtime, avoiding a 

starchy diet. For aggravated dyspepsia 

with constipation. {Da Costa.) 



R . Chloralis Hydratis, . . . 3 ss-j. 
Sodii Hyposulphitis, . . . %]. 
Aquae Menthae Pip. , . . ad^'\\]. 
M. Sig. — A teaspoonful in water after 
meals in nervous dyspepsia with severe 
gastric pain. 

R . Creosoti, ttbviij. 

Bismuthi Subcarb. , . . . Z ij. 

Glycerini, 

Aq. Menth. Pip., . . . aa^j. 
M. Sig. — To be well shaken. A teasp. 
every 3, 4 or 6 hours, for pain in stomach 
and wind. (B.) 



R 



M 



Pepsini (Jensen), .... giijss. 

Ac. Tartarici, gr- v. 

Glycerini, ,^j ss - 

Vini Xerici, . . q. s. ad Jviij. 
Sig. — Teasp. or two after meals. 



R. Tinct. Nucis Vom., . . . giij. 

Ac. Hydrochlorici Dil., . . gv. 

Glycerini, ^ ij. 

Aquae Lauro-cerasi, . . . ^j. 
M. Sig. — Dessertsp. before meals, 
improve appetite and digestion. 



R. Bismuthi Subnitratis, . . ^jss. 

Pepsini, gj. 

Strych. Sulphatis, . . . . gr. j. 

Tinct. Cardam. Co., q.s. ad ^iv. 
M. Sig. — Teasp. , thrice daily in water. 
For bilious dyspepsia. 



R. Sodii Bicarb., gij. 

Spt. Ammon. Aromat. , . . zij. 

Tinct. Zingib., Mj. 

Infusi Gentianae Co., . . ad gv'rij. 
M. Sig. — Teasp. or two thrice daily. 
For acid dyspepsia. 



R. 



Rhei, Gentianae, et Carda- 
momi,contus., . . . . aazij. 



Spt. Vini Gallici, . . . . 51J. 

Aquae, Jvj. 

Macera per horas 48, cola, et adde — 
Tinct. Nucis Vomicae, . . Zj. 
Potassii Carbonatis, . . . Zj. 
M. Sig. — Tablesp. in water thrice daily, 
before meals. 



644 DYSPHAGIA DYSPNOEA DYSURIA. 



Dysphagia. 

Cocaine, the Hydrochlorate in solution, 20 per cent., as spray or by swab, re- 
lieves the dysphagia of phthisical laryngitis (P). Cajuput Oil, in nervous dys- 
phagia, used in India with considerable success (P). Potassium Bromide, for 
congenital dysphagia of liquids in children, when no diphtheria or malforma- 
tion (R) ; in hysterical dysphagia (Wa) ; benefits a curious affection sometimes 
seen in children, who from their birth can swallow solids with ease but choke at 
liquids (R). Sprays of Ammonium Bromide, Chlorine-water, or other sedative 
agents in warm solution, for the dysphagia depending on specific disease of the 
larynx (Muirhead). Galvanism, in the vicinity of the oesophagus will speedily 
remove hysterical dysphagia (Muirhead). Tonics, as Strychnine, Iron and 
Quinine, for post-diphtheritic dysphagia. Iced Fluids, slowly swallowed, will 
often remove spasmodic dysphagia (Wa). 

Dyspnoea. 

Morphine, hypodermically, the most efficient agent in relieving dyspnoea 
from cardiac disease, or any other form ; but if albumen in the urine it must be 
withheld (Allbutt) ; controls dyspnoea from any cause, more energetically than 
any other agent, giving the very power to breathe (Huchard). Grindelia, of 
great service in dyspnoea with cough, occurring in emphysema (W). Cimicifuga, 
has often relieved most distressing cases from cardiac disease (P). Spigelia 
Anthelmia, produces and often relieves it when with palpitations (P). Valerian 
has proved useful when nervous (P). Prunus Virginiana, has proved very 
efficacious in cardiac dyspnoea (P). Amyl Nitrite, serviceable in cardiac 
dyspnoea and other forms (Wa). Asafcetida, in combination with other anti- 
spasmodics, often very beneficial in dyspnoea of chronic bronchitis (Wa). 
Chloroform, a few whiffs give great relief in the cough and dyspnoea of 
phthisis and bronchitis (Wa). Ethyl Iodide, by inhalation, is very serviceable 
in many forms (See). Terpin Hydrate, of especial value in asthmatic dyspnoea, 
gr. ij every % hour until gr. x are taken (Boyland). Terebene, for the dyspnoea 
of chronic emphysema of the lungs ; efficient in combating this symptom of 
various pulmonary affections. Arsenic, for the dyspnoea of weak heart. Oxygen 
inhalations, relieve the dyspnoea of advanced phthisis and also the cardiac 
dyspnoea connected with mitral disease (P). Dyspnoea is a symptom, and may 
be due to cardiac, pulmonary, pharyngeal, laryngeal or tracheal disease (T). 
[Compare Angina Pectoris, Asthma, Bronchitis, Croup, Emphysema, 
Phthisis, etc.] 

Prescriptions. 

R. Potassii Iodidi, gj. 1 R. Liq. Morph. (Magendie), . gj. 

Tinct. Lobelia, ^iv. Spt. Etheris Compos., . . ,^ij. 

Syr. Sanguinariat:, .... Jj. Syr. et Aquae, . aa q. s. ad Jij. 

M. Sig. — Teasp. every hour. M. Sig. — 3 ss-j thrice daily. 



Dysuria. 

Cantharis, gtt.j (sometimes v) of tincture ter die, for frequent micturition with 
pain (R) ; for irritable bladder, vesical tenesmus (B). Cannabis Indica, relieves 
dysuria (R) ; when bloody urine (P) ; an excellent anodyne in painful affections 
of the bladder, having specific action on that organ. Belladonna and Hyos- 
cyamus, have similar sedative effects in vesical and urethral irritation (P). 
Linseed, as infusion, is often a valuable adjunct (P). Opium, in suppository, 
gr. ij combined with Hyoscyamus, gr. x, an excellent palliative (P) ; an enema 
of Laudanum or Morphine hypodermically to relieve the strangury caused 
by blisters (B). Camphor, is said to relieve strangury (R). Chimaphila, has 
undoubted power (P). Squill, often produces the best effects, especially a com- 
bination of the Acetum with Spt. yEtheris Nitrosi equal parts, of which £ss m 



EAR ECTHYMA ECTROPION. 645 

31J of Anise-water, every hour or oftener (Wa). Gelsemium, a useful remedy 
(B). Ergot, in paralytic dysuria, with sensation of bladder being imperfectly 
emptied (P). Alkalies, the Citrates, when dysuria from uric acid crystals in 
young male children (R). Nitrous Ether, Spt. ^Etheris Nitrosi, 3j-jss in any 
convenient vehicle, a popular and efficacious remedy (Wa). Diluent Drinks, 
freely, especially a decoction of Uva Ursi, or of Cotton-root (P). [Compare 
Vesical Sedatives, Bladder Irritable, and Cystitis.] 



Ear Affections. 

Boric Acid, dry by insufflation, to destroy aspergillus in the external meatus ; 
used after weak astringent injections, leeches, fomentations, etc., in general 
inflammatory conditions of the external ear (Whitla). Sodium Bromide, in 
large dt)ses, gr. xxx ter die, gives some slight benefit in tinnitus aurium (Id). 
Cocaine, by instillation, sometimes gives considerable relief in tinnitus aurium, 
from its influence on arterial pressure (Id). Water, warm, by syringe, to re- 
move wax and foreign bodies. Olive Oil, poured into the canal, to drive out insects 
or their larvae. Iodol, renders good service in eczema of the ear; in moist, 
confluent eczema of the pinna, extending within the auditory canal, the sur- 
faces should be thoroughly cleansed, and the powder insufflated into the canal ; 
in dry, external eczema it is best applied in the form of a Lanolin ointment. 
The inflam'n disappears completely under this treatment in about 2 weeks, but 
irrigation should be kept up for a short time afterwards to complete the cure 
(Chatellier). [Compare Boils, Deafness, Otalgia, Otitis, Otorrhcea, 
Vertigo.] 

Ecchymosis. 

Arnica, rapidly disperses, if administered shortly after injury, rr\,v-x in water 
every two or three hours (P). Alcohol, diluted more or less, according to the 
amount of irritation present, is a good lotion (P). Hamamelis, the tincture 
diluted with 5 to 8 parts of water, as lotion, when much discoloration. Ammo- 
nium Chloride, in solution, as lotion on lint, or with bread or Linseed to form a 
poultice, in ecchymosis of the eyelids (Wa). Capsicum, the tincture or a strong 
infusion mixed with an equal bulk of mucilage or gum arabic and a few drops 
of glycerin added, painted on over the bruised surface, a second or third coat- 
ing being applied as soon as the first is dry ; there is nothing to compare with 
this treatment for a black eye. [Compare Bruises, Purpura.] 



Ecthyma. 

Quinine, cures, though in many subjects will cause it (B) ; when due to mal- 
nutrition (R). Lead, the Liquor Plumbi Subacet., 3j ad Oj aquae, a soothing 
application (Wa). Zinc Oxide, the Glycerite with a little Camphor, an excellent 
application (Wa). Cod-liver Oil, internally and locally (B). Grape-cure, often 
happily modifies (P). Borax, a solution in rose or elder flower water (Wa). 
Chlorinated Lime, a solution as a lotion (Wilson). Chrysarobin, internally, 
half-grain doses, in water or pill, given with good results (Stocquart). 



Ectropion and Entropion. 

Silver Nitrate, freely to the exposed surface, in ectropion of lower lid due to 
hypertrophy of conjunctiva after inflammation (C). Collodion, successfully 
used in entropion to restore position of the lid by its contraction. Should be 
concentrated (Wa). Faradization, in paralytic ectropion (C). Operative 
Measures, of great variety, are in use, Arlt's being the best for bad cases in 
the upper lid (Roosa). Epilation of lashes gives temporary relief in entropion. 



646 ECZEMA. 

Eczema. 

Aristol, is an excellent application. Mercury, as black and yellow wash in 
early vesicular and pustular conditions ; mercurial ointments are the most 
efficient of the local applications, especially those of White Precipitate, Nitrate, 
mild Chloride, and Black Oxide ; ointments of the Biniodide or Bichloride as 
irritating application in chronic indolent form (Pf ) ; Brown Citrine Ointment 
nightly in eczema of the margin of the eyelids after detaching scales (B) ; very 
useful when eczema on hairy parts of face ; often is best mixed with a tar oint- 
ment (R). Arsenic, tr^v of Fowler's solution thrice daily on a full stomach, 
gradually diminishing the dose, in the chronic type (B) ; especially in eczema of 
vulva, anus and scrotum (R) ; small doses for acute, full doses for chronic form ; 
the urine to be closely watched and the drug discontinued on the least sign of 
renal irritation (Pf ). Sodium Arsenate, hypodermically into an eczematous 
patch, to change the indolent form into an active one (Pf ). Rhus Tox., exter- 
nally and internally, when burning and itching, quickly subdues in some cases 
(P) ; in chronic form with rheumatism, worse at night-time ; also in acute cases 
if given at the very°beginning, rr\, yi^ of a good tincture is dose enough to begin 
with (Pf). Phosphorus, of undoubted service in eczema of long standing, prob- 
ably acts as a hepatic stimulant, gr. YFcT t0 ^5 m °^» or reliable pill (Pf ). Viola 
Tricolor, an infusion the best form, with purgative doses of Senna for a few days, 
then alone, in eczema of the head and face; gives prompt results (good or bad) ; 
often aggravates, which, though good in chronic forms, must be avoided in 
acute types (Pf ). Calcium Sulphide, gr. -3-^ to ■£% in acute and chronic cases 
of pustular character, the impetigo of old writers ; small doses in acute form, 
larger ones in chronic cases (Pf). Sulphur, internally and Sulphides as baths, 
but not in the acute stage (R) ; solution of Potassium Sulphide in water locally 
(B). Liquor Potassae, or a stronger solution of Potash, to infiltrated patch of 
chronic eczema, before attempting to heal it (Pf ). Croton Tiglium, the seeds 
bruised in alcohol, as liniment (Wa) ; the Oil as basis of stimulating applica- 
tions in the chronic form (Pf). Glyceriteof Tannin, locally (R). Potassium 
Iodide, is often efficient where a syphilitic history or inheritance can be traced. 
Salicylic Acid, locally, in eczema of hands and feet has been very successful 
(B) ; in plaster is of very great value, and becoming more recognized (Unna, 
Pick) ; thebest form is a salicylated soap-plaster (see formula below). Salol, as an 
antiseptic powder, has done good service. Belladonna, gr. % of extract with 
gr. iij of Quinine Sulphate thrice daily in eczema of the hand, with Bismuth 
Subcarbonate as a dusting powder (B). Zinc Salts, the Oxide and Carbonate 
as dusting powder, or the Sulphate, etc., in astringent ointments (Bulkley). 
Buckwheat Flour, one of the best dressings ; a limb may be enveloped in a bag 
filled with the flour (Bulkley). Tar, internally, the Pix Liquida in doses of gr. 
ij-v thrice daily, when Arsenic fails to relieve or is contraindicated ; locally in 
third stage when redness, drying and scaling; Oleum Cadini, when genuine, 
is the best form of tar, mixed with simple ointment (3ss-j ad ^) : 01. Rusci or 
Pix Liquida may be used (Pf ) : Tar should never be used in the moist stage, 
but only after the acute inflammatory symptoms have subsided, and then 
cautiously ; a useful combination, and one less likely than tarointments to cause 
irritation, is 01. Cadini, 3j-iij, 01. Amygd. Dulc, q. s. ad %}, brushed lightly 
over the diseased surface. 

Conium, the tincture may be added to one of the ointments for the pruritus, 
which is usually very obstinate; so also Stramonium or crude Petroleum (Pf). 
Hamamelis, locally as antipruritic, and in chronic eczema marked by decided 
venous retardation (Pf). Benzoin, to allay itching, the compound tincture 
painted on the skin (R). Lead, soluble salts as lotions when much inflamma- 
tion and discharge (R) ; also in early vesicular and pustular conditions ; 
Diachylon ointment comes next in efficiency to mercurial ointments (Pf). 
Zinc, the Oxide and Carbonate as dusting powders (R) ; the Sulphate with 
Alum, Glycerin, and Rose-water, an excellent lotion (B) ; the Oxide is not 
curative, but as a protective is the best ointment, when freshly and well made, 
for use over a large surface (Pf). Lime-water, as sedative application and to 



ECZEMA. 



647 



check discharge ; after inflammation is subdued, Lime-water and Glycerin (R) ; 
mixed with oil (Carron Oil) a very good application in acute eczema. Carbolic 
Acid, externally and internally in chronic forms (B) ; is analogous to Tar, and 
suitable to the same types of the affection as the latter is (Pf ). Phytolacca has 
cured obstinate cases (B). Graphite, in ointment, 1 to 10, or with some inert 
powder, as Lycopodium or precipitated Calcium Phosphate, in fissured eczema, 
especially that of the hands and behind ears (Pf). Bismuth, the Subnitrate or 
Subcarbonate locally (R) ; the Subgallate (Dermatol), has proven very useful 
in the treatment of moist eczema. Ichthyol, a promptly efficient remedy. 
Thiol, may well replace Ichthyol ; the dry form as a dusting powder has been 
used with remarkable benefit. Anacardium Orientale (Oil of Cashew), as oint- 
ment in patches of indolent chronic eczema (Pf). Iris Versicolor, in chronic 
eczema of gouty patients invaluable as a hepatic stimulant, Wkv-x of tincture 
from the fresh root twice daily (P). Glycerin, locally at night when caustic 
lotions have been used (R). Electricity has cured obstinate cases (B). Milk- 
cure, when acid indigestion present (B). Thyroid Extract, has been used with 
benefit (see page 132). Water, locally is injurious, unless its sp. gr. approaches 
that of the blood serum ; Rose-water with a little Glycerin and Sodium Chlor- 
ide when ablution necessary in second stage, that of exudation and crusting 
(Pf ). Soaps, Petroleum, Cade or Carbolic (R) ; Sapo Viridis, to soften up in- 
filtrated patches of chronic form, instead of the potash solutions mentioned 
above (Pf ). Diet should be largely vegetable, especially vegetables which are 
eaten raw ; Cod-liver oil as a supplemental article of diet. Chaulmoogra Oil, in 
old cases is often of great benefit, as an ointment; the Oil 1 part to 2 or more 
of Vaselin (Wa). Oil of Cajuput, put up by mistake of druggist for Oil of Cade, 
made a remarkable cure in a case which had resisted treatment for some time 
(Claiborne). 

Prescriptions. 



R. Violae Tricolor, ^j. 

Sennae, ^ss. 

M. Fiant chartulae no. iv. 
Sig. — Make an infusion with hot water 
from each paper, and take every night. 

{Piffard.) 

R. Vini Ferri Amari, . . . . Jfjss. 

Syrupi Toiutani, . . . . giij. 

Liq. Potass. Arsenit., . . t ^j. 

Aquae Anethi, . . . . . ^ij. 
M. Sig. — A teasp. to a dessertsp. thrice 
daily. [Wilson.) 

R. Ferri et Ammon. Citrat., . 3J. 
Potassii Citratis, . . . . 55 ij. 
Liq. Potassii Arsenit., . . gj-ij. 
Tinct. Nucis Vom. , . . . 15 ij. 
Tinct. Cinchon. Comp. ,ad ,^iv. 
M. Sig. — A teasp. in water, after meals, 



as tonic and alterative. 



(Bulkley.' 



R • Emplas. Diachyli Simplicis, 

Emplas. Saponat., . . aa p. xl. 

Petrolati, . p. xv. 

Acidi Salicylic!, p. v. 

Sig. — Emplas. Salicyl. Compos. [Pick.) 



R . Picis Liquidse, 

Pulv. Sem. Anisi, . . . aa 3 ijss. 

Magnesiae Calcin., . . . . q. s. 
M. Ft. pil. no. c. Sig.— Two to ten 
pills daily. (Miguet.) 



R 



Acidi Salicylici, gj. 

Zinci Oxidi, ^iij. 

Pulveris Amyli ^ lw ~ 

Adipis Lanae Hydrosi, . . 3J. 
M. Fiat unguentum. Sig. — Apply daily 
as a paste for eczema. (Practitioner.) 



R . Hydrarg. Ammoniat, 
Glyceriti Amyli, . . 
M. Fiat unguentum. 



gr. xv. 

(Mi'dler. 



R . Olei Cadini, 

Zinci Oxidi, aa^ss-j. 

Ung. Aquae Rosae, . . . %]. 
M. Sig. — Ointment, antipruritic and 
mildly astringent. (Bulkley.) 



R 



M 



Aluminis, gr. xx. 

Zinci Sulphat., gr. x. 

Glycerini, £j. 

Aquae Rosae, ^iv. 

Sig.— Lotion. (B.; 



R. Liq. Plumbi Subacet., . . ^jj. 

Glycerini, ^ ss. 

Aq. Laurocerasi, . . . . ^ ijss. 
M. Sig. — Lotion, when there is much 
weeping. (B.) 

R. 01. Cadini, ^ss. 

Glycerini, Z). 

Ung. Diachyli, 3 Ij ss . 

M. Ft. unguentum. In squamous ec- 
zema with thickened skin. (Pox.) 



EMACIATION EMISSIONS EMPHYSEMA. 



Emaciation. 

Calcium Phosphate, is especially useful in chronic wasting disease (R). 
Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr). Iodine, 
improves the appetite and digestion, and gives strength and plumpness to the 
body (Wa). Cinchona, in small doses improves the appetite, and the general 
tone (Wa). Iron Salts, cause marked gain in flesh and color (Wa) ; remark- 
ably promote the appetite and digestion (B). Cod-liver Oil, internally and 
externally with friction, often very effective in the mal-nutrition and marasmus 
of children (P). Olive Oil, by friction daily ; inunctions are of value in many 
wasting diseases (P). Pepsin, to promote digestion of food (P). [Compare 
Atrophy, Phthisis, Tabes Mesenterica.] 



Emissions and Erections. 

Hyoscine, the Hydrobromate in pill, gr. t |q- to ^ at bed-time, will always 
check seminal emissions (W). Belladonna, when emissions, genitalia relaxed, 
atonic state (B) ; in gradually increasing doses produces good results, even in 
extreme cases of emissions (Wa). Camphor, fails as often as it succeeds (P). 
Potassium Bromide, exercises special influence as a sedative in irritable states 
of the genito-urinary organs (Wa). Cimicifuga, as tonic to the nervous system 
removes irritation and melancholy, procures sound and refreshing sleep (Wa). 
Lupulin, useful to check emissions (P) ; gr. v-x, or xv, to keep penis at rest 
(Wa). Ruta, in small doses to limit discharge (P). Chloral, at bed-time, re- 
peated every night until the habit is broken off (Wa). Iron, the tincture of 
the Chloride in Z doses at bed-time, sometimes conquers nocturnal emissions 
(Wa). Cocaine, a few drops of a 4 per cent, solution upon the glans penis, 
promptly controls an erection. [Compare Chordee, Spermatorrhoea, and 
the List of Anaphrodisiacs on page 56.] 



Emphysema of the Lungs. 

Morphine, gr. l /e, and Atropine, gr. T |^, hypodermically for the asthmatic at- 
tacks : no remedy so efficient ; the disease being incurable, treatment must be 
chiefly palliative (B). Potassium Iodide, in full doses alone, or combined with 
the Bromide, affords most relief next to Morphine (B). Strychnine, is a valu- 
able respiratory stimulant; useful where there is constant dyspnoea with pro- 
longed expiration (Wa). Stramonium, the leaves smoked for the asthma and 
dyspnoea before retiring, will often give a good night's rest (Wa). Ammonium 
Iodide, with Arsenic, for the bronchitis, with Copaiba, Turpentine or Eucalyp- 
tol, continued for some time (B). Digitalis, or hydragogue cathartics as Pulvis 
Jalapae Comp., for the dropsy (Da C). Arsenic, when emphysema is con- 
nected with recession of a rash, is useful (R) ; long-continued it ameliorates 
(B). Terebene, gives good results on the dyspnoea. Lobelia, allays the dys- 
pnoea which accompanies capillary bronchitis in emphysema (R). Senega, 
often acts beneficially (P). Cod-liver Oil, continued for a long time (R). 
Hypophosphites, are useful (B). Chalybeates, the Phosphate of Iron, Qui- 
nine and Strychnine (B). Grindelia, for asthmatic breathing and bronchitis 
(B); of great service (Wa). Chloral, for the short breath of such patients 
brought on by catching cold; if obstructed circulation, caution required (R). 
Bleeding and Purging, have been used with great success in many emphy- 
sematous conditions (R). Compressed Air, the only scientific remedy yet 
brought forward for this disease ; affords much relief which is sometimes per- 
manent (B) ; the apparatus of Waldenberg is the best for this purpose. [Com- 
pare Asthma, Bronchitis, Dyspncea.] 



EMPYEMA ENDOCARDITIS ENDOMETRITIS. 649 

Prescriptions. 

H- Potassii Iodidi, 3 iij- 

Strychninee Sulph., . . . gr. j. t£ . Potassii Chlorat., .... £jss. 

Liq. Potassii Arsenit., . . gijss. Tinct. Belladon., .... ^jss. 

Aquae Laurocerasi, q. s. ad $iv. Ext. Pruni Virgin. Fluidi, 

M. Sig. — Teasp. 4 times daily. For Tinct. Cinchonae Comp., aa^ij. 

relief of dyspnoea, toning the cardiac ac- M. Sig. — A dessertsp. 4 times a day. 

tion, removing the bronchial catarrh, and Where chronic bronchitis and anorexia, 

preventing the progress of the affection. ! Dry cups also to chest night and morning. 

(Hzighes.) I [Da Costa.) 



Empyema. 

Carbolic Acid, a weak solution to be injected after evacuating the pus (R) ; 
Carbolate of Iodine, has been injected with benefit (B). Iodine, in solution to 
be injected after tapping (R) ; the undiluted tincture may be thrown in without 
risk and with great benefit ; or the compound solution ^j to ^xv aquae, as wash 
for the cavity to prevent re-formation of pus (B). Chlorine Water, or a solution 
of Quinine, to wash out the cavity (R). Salicylic Acid, in solution, answers 
well for the same purpose (P). Ammonium Acetate, the official Liquor Ferii 
et Ammonii Acetatis, with Quinine and stimulants, if the' affection shows a ten- 
dency to linger (Da C). 

Endocarditis. 

Aconite, should be given early in all inflammations of serous membranes 
(Wa) ; gtt. l /z or less, frequently (R) ; it is rare to meet with permanent organic 
heart disease as a result of rheumatic fever when the disorder is treated with 
Aconite from its commencement (P). Spigelia Anthelmia, is very useful in 
rheumatic endocarditis (P). Opium, in inflammation of serous membranes 
(B). Digitalis, to control the circulation, especially where irregular heart 
action (Da C). Veratrum Viride, has been used with remarkable effect on the 
pulse (Wa). Alkalies, as Potassium or Ammonium Carbonate, freely until 
urine is alkaline, to prevent permanent changes about the valves or orifices 
(Da C). Potassium Iodide, to promote absorption of the exuded lymph. 
Quinine, at the onset, may check the inflammation (B). Salicylic Acid, is use- 
ful in the rheumatic form (P). Rest for some days after active signs have 
abated, with agents to lower the blood-pressure within the heart and vessels 
(Fothergill). Leeching, in the stage of acute inflammation is to be recom- 
mended if done early, later is useless; use cups if no leeches are at hand 
(Da C). Poultices, give great relief and are of decided benefit (Id). Stimulants, 
as Ammonium Carbonate, etc., freely, if signs of oppressed circulation appear 
(Id). Iron, the tincture of the Chloride with alkalies, if pyaemic symptoms are 
manifested (Id). [Compare Pericarditis.] 



Endometritis. 

Carbolic Acid, undiluted, on cotton-wrapped probe; no better method of 
treating uterine catarrh (B). Iodine, the most valuable of all local remedies 
(E) ; Churchill's tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol ^j), one of the 
most useful applications to the endometrium (Munde). Iodized Phenol (Iodine j, 
Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, has 
given the best results of any agent used for years past (Battey). Chromic 
Acid, as caustic, when slough is required ; should only be used after dilatation 
of cervical canal, and at the patient's house (Munde); a solution of gr. xv to 
Z] of hot water applied with success to the uterine cavity for catarrh (Wooster). 
Nitric Acid, fuming, to uterine cavity through intra-uterine speculum (Atthill) ; 
is considered by many the one agent for all forms of intra-uterine medication ; 



65O ENEMATA ENTERITIS. 

is efficient and comparatively safe, but produces too much cicatricial tissue 
(Munde). Iodoform, as suppository in rectum (B) ; in pencils to uterine canal. 
Iodo-tannin, locally in chronic cases (B). Ergot, or better Ergotin, gr. j, sub- 
cutaneously, for the train of uterine disorders depending on passive congestion 
of the organ (P). [See Hysteria for formula.] Glycerin, as a local applica- 
tion introduced by Sims, is of great value ; esp. as vehicle for impure Carbolic 
Acid or Iodine, on cotton, or oakum (E). Hot Water injections in large 
quantity about the os uteri, are of great value (E) ; as usually made are of no 
value; must be applied by special syringe, in the dorsal recumbent posture 
with elevated hips, at a temperature of ioo° to 120 F. twice daily for at least 20 
minutes each time, and persevered in for months and years (Munde). [Com- 
pare Uterine Congestion and Hypertrophy.] 

Prescriptions. 



H . Potassii Iodidi, 

Potassii Bromidi, . . . aa gr. xx. 

Tinct. Iodi, 3 ss. 

Aquae, 3 { h 

M. For hypodermic injection into cer- 
vix, in chronic cervical metritis. (Bennett.) 



R . Ergotini, gr. xx. 

Tinct. Iodi, ^j. 

Glycerini, . . . . q. s. ad 3J. 
M. Sig. — Apply twice daily with cam- 
el's-hair brush, in cervical metritis. 

(Dabney.) 



Enemata. 

Enemata, for an infant, ^ss-j ; child 2 to 5 years, ^ij-vj ; 5 to 15 years, 
^vj-Oj ; adult, Oj-quartj. A simple domestic enema consists of soapsuds with 
a little common salt, or a pint of cold water (B). Simple warm water or gruel 
sometimes; or, to one or the other of these add Soap, Turpentine or Castor 
Oil, with soap or gruel, to suspend the two latter. Very cold water may be 
used without inconvenience. Starch, boiled or raw, of cream consistence, tem- 
perature ioo°, with a few drops of Tinct. Opii, in extreme cases of choleraic 
diarrhoea, or that of phthisis, or typhoid fever (R). Nutrient Enemata, should 
contain materials for artificial digestion, as the rectum is not an organ of diges- 
tion, and to secure rapid osmosis should have an acid reaction. A suitable 
formula is appended below. Inject slowly and not frequently ; five times in 
twenty-four hours should be the maximum. Defibrinated blood has also been 
used as a rectal injection with good results, being completely absorbed (B). 
Should not exceed three or four ounces of bland material, injected slowly, after 
ascertaining that the rectum is not filled with feces (R). [Compare the subtitle 
Injectiones, ante, page 540.] 

Prescriptions. 



Nutrient Enema. 
R. Infusi Carnis (Beef-tea), . Jiv. 
Acidi Hydrochlorici, . . . H\,x. 
Glyceriti Pepsini (Scheffer) , 3 ij. 
If rectum irritable add 10 to 20 drops of 
Laudanum. 



Enema Picini et Terebinth. 

R. 01. Ricini, 3jss. 

01. Terebinth, .... Jss. 

Ovum, . no.j. 

Decocti Hordei, vel 

Aq. Fervid. , % xiv. 



Enteritis. 

Opium, to the point of tolerance, is the remedy, the deodorized tincture in 
10-drop doses every second or third hour, according to age (Da C) ; of great 
value to control inflammation and quiet the intestines (B) ; proves of signal 
use (Wa). Aconite, of great utility in acute inflammation with high tempera- 
ture, sthenic condition, resisting pulse (R). Arsenic, surprisingly curative ; 
small doses with Opium (B). Podophyllum, with occasional doses of Aconite, 
will often allay the vomiting and diarrhoea (P). Ricinus Communis, is employed 
with great advantage (P). Lime-water, in mucous enteritis. Turpentine 



ENURESIS — EPIDIDYMITIS. 



65 1 



stupe?, hot, over seat of disease, are of manifest advantage (Wa). Skim-milk, 
is of the highest value as sole diet in acute inflammation of digestive organs 
(B). Poultices, Linseed, large and hot (Wa) ; may be used or not, as the 
patient feels benefit from them or otherwise (Da C). Water, hot fomentations 
constantly, followed by a wet compress ; cold and hot, principally cold, or ice, 
of unquestionable advantage (B). Ice or cold water freely swallowed. Perfect 
quiet in bed. Diet, no food until inflammation subsides, then beef-tea, milk, 
gum-water, etc., the very mildest and most bland diet for four or five days 
(Da C). [Compare Diarrhcea, Dysentery, Cholera, Peritonitis, Typh- 
litis.] 

Enuresis. 

Belladonna, no single remedy so uniformly successful; children require large 
doses ; a solution of Atropine, best, gr. y^ to ^ (B) ; the best remedy for 
children, gtt. x-xx of the tinct. three times a day ; if unsuccessful, and no worms 
or other irritation exist, try Strychnine, Cantharides, Turpentine, Santonin or 
Galvanism (R) ; small doses are useless (P). Santonin, in over-doses pro- 
duces incontinence of urine in children, but curiously will sometimes stay 
the habit, even when not dependent on worms, and in cases where Belladonna 
fails (R) ; in the enuresis from worms (P). Cantharides, one or two drops of 
the tinct. three or four times a day in middle-aged women or the aged, even 
when due to paralysis ; sometimes also in children, but for them Belladonna is 
generally better (R). Chloral Hydrate, enuresis in children (R) ; three-grain 
doses thrice daily for infantile incontinence (Da C). Strychnine, may succeed 
when the above remedies fail (B) ; sometimes useful for old people with paraly- 
sis of bladder, also for children (R). Quinine, in full doses, does good service 
in cases where chorea exists (Potts). Buchu, often successful in chronic enu- 
resis (P). Turpentine, small doses sometimes remove the trouble (B). Lupu- 
lin, said to be useful ; Herzfelder used it with advantage. Rhus Aromatica, 
has proven curative in 75 per cent, of cases treated with it, and of great benefit 
in the other 25 per cent. ; the fluid extract, rr\,x-xv four times daily in Glycerin 
and water (Stein). Scutellaria, remarkably efficient in many instances, Z 
doses of the fluid extract thrice daily for a child of 12 years old. Potassium 
Nitrate, has been recommended for children (R). Potassium Bromide, succeeds 
in some cases (Wa). Collodion, painted to form a cap over end of prepuce (R). 
Ergot, when from paralytic state of sphincter (B) ; said to be useful (R). Iron 
Iodide, the syrup TTLxv-xx, well diluted with water, ter die, in pale, delicate, 
strumous children (B) ; sometimes useful even when no worms (R). Habits, 
children to be taught to retain water as long as possible during the day ; little 
salt to be eaten ; abstinence from fluids not necessary ; bland fluids diminish 
acridity of the urine. Stopping meat from the diet has cured several cases 
permanently, after all remedies had been tried without success. 



Prescriptions. 



R. Strychninae Sulph., . . . gr. j. 
Pulv. Cantharidis, . . . . gr. ij. 
Morphinae Sulph., . . . . gr. jss. 

Ferri Reducti, gr. xx. 

Ft. pil. no. xl. Sig. — One thrice daily 



to a child of 10 years. 



( Gross. 



R. Tinct. Ferri Chloridi, . 3pj. 

Ext. Ergotae Fluidi, . . . 3 v. 

Spt. Chloroformi, . . . . ^ij. 

Tinct. Quassiae, . . q. s. ad g iv. 
M. Sig. — A teasp. in a winegl. of water 
thrice daily for children. 



Epididymitis. 

Aconite, alternately with Pulsatilla, the latter in very small doses, a few 
drops of tinct. in a glass of water, a teasp. every 2 or 3 hours produces the 
happiest effects (Pf, St). Belladonna, the extract, ^ j — ij ad ^j of Glycerin and 
water, on lint, applied to the inflamed testicle (Bumstead). Tobacco, with Lin- 
seed meal, as poultice, cautiously! (P) Mercury and Morphine, locally, a 20 



652 EPILEPSY. 

per cent, oleate by inunction, in cases of syphilitic origin (R). Silver Nitrate, 
gr. lxxx ad ^iv aq. destil. freely applied to the scrotum will sometimes abort an 
epididymitis (Wa). Strapping and suspensory bandage to support the testicle, 
also rest in the recumbent posture from the beginning, with a saline cathartic 
to clear the bowels, are all measures of great importance (Bumstead). [Com- 
pare Orchitis.] 

Epilepsy. 

Bromides, should be first employed in all cases, there being no remedy equal 
to large doses of Bromine salts, which should be persistently continued for 
many months, and with short periods of rest may be kept up for years ; the 
combination mixture of Bromides has been taken by patients for 8 to 10 years 
without harm (Brown-Sequard) ; Bromides taken for long periods without a 
physician's supervision, have caused profound muscular depression, mental 
alienation and death (Hammond). Potassium Bromide, gr. xl ter die before 
meals, double at bedtime, for two or more years after all epileptic indications 
have ceased ; is generally useful, especially in daytime seizures and grand mal 
of sexual origin ; also for infantile convulsions (B) ; especially in convulsive 
form, but often powerless (R). Sodium Bromide, gr. xx ter die, will arrest epi- 
lepsy without producing the cerebral symptoms of bromism (Clymer). Lithium 
Bromide, £ss daily, acts in some cases after Pot. Brom. has failed, and is gen- 
erally efficient in about one-half the dose of the latter salt (Weir Mitchell). 
Nickel Bromide, gr. v thrice daily, is remarkably efficient in the epilepsy occur- 
ring at the menstrual epoch, and those which have withstood the action of the 
other bromides (Da C). Ferrum Bromide, will often cure cases in weak and 
anaemic subjects ; also with Potassium Bromide to combat the anaemia and 
depression produced by the latter (B). Ammonium Bromide, preferred in 
petit mal by many authorities ; combined with other bromides, as in Brown- 
Sequard's mixture (see formula below), before meals, with a tonic of Strychnine 
or Arsenic and a vegetable bitter, after meals ; in combination with Antipyrin 
(see below) is highly efficient (W). Zinc Bromide, gr. v in water and glycerin 
four times daily ; may be combined with the other bromides. Strontium 
Bromide, in doses of gr. xx thrice daily, gradually increased ; has been bene- 
ficially used as an alternate, being much less liable than the others to pro- 
duce bromism (See); should be given in 30-grain doses, and combined with a 
fair dose of Physostigmine, when its effect on epilepsy is very marked (Stanley) ; 
both the Strontium and Calcium Bromides may be used with benefit (Fere). 
Aurum Bromide is highly efficient in doses of gr. y% to y z (see page 176); 
Aurum and Arsenic Bromide, the solution in 5-minim doses thrice daily, in- 
creased to 10 minims, gave very satisfactory results in a severe case in a boy 
aged 7^ years (Barclay). 

Opium, a valuable adjunct to the Bromide treatment, a prolonged treatment 
by opium rendering the organism extremely susceptible to the action of bro- 
mides ; for 6 weeks ascending doses beginning with 1 grain, up to a daily do- 
sage of 15 grains or more ; then suddenly stopped and replaced by 30-grain 
doses of Potassium Bromide four times daily, produced instantaneous effect on 
cases in whom all other medication for several years had failed (Flechsig). 
Digitalis, Belladonna or Physostigma, in combination with bromides give better 
results than the latter alone (Poulet) ; Digitalis is valuable in petit mal and in 
nocturnal epilepsy (Da C), a good addition to the bromides when there is 
cardiac weakness (Huchard) ; 10-minim doses of the tincture with 20 grains of 
Potassium Bromide thrice daily, in cases complicated with cardiac dilatation 
(Gowers). Belladonna, for petit mal and nocturnal epilepsy, in pale and anaemic 
subjects, should be given for a year or more ; extract and leaves, gr. \ of each 
in pill, every day at same hour, one additional pill every month (Tr); useful, 
especially when from fright (P). Atropine better, drop-doses of a 1 per cent, 
solution of the neutral sulphate in" white brandy (Tr). Arsenic, in epileptiform 
vertigo from stomach disorder (B) ; sometimes useful (R) ; the Bromide of 
Gold and Arsenic (see above). Sodium Borate, in doses of gr. xx 3 or 4 times 



EPILEPSY. 653 

a day, has produced very good results in nocturnal epilepsy : is of real value 
and better than Bromides in symptomatic epilepsy, also may be found useful 
in nervous forms after the bromides have failed (Mairet) ; if beginning with 
small doses may be gradually increased to 90 grains a day ; when dose exceeds 
60 grains daily it is advisable to add Glycerin to the water and syrup used as 
excipients (Dijoud); excellent results obtained from a combination of Borax 
with Bromides, especially Sodium Bromide (Alexander) ; in most cases the 
disadvantages of this drug more than counterbalance the slight benefits result- 
ing therefrom (Fere) : for cases in which the Borax acts best, and for the results 
of Borism see page 72. Physostigma used in 12 cases, of which 6 were im- 
proved, and in the others a notable increase took place in the number of the 
paroxysms (Williams). Chloral, a valuable auxiliary in troublesome cases with 
tendency to insomnia, violent convulsions, or maniacal excitement; should be 
given in the evening, combined with bromides and used with caution when 
cardiac debility (Y) ; in full doses at night the most suitable remedy for the 
nocturnal variety (B). Antipyrin in combination with Ammonium Bromide 
(gr. vj with gr. xx) has proved very efficient, alleviating some quite hopeless 
cases (W) ; is a real gain in the practical management of epilepsy (Y) ; 
Potts has published a striking report of 43 cases treated with this combina- 
tion. Acetanilid, of great value where bromides fail, in four such cases it 
produced definite cures in doses of 7^ grains in cachets thrice daily (Du- 
jardin-Beaumetz) ; of very uncertain action (Y) ; is most useful in the 
diurnal form and in cases of full habit, active circulation, red face, and injected 
eyes (B). 

Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack 
(B) ; or "ttUj-v in mucilage, when fits are very frequent (R). Nitro- glycerin, 
rr^yi^, slower in action than Amyl Nitrite, but more enduring (Pf). Chloro- 
form, by inhalation during paroxysm and also in interval (Wa) ; is of high 
value especially in cases of an hysterical character (Brown- Sequard) ; Anaes- 
thetics are rarely called for (W). Amylene Hydrate, in 10 per cent, solution, 
of which a tablesp. or two (gr. 30 to 90) a day, of value in petit mal and noc- 
turnal epilepsy, also when bromides have failed, and where the attacks are not 
only very frequent but severe (Nache). Hydrastinine, has been used with 
benefit, in doses of gr. X to ^ of the Hydrochlorate, up to gr. ij daily, in- 
ternally. Picrotoxin, anaemic subjects, attacks occurring at night, g 1 ^ to -^o 0I " 
a grain hypodermically or -^ to ^ by stomach (B) ; benefits cases resulting 
from onanism (P). Cannabis Indica, has given good results ; is suitable for 
petit mal, the nocturnal variety, and with Strychnine, Belladonna, or Picro- 
toxin, for cases characterized by anaemia and depression (B). Quinine, when 
of malarial origin (P) ; often useful in intermittent epilepsy (Ros). Ignatia, in 
convulsions unattended with cerebral congestion (P) ; is par excelle?ice the 
controller of functional phenomena of the cerebro-spinal axis (Pf ). Strychnine, 
is useful in idiopathic epilepsy, but injurious in symptomatic form ; benefits when 
Potassium Bromide fails ; when cerebral anaemia, nocturnal attacks (S, Pf ) ; if 
bromides fail and case is anaemic, give Strychnine, gr. -^ ter die, and push it 
(B). Silver Nitrate, is not without efficacy, and was formerly much used, but 
the danger of staining the skin has caused its disuse, especially as better agents 
have been found (Wa). Copper Salts, may be useful in cases originating from 
the stomach ; were formerly much used (B) ; the Nitrate or Oxide often given 
with benefit (R) ; the Ammonio-sulphate, gr. % in pill, thrice daily to begin 
with ; should not be continued beyond 3 or 4 months at a time (Brown- 
Sequard). Zinc Salts, have been much used in place of silver and copper 
salts, not having the serious drawbacks attending the latter agents; the Oxide 
is probably useful only in cases originating from the stomach; much said for 
and against it (R) ; the Citrate and the Lactate are preferred by many, as less 
likely to cause stomach derangement (Y). Orchitic Extract, also Spermine, have 
been used with benefit (see pages 136, 137). Turpentine, has long been used, 
when due to reflex impression of intestinal parasites (B). Conium, not equal to 
the bromides (B) ; not of much value (P). Valerian, has been used with some 
advantage (R). Bryonia, has an ancient reputation (P). Rue, may benefit 



654 



EPISTAXIS. 



when seminal emissions (P). Solanum Carolinense (the Horse-nettle), in tinc- 
ture of the berries, made by bruising them and steeping in whiskey, has quite 
a reputation among the negroes for epilepsy and other convulsive affections, 
and has rendered good service in my hands (Napier). Fats and Oils, espe- 
cially cod-liver oil when faulty assimilation exists (B). Galvanism, only in 
idiopathic epilepsy (B). Meat Diet, in many cases must be prohibited entirely. 
Trephining the skull, has given good results in several cases where a distinct 
impression from injury existed ; and in others where apparently indicated has 
been of no service. [Compare Convulsions.] 



Prescriptions. 



R 



B 



Potassii Bromidi, .... ^j. 

Ferri Bromidi, gr. iv. 

Aquae, ^ij. 

Syrupi Simplicis, . . . . ^vj. 
M. Sig. — A tablesp. twice daily. 



Strychninae Sulphatis, . . gr. j. 
Acidi Sulphurici Dil. , . . tt^x. 

Aquae Destil., ^iv. 

M. Sig. — A teasp. after each meal, 
gradually increased to a dessertsp. 



R. Potassii Bromidi, . . . . 5ss. 

Sodii Bromidi, . . . . . 3 ss. 

Liq. Potas. Arsenitis, . . 3 ss. 

Ext. Conii Fl., mj. 

Aquae Cinnamomi, . . . 5ij. 

Infus Gentian. Co., q. s. ad 3 viij. 
M. Sig. — A tablesp. two hours after each 
meal. 



R 



M. 



Potassii Bromidi, 
Sodii Bromidi, 
Ammonii Bromidi, . 
Potassii Iodidi, 
Ammonii Iodidi, . . 
Ammonii Carbonat, . 
Tinct. Calumbae, . . 

Aquae, q. s 

Sig. — A teasp. and 



3 H i- 




each meal, and three teasp. at bed-time. 

(Brown - Sequard. ) 



R. Potassii Bromidi, 

Ammonii Brom., . . . aa ^ij. 

Ext. Ergotae Fl., . . . . 5j. 

Aq. Cinnamomi, . q. s. ad £ viij. 
M. Sig. — A dessertsp. in water thrice 
daily. When maniacal excitement and 
danger of cerebral hemorrhage. (Smith.) 



Epistaxis. 

Aconite, has been used with the best results (P) ; small frequent doses 
quickly check epistaxis in children and plethoric people (R). Antipyrin, has 
been highly efficient ; in 5 to 15 per cent, solution as a local hemostatic, it 
will arrest almost any nasal hemorrhage (Huchard). Arnica, is of great ser- 
vice when from mechanical violence (P). Belladonna, when of congestive 
origin (P). Ipecacuanha, has been highly praised (R) ; acts upon the vessels 
(B) ; gr. j-ij every quarter hour until nausea is felt, but vomiting need not be 
excited (Wa). Hamamelis, venous hemorrhage (Pf ). Ergot, 5ss-gj of fresh 
powdered Ergot, or 3j-3ij of flu. ext. every half hour or hour, necessary in 
urgent cases (B). Alum, injected or snuffed up in powder (R). Iron Spray, 
in obstinate cases Liq. Ferri Subsulph., 3j to ^ viij aquae by spray or injection ; 
the Tinct. of the Chloride also useful (B) ; diluted gij in ^vj injected into the 
nostrils is often effectual (Wa). Tannin, finely powdered, blown into the 
nostrils through a quill (Wa) ; a strong solution, 5y ad giv, by nasal syringe 
(B). Turpentine, may be given internally with advantage (Wa) ; especially in 
debilitated conditions (B). Lead Acetate, gr. ij-iv with Opium gr. ss-j, proves 
signally useful (Wa). Vinegar, on lint introduced into the nostrils, sometimes 
highly efficient (Wa). Digitalis, is of undoubted benefit (B) ; the infusion best 
(R). Transfusion, when death from exhaustion is apparently imminent (B). 
Facial Artery, compression of (R). Keep head elevated and cool ; warm the 
feet and hands by plunging into hot water ; apply ice over the nose ; resort at 
once to the tampon, if bleeding becomes alarming. Cauterize with electric 
cautery any ulcers in anterior nares. [Compare Hemorrhage for formulas.] 



ERUPTIONS ERYSIPELAS. 65 5 

Eruptions Produced by Drugs, etc. 

Aconite, vesicular exanthemata. Antimony (locally), papules, vesicles, pus- 
tules, similar to the eruption of small-pox. Antipyrin, erythema and urticaria, 
chiefly on thighs and abdomen, with much itching. Antitoxin (Diphtheritic), 
erythema, with pain in the joints. Arsenic, erythema, eczema, papules, vesi- 
cles, pustules. Atropine, erythema, like the rash of scarlet fever. Belladonna, 
as Atropine. Borax, papules, scarlatiniform. Bromides, acne, chiefly on the 
face and back ; pustules, deep tubercles with ecchymoses, ulcers, pemphigus. 
Castor Oil, urticaria. Cinchona, as Quinine. Carbolic Acid, erythema. 
Chloral Hydrate, erythema on face and neck, itching, desquamation, eczema, 
petechias, purpura. Codeine, as Opium. Copaiba, also Cubeb, urticaria, 
erythema, eczema, pemphigus ; the Copaiba rash has a preference for the 
ankles and wrists. Cod-liver Oil, acne. Croton Oil (locally), papules, pus- 
tules. Digitalis, erythema, after long usage. Iodides, acne, papules, vesicles, 
pustules, eczema, ecthyma, ecchymoses and purpura ; the Iodide rash prefers 
the face and back of neck and shoulders. Mercury, erythema, eczema. 
Opium and Morphine, erythema, papular eruption with marked desquamation 
and itching. Phosphorus, purpura. Quinine, erythema, scarlatina, papular 
erythema, hemorrhagic purpura, pemphigus, and prurigo ; the prevailing type 
of the Quinine eruption is erythema, or exceptionally eczema or purpura, and 
is essentially ephemeral ; it is of a bright vivid hue, disappearing on pressure, 
and resembles scarlatinal rash, first appearing on face and neck, and thence 
spreads over the body : in some instances it comes in distinct spots and re- 
sembles measles ; in others it is an urticaria, with some oedema, and distress- 
ing burning, tingling, and itching; five cases of purpura are authentically re- 
ported. Rhus Toxicodendron (and other varieties of Sumac), vesicles, perhaps 
pustules, with redness, swelling, and intolerable itching. Salicylic Acid, urti- 
caria, purpura, pemphigus, vesicular angina. Santonin, pemphigus, vesicles. 
Stramonium, as Atropine. Strychnine, as Quinine. Sulphur (locally), ery- 
thema, eczema. Tar, acne. Tartar Emetic (locally), as Antimony ; in some 
cases of poisoning by tartar emetic a rash of the above description appeared 
all over the body. Turpentine, as Copaiba. 

Articles of Food producing eruptions are : Acid Fruits, may cause acute ec- 
zema. Strawberries, urticaria. Apples, acneform efflorescence about the 
mouth. Walnuts, inflammation of buccal mucous membrane. Shell-fish, 
urticaria. Roast Turkey, in one case caused great urticaria. Lager Beer, 
acne in some. Alcohol, aggravates cutaneous inflammations. Butter, Oat- 
meal, Buckwheat, Fish, are popularly credited with causing eruptions, but 
there is no evidence therefor. 



Erysipelas. 

Antitoxin (Streptococcus), see page 154. Pilocarpine, to abort the disease, 
very efficient if used early, gr. */£ hypodermically, or fluid extract of Jaborandi 
internally ; when free diaphoresis occurs, the temperature and pulse fall to 
normal, and the disease is checked ; not suitable to debilitated cases, or those 
with a weak heart (Da C). Aconite, a favorite remedy with Liston, if used at 
beginning, when fever high (Wa) ; no more useful agent in idiopathic erysipe- 
las, especially facial, and cases of sthenic type (B); at onset, often cuts the 
attack short ; is very useful in the erysipelas following vaccination (R) ; very 
valuable in sthenic cases (P) ; especially so in traumatic erysipelas (Tr). 
Belladonna, rr\,v of tincture in water every hour for five or six doses, also 
locally ; has astonishing power in superficial and non-vesicular forms, also 
when erysipelas attacks the brain, and in the phlegmonous type (P); for simi- 
lar indications as noted under Aconite, also when adynamia ; if much fever, 
combine it with Digitalis or Aconite; when much depression, give it with 
Quinine ; gr. % of the extract with gr. ij of Quininae Sulph. every 3 or 4 hours 



656 ERYSIPELAS. 

(B) ; the extract with Glycerin, equal parts, spread thickly over the surface 
(Ouain) ; should be used both internally and externally, and may be combined 
with Aconite (R). Iron, Tincture of the Chloride, the nearest to a specific yet 
discovered ; the remedy of most service, any man being decidedly to blame 
who neglects its use ; requires decided doses, gtt. xl every 4 hours (Da C) ; 
treatment by it very general, but questionable (B) ; should be given with 
shorter intervals than 4 hours (R) ; is very successful in this disease (P) ; ten- 
drop doses every hour, or ir^xl every 4 hours (Ouain) ; is also used locally with 
much success, being painted over the surface in full strength. Quinine, may 
be given with the Iron ; also alone if thoracic complications, wherein Iron 
might be contra-indicated (Da C) ; if pulse soft and tremulous, or very rapid 
with low muttering delirium (D) ; a combination of Quinine and Tincture of 
the Chloride of Iron offers special advantages (Wa) ; in the more severe cases 
to sustain the vital powers, and prevent cerebral embolism ; but large doses, 
gr. xv-xx every 4 hours, are alone of any use (B). Ammonium Carbonate, 
when feeble circulation, cyanosis and delirium ; also when any signs of embol- 
ism appear (B) ; highly useful in debilitated subjects (Wa) ; after free purgation 
the continued use of this salt is all that is needed in most cases (Watson). 
Potassium Iodide, with agents to secure free action of the bowels, skin and 
kidneys, the most efficient treatment in erysipelas ambulans, in which Iron 
and Quinine are useless (Da C). Antipyrin, is particularly efficient when hy- 
perpyrexia (Ernst). Rhus Tox, a very useful remedy in the vesicular form 
(P). Tartar Emetic, in doses of gr. ^ frequently repeated, renders incontest- 
able service (B). Calomel and Jalap, as purgative at onset, followed in 4 or 5 
hours by Magnesium Sulphate, §ss (Da C). Chloral, is an admirable adjunct 
to give sleep at night (Id). Turpentine, as a stimulant in traumatic erysipelas, 
more generally serviceable than Alcohol (B). 

Local Applications. Silver Nitrate, by Higginbotham's method in traumatic 
form ; gr. lxxx of the brittle stick dissolved in £iv of water and painted 2 or 3 
times over inflamed surface and beyond, after careful washing and drying 
(R) ; no agent more useful in subduing external inflammation. Iodine, 
painted over affected and neighboring surface, to prevent spreading (R). 
Ichthyol, is very efficient as a 10 to 25 per cent, collodion : Ichthyol and Ether, 
of each 5, Collodion 10 parts, with or without the addition of Castor Oil ; has 
almost specific properties in this disease (Radcliffe). Thiol, dry, as a dusting 
powder, has given excellent results. Iodized Collodion, is very successful as a 
local application. [See formula below.] Collodion, a thick coating relieves 
(B). Digitalis, an infusion is of much service, applied as a lotion (R). Sulph- 
urous Acid, and Glycerin, equal parts, or a solution of Sodium Bisulphite 
(Dewar). Zinc, Benzoated, as ointment, or the Unguentum Zinci Oxidi, any- 
thing to exclude the air, and whichever one is most agreeable to the patient 
(Da C). Bismuth, the Ointment of the Oleate, a very certain application to 
allay itching and burning, lessen pain, etc. (Shoemaker). Oil, by inunction, is 
very grateful in simple erysipelas (B). Oil of Turpentine, painted over surface 
is said to be remarkably efficient. Vaselin, Lard or Mercurial Ointment 
diluted, 3j to ^j of Vaselin; the simplest applications are the best (B). Car- 
bolic Acid, one part, with 8 to 14 parts of Oleic Acid, locally by inunction for 3 
or 4 minutes every }( hour, all around the edge of the diseased part until it 
ceases to spread (Jacobi). Cotton Wool, sprinkled with flour or a mixture of 
Starch and Zinc Oxide, is a good application (B). Earth, clean yellow clay, 
free from grit or sand, and powdered, applied directly to the skin in the form 
of a smooth paste, made by mixing it with water, the best of all applications, 
having properties of antiseptic, antiphlogistic, antipyretic, and antimorbific 
nature (Hewson). 

Tracheotomy, promptly if oedema of glottis occurs, the operation giving time 
for inflammation to subside (Da C). Incisions, may be necessary in traumatic 
erysipelas when limb is greatly swollen and inflamed ; also in the phlegmonous 
variety (Id). Diet, a milk-diet is generally suitable ; should be light but nutri- 
tious (R) ; feed the patients well (Da C). [Compare Phlegmon.] 



ERYTHEMA EXHAUSTION. 



657 



Prescriptions. 



R. Quininae Sulphatis, . . . t ^ss. 

Ext. Belladonnae, . . . . gr. ijss. 
Ft. pil. no. xx. Sig. — Two pills every 
4 hours, where much depression. (B.) 



q. s. 

I* 

Jss. 

3 V J- 



R • Quinine Sulphatis, 

Ac. Sulphurici Dil. 

Aquae, 

Tincturse Ferri Chlor. 

Spt. Chloroformi, 

Glycerini, . . . . q. s. ad £ iv. 

M. Sig. — A teasp. in water every two 

hours. (Loomis.) 

R. Tinct. Ferri Chi oridi, . . ^j. 

Syrupi Tolutani, jj. 

Liq. Potassii Citratis, . . 3 iv. 
M. Sig. — Teasp. to tablesp. according 
to age, every 3 hours, gj has Tt^x, gij 
has ir^xx, 3"sshasn\xl. (Anderson.) 



R. Tinct. Ferri Chlor., . . . gij-iij. 

Glycerini, Aquae, . . . aa ^j. 
M. Sig. — Teasp. every 2 hours for 
children. (Gibney.) \ 



aa gv. 



R . yEtheris, 

Alcoholis, .... 

Pyroxylini, . . . 
Solve, et adde — 

Ammonii Iod., gr. xl. 

Cadmii Iod., 

Cadroii Brom., .... aa gr. xx. 

M. Sig. — For local use with a camel's 

hair pencil. If the cadmium salts are not 

to be had use 3"j Ammon. Iod., and gr. xx 

of Pot. or Amm. Bromide. (Humphreys.) 



R . Plumbi Acetatis, 

Ammonii Carb., . . . . aa pjj. 

Aquae Rosae, ..... ^viij. 
Ft. lotio. Sig. — Apply on lint, to allay 
irritation. (Peart.) 

R . Acid Carbolici, 

Alcoholis, aa gij. 

01. Terebinth., 5 iv. 

Tinct. Iodi., . . . . Sjij. 

Glycerini, ....... 3 x. 

M. Sig. — Brush over surface every 2 
hours, and cover with a thin layer of wad- 
ding. 



Erythema. 

Antipyrin, internally, for the itching, is efficient. Belladonna, useful in 
cases resisting ordinary treatment (B). Quinine, the most valued remedy 
in erythema nodosum (B). Rhus Toxicodendron, a valuable remedy (P). 
Zinc Sulphate, as lotion, with Alum and Glycerin [see Eczema, for formula] ; 
or the Acetate, in ointment (see below). Bismuth, dusted over erythema 
about genitals of infants soothes pain and promotes healing (B). Mineral 
Acids, Nitric and Nitro-hydrochloric, have been advantageously used when 
from imperfect digestion (B). Dusting Powders, of Starch, Lycopodium or 
Buckwheat flour are very useful. Thiol, the dry form, as a dusting powder. 



Prescriptions. 



R . Plumbi Carbonatis, 

Bismuthi Subnit., . . . 
Sodii Bicarbonat., . . 
Ung. Zinci Oxidi Benz., . 3IJ 
Ft. unguentum. Sig. — Local use, 



aa 3-j. 

• §■?• 



R. Zinci Acetatis, gr. ij. 

Aquae Rosae, zj. 

Ung. Aquae Rosae, . . . 3J. 
M. Sig. — Ointment. 



Exhaustion. 

Acetanilid, for the " tired feeling," a pinch put into the mouth, mixed with 
saliva and swallowed, rests one up in a few minutes and makes one as fresh as 
before (Brodnax). Arnica, a few drops internally for aching of the muscles 
(R) ; in nerve prostration with general aching from over-fatigue (P). Phos- 
phorus, for physical or mental exhaustion ; also in depression from overwork 
(R). Calcium Phosphate, combined with Calcium Carbonate and Ferric Phos- 
phate, gr. j of each for a dose (R). Potassium Bromide, when insomnia, bad 
dreams and irritability (R). Opium, gtt. j of Laudanum with 2 or 3 of the 
Tinctura Nucis Vomicae, 3 or 4 times a day, for symptoms of exhaustion with 
42 



658 EXOPHTHALMOS EXOSTOSIS EYE DISEASES. 

headaches, flushing and dyspepsia (R). Ammonia, internally ; its influence is 
but brief (R). Coffee or Tea, in hot or cold climates (R). Castor, is service- 
able, but seldom used (P). Musk, benefits all forms of nerve-exhaustion (P). 
Cimicifuga, for headache from over-study or excessive fatigue (R). Alcohol, 
of value in all conditions of fatigue (P). Coca, lessens the sense of fatigue 
under exertion, relieves thirst, and obviates the effects of a too rarefied atmo- 
sphere; is suitable for weakly subjects easily fatigued, and convalescents (P). 
Cocaine, has been used successfully in exhaustion from sunstroke, loss of blood, 
and diarrhoea (P). Wet Sheet, dripping, cold, as a restorative, and to prevent 
aching of muscles (R). Sea Bathing, is also valuable (R). Habits, change of 
occupation better than absolute rest. [Compare Adynamia, Convalescence, 
Insomnia, Myalgia, Neurasthenia. 1 



Exophthalmos. 

Exalgin, has been used with some success in the treatment of exophthalmic 
goitre (Churton). Belladonna, rr^v of tincture hourly, of great service (R) ; 
results recorded from its use are very remarkable, but Digitalis will usually 
answer better (P). Duboisine, gr. y^ of the sulphate 2 or 3 times daily, has 
produced remarkable results in one case (Hunt). Opium, may be of use in 
some cases (P). Iron, with Digitalis, seems to do more good than any other 
medicines (Da C). Chalybeate Waters, are beneficial (B). Aurum Bromide, 
in daily doses of gr. yi to ye, continued until its characteristic headache is 
produced (Goubert). Thyroid Extract, is used with benefit (see page 132). 
Thymus Extract (see page 133). Bromides, with Iron, of very great value in 
the milder forms associated with anaemia in young women (Y). Digitalis, to 
raise arterial tension and slow the heart, is decidedly ameliorative in young 
subjects (B); in some cases beneficial, but in others it increases the cardiac 
excitement and makes matters worse, while its tendency to cause gastric irri- 
tation is more manifest in this disease than in any other (Y). Strophanthus, 
quiets the cardiac action and is of real service in this malady ; 5 minims may 
be given thrice daily (Y). Convallaria, ameliorates the painful palpitation 
(Wa). Arsenic, gr. -^ twice daily, increased with intermissions up to gr. -^ 
daily, is my favorite remedy (Jaccoud). Zinc Valerianate, gr. j thrice daily, 
is valuable to allay the nervous symptoms and the insomnia (Y). Galvanism, 
of the cervical sympathetic and pneumogastric, also of the eyes and thyroid 
gland, is decidedly curative in uncomplicated cases (B). 



Exostosis. 

Potassium Iodide, may promote absorption when recent ; also use friction 
with an ointment of Mercury or Iodine (D). Aconite, was used by Storck (P). 
Mercury, a moderate course of mercurials may be effectual, when exostoses are 
due to a blow or from syphilis (D). Excision, if required (MacCormac). Ex- 
ostoses of the clavicles in children almost always disappear of themselves (D). 



Eye Diseases. 

Belladonna, locally and internally in iritis, conjunctivitis and other inflam- 
mations. Atropine, in iritis, locally ; hypodermically in glaucoma (R) ; the 
best application generally in inflammatory conditions of the eye; the indis- 
criminate instillation of Atropine in persons over 35 or 40 years of age by 
general practitioners is to be condemned, being liable to light up an incipient 
or latent glaucoma. Pilocarpus, is used with great benefit in many eye- 
affections, particularly amblyopia from alcohol and tobacco, detachment of the 
retina, chronic iritis, keratitis, hemorrhage into the vitreous, glaucoma, muscae, 



EYELIDS — FACE. 659 

atrophic choroiditis, hemorrhages of the retina, white atrophy of the optic 
nerve, and inflammatory affections with effusion and exudation, to promote 
resolution and absorption (Wecker). Strychnine, hypodermically in muscular 
asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy not de- 
pendent on intercranial diseases (R) ; increases the sensibility of the eye, the 
field of vision becoming extended, and the vision more acute (Br). Ergot, is 
useful in many eye affections, especially disturbances of accommodation, acute 
and chronic inflammations, and the blepharitis and pustular conjunctivitis of 
children (Wa) : is a myotic. Acetanilid, is exceedingly effective in optic neuritis 
with pain, not only to remove the latter but also to arrest the inflammatory 
process (Dujardin-Beaumetz). Cocaine, as a local anaesthetic in ophthalmic 
surgery, a 4 per cent, solution, by instillation, sometimes injection required, as 
into the muscles for squint operation ; is mydriatic, and in some cases panoph- 
thalmitis has resulted after operations under it (R). Chloroform vapor, close 
to a photophobic eye, relieves (R). Oleate of Mercury and Morphine, outside 
the eye in palpebral conjunctivitis, and stye; also in syphilitic iritis (R). Silver 
Nitrate, Copper and Zinc Salts, are much used in weak solutions for conjunc- 
tivitis, etc. Euphrasia, had an extended reputation in Germany, is a mild 
astringent, and of service in catarrhal conjunctivitis (P). Pulsatilla, as lotion 
in inflammations and ophthalmic cases (P). Santonin, gives good results in 
inflammatory and atrophic conditions of the retina and optic nerve, and in the 
stage of effusion of many other inflammations (Wa). Ruta, minim doses, night 
and morning, in dimness of vision depending on functional amaurotic condi- 
tion, produces good results (P). Physostigmine, topically, to contract pupils ; 
to reduce excessive atropinization ; stimulates the third nerve (P). [Compare 
Amaurosis and Amblyopia, Asthenopia, Cataract, Conjunctivitis, Cor- 
neal Opacities, Glaucoma, Iritis, Keratitis, Myopia, Ophthalmia, 
Photophobia, Retina, Strabismus, etc., also the Lists of Mydriatics, Myotics 
and other Agents acting on the Eye, on pages 37 and 38.] 



Eyelids. 

Calomel, locally, or Brown Citrine Ointment, as an application in many dis- 
eases of the lids (B). Mercury and Morphine, the 20 per cent, ointment with 
Lard, applied outside the lid, for stye (R). Pulsatilla, internally, and exter- 
nally as wash, in ophthalmic cases and inflammations ; the so-called stye may 
often be aborted by this treatment (P). Cadmium, much esteemed as colly- 
rium, gr. ij of sulphate to ^j aquae rosae (R). Zinc and Copper Sulphates, are 
esteemed applications (B). [See Conjunctivitis for formulas.] Ergot, an 
aqueous infusion, as a collyrium, in ptosis and paralysis of the eyelids (Wa). 
Tannin, a strong solution (1 to 3 aquae), locally; or a weaker solution (1 to 20, 
30 or 50 aquae), is much employed; also used in pomade, or as fine powder 
(Wa). Veratrine, in solution, brushed over lids once daily in painful spasmodic 
contraction of the orbicularis (Wa). Ammonium Chloride, in solution as lotion, 
for ecchymosis of eyelids, vulgarly known as black eye. Capsicum, the tincture 
or infusion for a black eye (see under Ecchymosis). [Compare Blepharitis, 
Conjunctivitis, Ecchymosis, Ectropion, Ptosis, etc.] 



Face. 

Amyl Nitrite, h^tV to /^. m 30 times its volume of spirits, for flushing of face, 
or sensation of flushing, with cold feet and hands, and great prostration, chiefly 
in women at change of life (R). Curare, effective in facial spasm, when other 
remedies failed (P). Blisters, behind the ear, in facial palsy, followed by warm 
covering to the part (H). Strychnine, has improved some cases of facial palsy 
(P). [Compare Acne, Freckles, Neuralgia, Odontalgia, Parotitis, 

TlC-DOULOUREUX.] 



66o FALSE PAINS FEET FEVER. 



False Pains. 

Tartar Emetic, with small doses of Opium, and external fomentations, where 
evidence of congestion (L). Opiates, to allay uterine irritation, after rectifying 
any derangement of bowels (L). Opium, is valuable, having specific action 
on uterine muscular fibres, relaxing some, stimulating others (Wa). Acetanilid 
may be given with benefit. 

Feet. 

Arsenic, swelled feet of old or weak persons (R) ; oedema of feet and ankles 
in the old, from feebleness of the heart (B). Lead, as ointment, equal parts 
of Emplastrum Plumbi and Linseed Oil spread on linen, and wrapped round 
sweating feet; to be renewed every third day for nine days (R). Potassium 
Permanganate, solution gr. j to the ^, as wash, will remove fetor of feet (B) ; 
temporarily discolors the skm. Boracic Acid, in strong solution, is used with 
good results. Chloral, I in 50 of water, as bath, efficient. Sodium Bicarbon- 
ate, a solution freely applied will remove fetor (B). Belladonna, will check 
fetid secretions (R). Salicylic Acid, in solution with Borax, the most agreeable 
and efficient deodorant for fetid perspirations (B) ; 3jss-iij with ^iij of dried 
Alum, in powder, applied freely to feet after washing and drying ; Acid. Sali- 
cyl. 3, Magnesium Silicate 87, is the composition of the powder used in the 
German army for sweating of the feet. Iron, the Chloride, mixed with y^ its 
weight of glycerin, as paint to the soles and interdigital spaces, in severe cases 
of sweating feet ; should be exposed to the air while drying ; repeat after 48 
hours at first, subsequently at longer intervals, during which the feet should be 
washed in vinegar and water night and morning and powdered with salicylated 
talc or starch and tannin (Vignol). Alum, powdered, locally, the most satisfac- 
tory application for bromidrosis (Baylor). Sodium Chloride, 3 tablespoonsful to 
Yz a pint of water, as antiseptic lotion for tender feet, answers perfectly in most 
cases. Ice, to the spine, or heat and cold alternately, to equalize the circula- 
tion, has been strongly advocated ( Wa). Stockings, should be changed every 
day, and dipped in a strong solution of Boracic Acid and dried, to effectually 
check fetid perspirations. Cold Footbath, and drying with friction, for cold 
feet (R). [Compare Chilblains.] 

Prescriptions. 

R- . Ac. Salicylici," gr. xv. 

Amyli, gr. cl. R. Ac. Borici (pulv.), . . . gjss. 

Talci, :|iij. Vaselini, 3J. 

M. et trit. Sig. — Locally for sweating , M. Sig. — Ointment for bromidrosis. 

feet. (Kohnhom.) \ (Championniere.) 



Fever. 

[See also the titles of the Fevers, in their alphabetical order.] 

Guaiacol, applied to the surface, as antipyretic (see page 259). Aconite, has 
the highest value in the eruptive fevers, also in all hyperpyrexiae (B) ; always 
indicated in early stage of simple inflammatory fevers, pneumonia, and in 
most acute congestions (P) ; has marvellous power over sthenic fevers ; ther- 
mometer should go hand in hand with Aconite (R). Veratrum Viride, pos- 
sesses considerable power as an antipyretic ; useful in rheumatism, pneumonia 
(P) ; in delirium ferox of fevers it is of value (B) ; strongly recommended in 
both sthenic and asthenic fevers (R). Belladonna, in the eruptive fevers, espe- 
cially scarlatina (B) ; in typhus, with delirium, insomnia, painful sensitiveness 
to light and sound, and in all hyperasmic states of brain and spinal cord (P) ; is 
prophylactic often against scarlet fever (Pf ) ; in delirium of fevers, also excellent 
in typhus (R). Gelsemium, in remittent and typho-malarial, of real benefit; is 



FEVER. 66 1 

antipyretic (B) ; in bilious remittent, of value (Pf ). Arsenic, in prostrating 
acute fevers to strengthen pulse and invigorate patient ; except quinine no drug 
subdues intermittents so well (R) ; in malarial, especially typho-malarial, it is of 
great value (B). Quinine, in the eruptive fevers and all malarial, remittent, and 
intermittent ; as apyretic, less effective and more dangerous than cold baths ; 
useless in typhus and typhoid, except for hyperpyrexia (B) ; it is anti- 
miasmatic, antiseptic, and antiphlogistic ; and of great value in intermittent, 
septicaemic, and hectic fevers (P) : large doses at night to reduce temperature 
in typhoid and other fevers, are strongly urged in Germany. Cinchonine is 
better than quinine as prophylactic against ague (R). Antipyrin, the type, 
also the best, of the new series of synthetical antipyretics, which includes 
Acetanilid, Kairin, Phenacetin, Chinolin, Thallin, etc. ; is antipyretic and 
diaphoretic, moderates the intensity of the febrile movement, and is especi- 
ally indicated in self-limited diseases with persistent hyperpyrexia, especially 
pneumonia, typhoid, etc. Phenacetin, the favorite antipyretic among the new 
synthetical compounds ; is efficient and safe. Kairin, is an efficient antipyre- 
tic, but profusely diaphoretic, also a cardiac and nerve depressant of great 
power, and highly dangerous in pneumonia and other fevers where the heart 
is weak ; it often produces nausea and vomiting with headache and tinnitus 
aurium (P). Resorcin, has been given in acute rheumatism, typhoid, typhus, 
pneumonia, erysipelas, etc., as an antipyretic ; like Kairin, however, its action 
in lowering temperature is transient as compared with Quinine or Salicylic 
Acid (P) ; may be used hypodermically as it is not irritant (B). Salicylic Acid, 
or Sodium Salicylate, nearly equal to Quinine as an antipyretic ; very useful in 
all forms with high temperature and in intermittents, especially in septicaemia, 
pyaemia, erysipelas, and surgical fevers (R). Digitalis, the German antipy- 
retic ; very useful in scarlet fever, rheumatic, and pneumonia (B) ; especially in 
typhoid (R). Cimicifuga, as substitute for Digitalis, but less effective ; good 
in hectic fever (B). Hydrastine, intermittents, typhoid with copious sweats (P). 
Arnica, is antipyretic, full doses in sthenic cases, small (tt\,v of tincture) in 
asthenic ; large and small doses produce different results (B) ; in rheumatic 
fever and typhoid it is highly extolled (P). Camphor, subdues reflex excitabil- 
ity ; is praised as stimulant in adynamic fevers (P) ; in adynamic fevers and 
where there is delirium (R). Mercury, large doses of Calomel, the German 
specific treatment of typhoid (B) ; small doses in typhoid at commencement ; 
has marked effect on tonsils in scarlatina (R). Rhus Tox., in rheumatic fever 
after Aconite, and in scarlatina with typhoid symptoms, is invaluable (P). 
Opium, much less used than formerly ; useful in delirium, and with Quinine in 
remittents and intermittents (B) ; fevers characterized by prostration, insomnia 
and delirium, noisy or muttering, with picking of bed-clothes and twitching of 
the muscles, — in such cases Opium, judiciously given, may save an almost hope- 
less case (R) : Morphine, hypodermically, the best form in febrile diseases, 
being less disturbing to the stomach and digestive power (P). Turpentine, in 
typhoid, puerperal, and yellow (rt\,x-xxx) as a stimulant to vaso-motor nervous 
system (B) ; as enema (3ss-j in starch mucilage with tr^x of Tinct. Opii 
if pain) invaluable when in typhoid hemorrhage occurs with tympanites (R). 
Tartar Emetic, minute doses (gr. T ^) frequently repeated, and with Opium, are 
of great value in many acute febrile diseases (B) ; as a diaphoretic ; in ague ; 
in large doses to abort specific fevers (R). Muriatic Acid, very useful in all 
forms, especially in typhoid and the exanthemata ; relieving dryness of the 
mouth and fauces, increases digestion, and restrains the diarrhoea (B). Acid 
Drinks, such as raspberry vinegar, citric acid, etc., very grateful and useful (R, 
B) ; two sliced limes or lemons, with ^ij of sugar, in Oj of boiling water, cooled 
and strained, makes an agreeable refrigerant beverage (Wa). Baptisia, useful 
in common continued fever, or in the first stage of typhoid ; drop doses of a 
fresh tincture every hour. Eucalyptus, has given varied results in malarial 
fevers, some observers praising it very highly (P). Valerian, has done much 
good in fevers of a nervous character (P). Sumbul, is used in Russia for low 
fevers of typhoid type (P). Cocculus,.for tympanites of typhoid (P). Ammo- 
nium Acetate, as a diaphoretic, and in simple forms, as catarrhal ; the Carbon- 



662 FEVER FISTULA. 

ate, in scarlet fever and measles (R). Purgation, by Castor Oil, Magnesium 
Sulphate, etc., before exhaustion (R). Mustard Bath, on recession of rash in 
eruptive fevers (R). Aliment, milk and beef-tea alternately, every 3 hours; 
milk only, in fevers and inflammations of the digestive tract (B). Alcohol, in 
low conditions is useful when it causes improvement in symptoms, which may 
become worse (R) ; Coffee better than alcohol (P). Water, especially car- 
bonated water as a drink, is a valuable adjunct to remedies in the treatment of 
fevers ; warm baths, the wet pack, hot and cold compresses, fomentations, 
moist inhalations, etc., have great value (see the various fever titles) : a most 
important agent : cold baths or cold wet pack to reduce temperature (B) ; cold 
affusion, baths, packing, ice, and ice-bag; hot affusion and sponging, all of 
great value in every form (R). 

Prescriptions. 
R. Tinct. Aconiti, 3 ss ~j- ! R • Antipyrini .^ss-j. 

Spt. Etheris Nitrosi, . . 3 ij. Aquae Cinnamomi, . . . Jjij. 

Glycerini, .... q. s. ad %{]. M. Sig. — A teasp. every 2 hours for 

Sig. — A teasp. hourly to an adult. 1 children, to control pyrexia. 

Fever, Simple. 

Aconite, in small repeated doses, the best remedy for febricula, etc. (B) ; in 
ordinary febrile conditions, if given early, will abate fever and induce free per- 
spiration ; may be administered in conjunction with any other remedy indi- 
cated (R). Veratrum Viride, in small doses, as antipyretic (P). Hyoscyamus 
or Belladonna, very useful in febricula, especially for head symptoms and con- 
stipation (P). Gelsemium, when remittent or bilious symptoms (P). Arsenic, 
if typho-malarial symptoms (B). Phenacetin, in hourly doses of gr. iv or less, 
in the simple continued fever of children, as antipyretic. Hydrochloric Acid, 
in the continued fever of childhood, has a beneficial influence (West). Valer- 
ian, when nervous excitability (P). Lemon-juice, as lemonade or with Potas- 
sium Bicarbonate, as a mild diaphoretic and diuretic (P). Pomegranate-juice 
is very grateful if mixed with sugar or honey (P). Bromides, gr. ss-j every 
quarter-hour are excellent for the febrile disturbances of children (Smith). 
Baths, warm, in simple fevers of children (R). Aliment, milk and beef-tea 
alternately every 3 hours, the most useful (B). 

Prescriptions. 
R. Ac. Hydrochlor. Dil., . . 3 ss. R . Potassii Acetatis, .... J^ij. 

Spt. ^Etheris Co. , .... ^jss. Spt. ^Etheris Nitrosi, . . %' 



iv. 



Syr. Rosae, ^ ss. Syr. Simplicis, 5 3. 

Aquae Camph., . q. s. ad £iv. Liq. Ammonii Acetatis, . Jij. 



M. Sig. — Teasp. to tablesp., according 
to age, every 6 hours. 

{Modified from West J) 



Aquae Camphorae, . q. s. ad J^ viij. 
M. Sig. — Teasp. to tablesp. doses, 
cording to age. 



Fistula. 

Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P). 
Iodine, by injection, sometimes curative, but generally fails (Wa). Sangui- 
naria, as injection, has cured (P). Capsicum, the weak infusion, a useful 
stimulant in fistulous ulcerations (P). Glycozone, Z\ in %'} of lukewarm water, 
as enema once or twice daily, soon produces good effects in cases of fistula in 
ano (Edson). Bismuth Subiodide, after operation, dusted over the surface of 
the wound after washing, to stimulate granulations when the healing process is 
indolent, is remarkably efficient. Surgical, division of sphincter in anal 
fistula, by knife or ligature, the best treatment (D) ; in fistula lachrymalis, dila- 
tation of passage by probing the canaliculus, or slitting the canaliculus up(D) ; 
in vesico-vaginal, or recto-vaginal, surgical methods best. Diet should be 
nourishing and digestible ; fresh air and general hygienic conditions are 
necessary (R). 



FLATULENCE FLUSHING FOREIGN BODIES. 663 



Flatulence. 

Nux Vomica, will remove flatulence and intestinal indigestion (B) ; when 
constipation, heartburn, weight on head (R). Charcoal, gr. v or x, soon 
after or just before meals (R) ; mixed with Bismuth (R). Chloroform, pure, 
in drop doses, benefits (R) ; by far the best agent in flatulent dyspepsia to 
prevent flatulence, always given well diluted (Huchard). Carbolic Acid, 
when no acidity present (R). Turpentine, gtt. iij-v on sugar, will quickly 
relieve (B). Strontium Bromide, is excellent in flatulence from decomposition. 
Asafcetida or Valerian, quickly relieves the flatulence of hypochondriasis (P). 
Asaf. Z] of tinct. to 0)4 water, dose Z] ', useful for children (R). Sodium 
Sulpho-carbolate, gr. xxx after eating, will be found very serviceable (R). 
Phosphoric Acid, dilute, is often promptly alleviative. Anise, the Oil, also 
Ether, or any other member of the carminative group (see page 46), will 
promote the expulsion of gas from the stomach and intestines. Mercury, in 
flatulence with clayey stools (R). Calumba, an effective remedy for flatulent 
disposition is an infusion of ^ss each of Calumba and Ginger, 5j of Senna, hot 
water Oj, a wineglassful ter die (P). Potassium Permanganate, in flatulence 
attendant on obesity (B). Physostigma, flatulence of women at climacteric 
(B). Sulphurous Acid, in 5 to 10 minim doses, when flatulence due to fer- 
mentation (R). Diet, abstain from sugar, starchy food and tea — especially 
sugar ; eat little, slowly and regularly ; as a general rule abstain from alcoholic 
drinks and from vegetables, especially cabbage. Pepsin or Ingluvin after 
meals, to promote digestion (R). [Compare Colic, Dyspepsia.] 

Prescriptions. 

R . Tinct. Nucis Vomicae, ! R . Gumnii Camphorae, 

Tinct. Physostigmatis, Pulv. Zingiberis, 

Tinct. Belladonnas, . . aa ^j. 
M. Sig. — Fifteen drops twice daily in 

a little water. 



R . Tinct. Illicii Anisati, 
Tinct. Gentianae, 
Tinct. Nucis Vomicae, . aa£jj. 
Chloroformi, TT^xv-xxx. 



Pulv. Capsici, . . . . aa gr. j. 
Ft. pil. no vj. Sig. — One pill as re- 
quired for gastric and intestinal flatulence. 



water, before meals. 



R . Bismuthi Salicylatis, . . . 5 iv. 

Magnes. Calcinat. , . . . giv. 

Pulv. Carb. Ligni, . . . . gvj. 

Olei Anisi, 31J. 



M. Sig. — 8 to 10 drops in a winegl. of Ft. pulv. Sig. — A teaspoonful before 



each meal. [Huchard.) 



Flushing-heats. 

Nux Vomica, TT\jj of the tinct. with rr\j of Laudanum in hysterical flushings 
of the middle-aged, with flatulence, weight on head and perspirations (R). 
Amyl Nitrite, ^^u t0 l A> m thirty times its volume of rectified spirits, is effect- 
ive for flushing of face, or sensation of flushing, followed by coldness, with 
cold feet and hands and great prostration occurring at climacteric chiefly (R). 
Potassium Bromide, at climacteric, with mental depression (R). Zinc Vale- 
rianate, or Valerian, flushings at the climacteric (R). Eucalyptol, for the 
flushings, palpitations and flatulence incident to the change of life (R). [Com- 
pare Climacteric Disorders.] 

Foreign Bodies. 

In the Eye, remove by bathing, or wiping towards the lower inner corner 
with a soft, moistened handkerchief, or a bent bristle, the two ends being held 
in the fingers: use tepid solution of Vinegar (3ss to ^j) for removing lime, 
tepid water for powder ; then apply a weak Zinc or Alum collyrium, or instil a 
solution of Atropine (gr. ij to the ^), or Cocaine, 4 per cent. In the Ear, 



664 



FRACTURES FRECKLES GANGRENE. 



examine carefully with speculum before removal ; first syringe with warm 
water, or a drop of sweet oil to drive out insects, before using the forceps ; 
apply equal parts of Laudanum and Olive Oil, a few drops on cotton, if much 
pain. In the Nose, a current of tepid salt water, forced up one nostril, may 
force down the body through the other, if the mouth be held open. In the 
Larynx or Pharynx, if water can be swallowed, the obstruction is in the 
trachea. Never push a body down ; remove by curved forceps or blunt 
hook. If passed into the stomach use solid diet to imbed the article. If all 
fail and the case be urgent, resort to catheterism or tracheotomy. In the Flesh, 
remove at once by forceps, or sponge and water. [Compare Asphyxia and 
Apncea.] 

Fractures and Dislocations. 

Arnica, internally is excellent to neutralize the ill effects of mechanical inju- 
ries, nvv-x in a wineglassful of water every 2 or 4 hours ; when used after 
amputations, it certainly has the power of promoting the rapid union of the 
surfaces : the infusion is better than an alcoholic preparation for external use 
(P). Aconite, quickly and repeatedly, if feverish symptoms ensue (P). Iodine, 
internally and by friction, occasionally useful in ununited fractures (Wa). 
Calcium Phosphate, promotes formation of callus (Wa). Opium, useless in 
surgical fever, and may do harm (CI) ; for nervousness or muscular spasms 
after dressing, gr. % of Morphine hypodermically as anodyne (Ag). Benzoin, 
the tincture on lint, as a dressing for compound fractures and other severe 
injuries, leads to rapid and satisfactory healing (Bryant). Carbolic Acid, 1 to 
20 or 1 to 40 solutions, for irrigation and dressings in compound fractures, 
obviates pyaemia and most of the other preventable causes of death (P). 
Lead-water and Laudanum, on lint, or a Calendula lotion to the part, after re- 
duction of the injury, with Morphine hypodermically and perfect quiescence. 
Diet, should be very simple for a week or ten days. [Compare Wounds.] 



Freckles. 

Resorcin, as paste with Zinc Oxide, applied to the face, to promote peeling 
of the skin and removal of freckles and other superficial spots (Unna). [See 
under Acne.] Iodine, the tincture or glycerite, locally (B). Liquor Potassae, 
5] to ^ij aquas rosae, as a lotion (Todd). Benzoin, the compound tincture with 
water, as cosmetic to remove freckles (P). Sodium Borate, a saturated solution 
of Borax is a safe and often efficient lotion to remove freckles (B). Lime- 
water, and Olive Oil, equal parts, with a little Liq. Ammonias, as liniment 
(Wa). Potassium Carbonate, makes a good lotion for freckles, sunburn and 
tan (B). Mercury, the Bichloride, with Alcohol and Glycerin, as a lotion, has 
been found effective: Donovan's solution, mjxxx to ^viij of water, of which 
Jj every three hours, has been highly successful (Wa). 



Prescriptions. 



H • Potassii Carbonatis, . . . ^iij. 

Sodii Chloridi, £ij. 

Aquae Aurantii Flor., . . % ij. 

Aquae Rosae, ^ y iij- 

M. Sig. — Face-wash. (B/ 



V J- 



R . Hydrarg. Chlor. Corr. , . . gr 
Ac. Hydrochlor. Dil., . . %'). 
Alcoholis, Aq. Rosae, . aa ^ ij. 
Glycerini, ^j, Aquae, ad ^ viij. 
Apply at night, wash off in morning 



Gangrene. 

Salicylic Acid, pure, in powder locally, to destroy fetor and change the 
character of the morbid action (B). Carbolic Acid, acts in the same way 
(B) ; a 1 per cent, solution as lotion in gangrenous ulcers (Wa). Sodium 
Sulphate, in solution, 1 to 5 or 10 of water, as lotion or applied on compresses, 
to destroy odor, soothe pain and restore healthy action (Wa). Ammonium 



GASTRALGIA, GASTRODYNIA. 665 

Chloride, in solution as baths and fomentations, very successful in one case of 
senile gangrene (Wa). Cinchona, or better, Quinine, has often proved of value 
(P) ; generally decoction of Cinchona is best(Wa). Turpentine, locally, after 
removal of gangrenous part, a most efficient application (B) ; by stomach and 
inhalation from hot water in gangrene of lungs ; the oil locally in dry and 
chronic gangrene (P). Sanguinaria, has been recommended (P). Oxygen, as 
gaseous bath in senile gangrene (R). Charcoal, as poultice, value doubtful (R). 
Citric Acid, Lemon-juice dropped into wound, which is then covered with lint 
steeped in a solution of Chlorine; very effective for hospital gangrene, in 
Parisian hospitals {Lancet, October, 1879). Ferric Chloride, locally, is consid- 
ered superior to the mineral acids (Wa). Nitric Acid, strong, applied carefully 
until the ulcer is converted into a firm, dry mass ( Wa) ; is probably the best 
escharotic, next to Bromine, for gangrenous destruction (B). Bromine, is the 
best escharotic for hospital gangrene (B). Chromic Acid, is a very efficient 
caustic, penetrating deeply with but little pain (B). Opium, to soothe the pain, 
and diminish restlessness and irritability (Wa). Myrtol, 1 or 2 drops, in cap- 
sules, internally, for gangrene of the lungs. 



Gastralgia, Gastrodynia. 

Resorcin, internally, acts exceedingly well. Opium, in some form necessary 
to relieve the pain in severe cases (Da C). Morphine, is of great value (P) ; 
subcutaneously in epigastrium very efficient, or in small doses with Bismuth and 
milk before meals (R) . Belladonna, is useful in painful affections of the stomach 
(R). Atropine, often relieves promptly, and is excellent in neuralgic pain of 
the abdominal viscera (P). Nux Vomica, an excellent stomachic, gtt. v-x of 
tincture before meals (B) ; gtt. j-ij every 2 hours in many forms of gastric de- 
rangement (R). Strychnine, hypodermically for gastralgia and gastrodynia 
(R) ; in very small doses, gr. ^-q— j?, two or three times daily, a very successful 
remedy (P). Arsenic, sometimes dissipates the pain surprisingly (B) ; a drop 
of Liquor Arsenicalis before food in irritative dyspepsia and gastralgia with 
heartburn (R). Bismuth, when gastralgia due to irritation of mucous mem- 
brane, acts well alone, but is most efficient when given with aromatic powder 
and a little Morphine (R) ; or a combination of Bismuth and Arsenic in more 
chronic cases (B) ; the Subcarbonate is especially adapted to gastralgia with 
laborious digestion and putrid or acid eructations (Wa). Manganese, the Black 
Oxide in gastrodynia and pyrosis (R). Zinc Oxide, an excellent remedy when 
gastralgia occurs after food, gr. v-x with aromatic powder and Morphine, before 
meals (B). Silver Nitrate, in solution to check the pain of many stomachal 
disorders (R) ; a pill of gr. ss, with Extr. Hyoscyami gr. ij-iv (Wa). Hydrocy- 
anic Acid, often cures rapidly when gastralgia from nervous derangement (B) ; 
may check vomiting as well as relieve pain (R) ; Cherry-laurel water a useful 
form (P). Nitro-hydrochloric Acid, gtt. ij-iij of the dilute acid, is serviceable 
(Da C). Ether, a few drops or the compound spirit ttlx-xx, often relieves 
quickly (B). Chloroform, n\,ij-v on sugar, often relieves (B). Chloral, some- 
times relieves pain in gastralgia (R). Pulsatilla, is efficient in many cases of 
painful dyspepsia, with coated tongue, headache and nervous depression (P). 
Pepsin, when gastrodynia from indigestion (P). Creosote, checks pain after 
food (R). Alum, often affords relief (B). Ergot, of value in visceral neuralgiae 
(P). Alkalies, for pain in stomach, Liquor Potassae generally employed (R). 
Quinine, in cases showing periodicity, and those of neuralgic type (P). Sodium 
Salicylate, for gastralgia with fermentation (R). Nitroglycerin allays the pain 
speedily (B). Carbonic Acid Water, in painful and irritable conditions; may 
be mixed with milk (R). Milk-cure, very efficacious in obstinate cases (B). 
Galvanism of the pneumogastric, and locally to the organ itself (B). Aqua- 
puncture has given extraordinary relief (B). Diet is of the greatest importance ; 
food should be easily digestible, varied and plainly cooked ; sedentary livers 
should refrain from much animal food ; meals should be regular and frequent, 
eating little at a time, and that very slowly. Alcoholic beverages do harm as 



666 GASTRIC DILATATION GASTRITIS. 

a rule, but may benefit particular cases. Eating should be done in as agree- 
able a frame of mind as possible, and the patient should rest for a time after a 
meal. [Compare Acidity, Dyspepsia, Neuralgia.] 

Prescriptions. 

ft. Morphinae Sulph., . . . . gr. j. R. Bismuthi Subnit. , 

Ac. Carbolici, Zss. Magnesii Carb., . . . aagr. xvj. 

Aq. Menth. Pip., . q. s. ad^'w. Ac. Hydrocy. Dil., . . . rt\x. 

M. Sig. — Teasp. thrice daily. Aquae, ^ iv. 

[Da Costa.) M. Sig. — Dessertsp. for a child of 3 
years in flatulent gastrodynia and gastralgia. 

ft . Bismuthi Subnit., . . . . 3 ij. 

tt&tZSL™ 3SS ' B. Ac. Hydrocy. Di, _ gfi. 



M. 



Mucil. Acaciae, 

Aq. Menth. Pip., . . . ugij. M Aq. Lautocerasi, . q. s. ad 3 v 

Sig.-Tablesp. thrice daily. M " *»g— Teasp. every 4 hours. 



ft. Pepsini, 3 ). 

ft. Atropine Sulph., . . . . gr. j. Ac. Hydrochlor. Dil., . . zss. 

Zinci Sulph., Zss. Glycerini, ,lJ ss - 

Aquae Destill., 3J. Aq. Cinnamomi, .... Jijss. 

M. Sig. — 3 to 5 drops two or three ' M. et filtra. Sig. — Tablespoonful doses 
times daily. (B.) for slow and feeble digestion. 



Gastric Dilatation. 

Carbolic Acid, internally to allay fermentation, with an occasional washing 
by the stomach-pump (Da C). Strychnine, hypodermically or by the mouth, 
or Nux Vomica, the best remedy, conjointly with washing of the stomach and 
strict diet (Da C). Bismuth Subnitrate, with Magnesia or Soda, or Lime- 
water frequently, for the acidity, which is one of the most distressing symptoms 
(Fenwick). Bismuth Salicylate, as an internal antiseptic, is highly praised. 
Salophen, relieves the fermentive disturbances. Diet, should be free from all 
starch and sugar, and from vegetables of any kind (Fenwick) ; milk not advis- 
able, as much fluid will further dilate the organ ; solids better, as small quan- 
tities of dry, stale bread, or gluten bread, and underdone meat (Da C). 



Gastritis, Acute. 

Mercury, Calomel in broken doses, with ice, frequently swallowed, for the 
idiopathic form, which is occasionally seen and cannot be distinguished from 
that due to irritant poisons (Da C). Bismuth, the Subnitrate or Subcarbonate 
in full doses after the acute symptoms have abated (Da C). Morphine, hypo- 
dermically for pain (B). Ice, internally and externally gives great relief (R). 
Aliment should be given per rectum ; no food, except milk and Lime-water, 
being admitted to the stomach for some time (Da C). Antidotes, in cases of 
irritant poisoning, as Alkalies to neutralize acids, Dialyzed Iron or the Hy- 
drated Sesquioxide for arsenic, Turpentine for phosphorus, etc. (see Ap- 
pendix) : then Oil, Albumen or milk, to protect the mucous membrane ; stimu- 
lants, Opium, Ammonia, etc., to antagonize the depression of the vital powers. 



Gastritis, Chronic. 

Arsenic, sometimes surprisingly curative ; for the vomiting gtt. j-ij of Fow- 
ler's solution before meals (B). Pulsatilla, in subacute gastritis of phlegmatic 
temperaments, white tongue, heartburn, nausea, flatulency, little or no taste 
(P). Hydrastis, gtt. v-xv of tincture or fluid extract, daily before meals, espe- 
cially for gastric catarrh of acute alcoholism (B). Nux Vomica, gtt. j of tine- 



GASTRITIS. 667 

ture every 5 to 10 minutes for 8 or 10 doses, in acute gastric catarrh, with head- 
ache or sick-headache ; also drop or 2-drop doses every 2 hours or oftener, 
when chronic gastric catarrh occurs in the course of chronic disease (R). Cin- 
chona, to promote healthy state of mucous membrane, the infusion best with 
mineral acids, or Quinine ; the Red Bark in gastric catarrh of drunkards (B). 
Alkalies, either shortly before meals, to stimulate production of gastric juice ; 
or some hours after, to neutralize the acids of decomposition (Da C). Pepsin, 
gr. v immediately after a meal, to assist digestion (Da C). Podophyllum, in 
small doses at night, to act on upper bowel ; purgation as a method of treat- 
ment stands at the head (Da C). Ipecac, in small doses may prove highly 
useful, rr\,v-x of the wine (P); for the nausea and vomiting (R). Tannic Acid, 
in 4-grain doses with a drop of Glycerin to make a pill (B). Bismuth Subni- 
trate, is very useful in chronic gastritis, especially that of drunkards, and the 
chronic gastric catarrh of children with vomiting (R) ; invaluable for its seda- 
tive, alterative and astringent action; 10-15 grain doses several hours after 
meals (Da C) ; the Subgallate (Dermatol) is being advertized as a remedy for 
chronic gastritis. Bismuth Salicylate, as an internal antiseptic, is highly 
praised in chronic gastric affections. Strontium Bromide, gave successful re- 
sults in 32 cases of gastric catarrh (See). Resorcin, acts exceedingly well. 
Glycozone, is one of the best remedies for the chronic gastric catarrh of alco- 
holism, and that from other causes (Edson). Hydrocyanic Acid, is much used 
(R) ; in subacute gastritis it often proves useful given in an ordinary efferves- 
cing draught (Wa). Silver Nitrate, in ]i or J^ -grain doses with Opium if pain, 
or preferably Belladonna, is extremely useful (Da C) ; to check pain and vom- 
iting (R). Silver Oxide, is nearly as good as the nitrate, and not liable to pro- 
duce staining (Da C). Opium, or Morphine, to quell pain in chronic gastritis 
from alcoholic excess (R). Eucalyptus, a most useful stomachic, not to be 
used in inflammatory states (B) ; is used with benefit (R). Mercury, the Yel- 
low Oxide, in doses of gr. ^-^q, in chronic form (see under Dyspepsia). 
Calumba, and other bitters are useful (B). Ammonium Chloride, in high 
repute in Germany (B). Caffeine, especially when associated with migraine 
(B). Lead Acetate, in chronic gastritis with gastralgia and pyrosis, may be 
combined with Morphine beneficially (B). Alum, when vomiting of glairy 
mucus (B). Aliment, such as will be digested in the small intestines ; requires 
careful attention ; the milk-cure has been very effective in bad cases ; malt 
liquors are harmful (B) : mineral waters of purgative type, to keep the portal 
system drained: exercise is not beneficial, better live quietly, and occasionally 
spend a day or two in bed (Da C) : Kumyss very agreeable, and tolerant to 
stomach ; the milk-cure and buttermilk have been very efficient ; the farinace- 
ous vegetables, rice, tapioca, arrowroot, aerated bread. [Compare Dyspepsia, 
Gastralgia.] 

Prescriptions. 

R. Sodii Bicarbonat., . . . . ^jss. | R . Magnesii Sulphatis, . . . gj-ij. 

Tinct. Aurantii Cort, . . £ ss. Sodii et Potassii Tart.,. . ^ss-j. 

Infusi Calumbfe, . q. s. ad ijviij. Ac. Tartarici, . . . . . gr. xx. 

M. Sig. — Two tablesp. before each Sig. — Dissolve in a glass of water, and 

meal. In chronic gastric catarrh. drink, an hour before breakfast. 

R. Aluminis, £ij. 

Ext. Gentianse, q ss. „ o ,.. ^. , , 

M-L-v -l c- tJ •. •" R. Sodii Bicarbonat., . . . . gr. lxxx. 

. It. pil. no. xxx. Sig. — Two twice ** c L ^, , , . » *». 

dai] fe Spt. Chloroformi, .... gjss. 

Tinct. Gentianse, . . . . 3 ss. 

R. Argenti Oxidi, gr. xij. Infusi Rhei, *iv. 

Ext. Belladonnae, . . . . gr. iij. Aq. Menth. Pip., q. s. ad ,^viij. 
Olei Caryophylli, .... gtt. xx. M. Sig. — A tablesp. or two before each 
M. Ft. pil. no. xxiv. Sig. — One pill ' meal. In chronic gastric catarrh, with flat- 
twice daily. — (Da Costa.) 1 ulence. 



668 



GASTRIC ULCER — GLANDERS AND FARCY. 



Gastric Ulcer. 

Arsenic, Fowler's solution in drop doses lessens the pain and relieves the 
vomiting' remarkably (B) ; has given relief when commonly-used remedies 
failed (R) ; gives good results when used in very small doses (Da C). Bismuth 
Subnitrate, relieves pain and vomiting and contributes, to the cure (B) : See 
under Gastralgia for formulse. Chloroform I, with Bismuth Subnitrate 3, and 
Water 150, of which 3j-ij hourly, or without the bismuth, which is not necessary, 
gives marked improvement in recent ulcer as well as in long-standing cases 
Stepp). Silver Nitrate, in solution, to check pain and relieve the vomiting 
R) ; is next in value to Bismuth, promoting cicatrization and easing the pain 
(B). Silver Oxide is equally efficient, and is not liable to produce staining 
(Da C). Atropine, often happily relieves the pain and vomiting even when 
given in very small quantity (B). Morphine, for the pain and vomiting (R) ; 
in full doses if perforation occurs, to localize peritonitis until adhesions take 
place (Da C). Ergotin, 1 part to 10 of water, of which gtt. xv hypodermically 
several times a day for the hemorrhage. Gallic Acid, in 5-grain pill every hour 
for hemorrhage. Lead Acetate, is sedative and hemostatic ; gr. ss-ij in pill 
with Opium, very useful to check hemorrhage and allay pain (R). Turpentine, 
5 to 10 drops frequently repeated in hemorrhage (R). Resorcin, acts very well ; 
its analgesic property herein is so marked that the stomach is enabled to tolerate 
food (Pope). Glycozone, is the best of all known agents for the treatment of 
gastric ulcer (Edson) ; should be given on an empty stomach, one or two teasp. 
in a wineglassful of water. Charcoal is said to ease the pain by preventing 
formation of acid products (R). Mercury, Corrosive Sublimate an effective 
remedy; gr. ^V~s& thrice daily before meals (B). Pepsin, by facilitating diges- 
tion, is useful (B). Iron, for the anaemia; the Lactate or Ammonio-citrate if 
stomach irritable (Da C). Ice-bag, to the epigastrium, for pain and vomiting, etc. 
(R). Nutrient Enemata, to rest the stomach ; (see under Enemata for formu- 
la) ; Brandy may be added, also Laudanum, gtt. x-xx, if the rectum is 
irritable (B). Milk-cure, has succeeded admirably (B) ; a strictly skimmed 
milk diet with Lime-water, 2 parts of milk to 1 of Aqua Calcis (Da C). Diet, 
should be of non-irritating character, which, with cold or hot compresses to the 
epigastrium, leaves little room for medicine : in bad cases nourish per rectum, 
so as to give the stomach complete rest ; in any case such food as is chiefly 
digested in the small intestines, farinaceous vegetables, rice, arrowroot, etc. 
A nice change from milk diet is a warmed pancreas, chopped up with rare meat, 
being nutritious and well relished (Da C). Rest, in bed for several months is 
imperative (Da C). Defibrinated Blood, by injection into rectum, in doses of 
from ^iij-vj (A. H. Smith). [Compare Hematemesis.J 



R- • Argenti Oxidi, 
Ext. Hyoscyami, 
Ft. pil. no. xx. Si| 
daily before meals. 



Prescriptions. 

R . Argenti Nitratis 



-One pill thi 



R. Bismuthi Subcarb., . . . giij. 

Morphinse Sulph., .... gr. j-ij. 

Pulv. Aromat. , gj. 

Ft. pulv. no. xij. Sig. — One powder in 
milk before each meal. 



. . . gr. v. 

Ext. Opii, gr. iij. 

Ft. pil. no. xx. Sig. — One pill thrice 
daily. 



R • Argenti Oxidi, gr. v. 

vel Zinci Oxidi, gss. 

Morphinae Sulph. , . . . . gr. j-ij. 
Ft. pil. no. x. Sig. — One pill thrics 
daily, before meals. 



Glanders and Farcy. 

Ammonium Carbonate, in water, hourly, as concentrated as can be swallowed 
followed by an opiate, and preceded by an emetic of Ipecac, and an incision 
into each of Wharton's ducts ; proved successful in a case of acute glanders 



GLANDS GLAUCOMA GLEET. 669 

(Wa). Carbolic Acid, and the Sulphites, as Sodium Sulphite, are most worthy 
of trial. Creosote, or Carbolic Acid, in Glycerin, locally (Wa) ; or dilute Chlori- 
nated Soda, and Lime-water. Escharotics, to destroy the affected spot, if inocu- 
lation occurs. Iodine, internally, also Arsenic and Strychnine, have been 
recommended. Quinine, in large doses, and Ferric Chloride, may be useful. 
Potassium Iodide, grs. 150 daily, with baths in Hot Springs of Arkansas, con- 
quered the disease in me, probably the only man who ever survived it. (Dr. 
Paul Paquin, Univ. Mo.) No drug yet tried has any marked specific effect on 
the disease (Durham). Mallein, for diagnostic purposes (see page 480). 

Glandular Affections. 

Iodine and Iodides, no remedy more efficient, when simple hypertrophy; 
useless (with all other medicines) when caseation or suppuration has set in ; 
Iodine injected into cystic and glandular growths of neck ; Syrup of Ferrous 
Iodide occupies an important place (B) ; Potassium Iodide for mammae and 
testicles, but especially for thyroid (R). Iodoform is equal, if not superior to 
Iodine, in enlarged scrofulous glands, and other glandular swellings (Wa). 
Lead Iodide, as an ointment. Ung. Hydrarg. Iodidi Rubri, produces very 
striking effects in goitre, enlarged spleen, etc. (B). Sulphides, especially the 
Blue Lick water, are said to abort or to mature suppuration in glands (R). 
Calcium Sulphide, for hard, swollen glands behind the angle of the jaw, with 
deep-seated suppuration (R). Calcium Chloride, highly useful in strumous 
inflammation and suppuration (B). Pilocarpus, is curative in acute affections 
of parotid and submaxillary glands (B). Mercury, useful in acute inflamma- 
tory states, tonsillitis, parotitis, etc.; Hydr. Chlor. Corr. gr. -£$ or Hydr. cum 
Creta, gr. A, every two hours (B) ; the Oleate of Mercury and Morphine in 
obstinate and painful tonsillitis, and inflammation of lymphatic glands (R). 
Aurum Salts, have cured enlarged and indurated cervical glands. Aurum and 
Arsenic Bromide, the solution is highly efficient in cervical adenitis (Barclay) ; 
rendered good service in a case of adenitis with enormous enlargement of the 
left side of the neck (E. A. Wood). Belladonna, especially in tonsillitis (P). 
Valerian, with Guaiacum, in strumous enlargement (P). Hydrastis, frequently 
controls (P). Carbolic Acid, a 2 per cent, solution injected into substance of 
gland (B). Electrolysis, used by me to remove a number of swollen and pain- 
ful lymphatic glands in the neck (Remak) ; by the use of strong and often 
interrupted faradic currents multiple indurated lymphatic tumors have been 
removed or diminished (Meyer) ; enlarged glands have been repeatedly cured 
by electrolysis (B). [Compare Bubo, Wen, Goitre, Tabes Mesenterica, 
Parotitis, Tonsillitis, etc.] 

Glaucoma. 

Atropine, gr.^ hypodermically is beneficial (Anstie); imprudently used has 
caused the disease (Graefe, Wells) : should not be indiscriminately instilled 
into the eyes of persons over 35 or 40 years of age, in whom it may light up a 
latent or incipient glaucoma. Physostigmine, lowers intra-ocular tension, and, 
with Quinine, is indicated in all cases of threatened glaucoma, to preserve the 
eye from the risk of consecutive glaucoma, and after iridectomy or sclerotomy 
(Wecker). Iridectomy, the only remedy for the disease, medicine being worse 
than useless ; the operation should be performed as soon as a state exists which 
can be called glaucomatous ; even when vision is lost, the operation will best 
relieve the pain (C) : almost a certain cure in early stages ; in later nearly 
always palliative and often curative. Drainage of Eye, by gold wire or catgut, 
has proved successful (Wecker). 

Gleet. 

Cantharis, in drop doses, when frequent desire and pain in region of pros- 
tate (R) ; of benefit in subjects of relaxed fibre and feeble circulation (B). 
Blisters, to the perinaeum, of undoubted benefit (R). Piper Methysticum, has 



670 



GLOSSITIS GLOTTIS. 



cured obstinate gleet (Switzer). Bismuth, 1, Glycerin 1, water 6 parts, as an 
injection, often useful in gleet (R). Eucalyptol,is used with benefit in chronic 
catarrh of the genito-urinary tract (R). Iron, the Tincture of the Chloride, £ss 
in Oss of water with 3j of Laudanum, makes a good injection for gleet (R) ; 
internally for anaemic subjects (St). Mercury, y 2 grain of Corrosive Sublimate 
in 3 vj of water, is a good injection in gleet, used every 2, 3 or 4 hours (R); 
Donovan's Solution in doses of 10 minims thrice daily, so uniformly successful 
in controlling chronic urethral discharge as to be almost a specific for gleet. 
Zinc Salts, the Sulphate or Chloride, gr. ij of the latter to a pint of water, as 
injection every hour (R). Bougies, of gelatin, medicated with astringents, are 
extremely efficient. Turpentine, in moderate doses, when due to relaxed con- 
dition (R). Copper Sulphate, a solution as injection (R) ; astringent injections 
may be used with benefit (Wa). Copaiba, smeared on a bougie, and introduced 
into the urethra, will sometimes cause gleet to yield (Wa). Sandalwood Oil, 
tt^xv ter die (R). Glycerite of Tannin, with equal quantity of Olive Oil or 
mucilage, as injection, Z\] enough ; persevere 8 or 10 days after discharge 
ceases, and do not use at bedtime (R). Balsams of Peru and Tolu, Buchu, 
Canada Balsam, Copaiba, Mastic, and Tannin, are used with advantage (P, R). 
Gleet is often kept up by over-treatment, will some time or other come to an 
end (St). Diet and Habits important ; stimulants, both solid and liquid, 
should be rigidly avoided, also coffee ; frequent ablutions, fresh air, good nour- 
ishment. [Compare Gonorrhoea.] 

Prescriptions, 



R. Tinct. Ferri Chlor., . . . ^vj. 
Tinct. Cantharidis, . . . 55 ij. 
M. Sig. — 15 drops in water three times 
daily. 

R- . Zinci Sulphatis, gr. iij. 

Ac. Carbolici, ..... rt^i). 

Ext. Hydrastis, 

Ext. Belladonnae, . . . aa gr. vj. 

Gelatini, q. s. 

M. Ft. bougia no. vj. Sig. — One in 
urethra at bedtime. 



R- . Pulv. Cantharidis, .... gr. iij. 

01. Terebinth, 3J. 

M. Ft. pil. no. xij. Sig. — One thrice 
daily in obstinate gleet. If strangury 
occur, stop for a day or two. 



R- . Ac. Tannici, gr. x. 

Bismuthi Subnit., . . . . gij. 

Aq. Rosae, gvj. 

M. Sig. — Shake and use as an injection 
thrice daily. {Maury.) 



Glossitis. 

Bismuth, gr. xx of Subnitrate with ^j of Glycerin and £vij of water, as 
lotion, for erythematous inflammation of tongue (A). Purgatives, with gargles, 
leeches, antiphlogistic regimen generally (D). Quinine and Iron, should be 
given internally, with dilute acid washes, and free purgation (CI). Alum, dry, 
powdered, may be dusted on tongue (CI). Leeches, applied beneath the jaw, 
if symptoms are urgent (CI). Abscess, should be opened, if any form. In- 
cisions, along superior surface, followed by vapor of hot water, may instantly 
relieve congestion (A). Tracheotomy or Laryngotomy, if suffocation is appa- 
rently imminent (A). 



Glottis, CEdema of. 

Emetics, non-depressing when oedema slight (A). Inhalations, of steam 
with Benzoin, or Conium, of great service (A) ; or of Tannin, gr. viij or x to 
^j of water; or Alum, gr. x to the ^, or a saturated solution of Potassium 
Chlorate, all as spray (Walker). Ethyl Iodide, by inhalation, proved curative 
in one case in which it was repeated twelve times (See). Scarification, by 
laryngeal lancet, of paramount value (A). Tracheotomy, if the above fail 
(A). O'Dwyer's laryngeal tubation promises well. [Compare Croup, Laryn- 
gitis.] 



GOITRE GONORRHOEA. 67 I 

Goitre. 

Iodine, is curative in simple hypertrophy (ordinary goitre) used both inter- 
nally and externally : deep injection of the tincture is very successful in cystic 
degeneration of the gland (B) ; also in the fibrous and fibro-cystic varieties, 
if injection be made into the tumor; dangerous, if into a vein or into the 
surrounding areolar tissue (Wa). Mercuric Iodide, as oint. assisted by the 
sun's rays ; a piece the size of a large pea rubbed in daily, very successfully 
used in India for simple hypertrophy (R) ; the official Unguent. Hydrarg. 
Iodidi Rubri, 1 in 10, daily (B) ; is too strong (Gross) ; gr. xv to the ^ strong 
enough for the worst cases (Wa). Potassium Iodide, internally, also exter- 
nally as ointment, in simple hypertrophy of the gland (R). Strychnine, 
gr. y 1 ^ thrice daily, has been successful in several cases (Holmes). Ferric 
Chloride, injections of the solution used in thirty-eight cases with curative 
results (Mackenzie). Ergotin, injected with benefit into the parenchyma of 
the goitre (P) ; also used hypodermically with good results (Wa). Ammoni- 
ium Chloride, as an internal remedy has proved curative (Stevens). Thyroid 
Gland, 3j to ij, once a week, cured 4 children completely, and cured or relieved 
9 out of 12 cases so treated (Bruns) ; Thyroid Extract is used with benefit (see 
page 132). Electrolysis, has sometimes cured in cases of simple hypertrophy 
and cystic gland (B) ; 6 out of 14 test cases of goitre were absolutely cured by 
electrolysis (Duncan). Spongia Usta, was formerly considered a sovereign 
remedy (Wa). Seton, has cured. Fluoric Acid, in doses of rt^xv to Z) thrice 
daily, largely diluted, cured seventeen cases out of twenty (Woakes). Excision, 
is a very difficult operation, only to be considered in extreme cases ; it has been 
performed successfully by Desault, Harris, Lane, Hedenus, Billroth and Greene. 
[Compare Exophthalmos.] 

Prescriptions. 

R- . Ammonii Chloridi, . . . Svss. 
Syrupi Simplicis, . . . . Mss. 
Aq. Cinnamomi, . . . . giv. 
M. Sig. — Teasp. thrice daily. 



R- . Unguenti Hydrargyri Iodidi 

Rubri, g'j. 

Vaselini, 3 vij. 

M. Sig. — Use as directed. (Gross.) 



Gonorrhoea. 

Aconite, a drop of tinct. each hour in the acute stage (R) ; when inflamma- 
tion (Pf, St). Gelsemium, serviceable, acute stage (Pf ). Cannabis Sativa, 
after acute symptoms subside, a few drops 3 or 4 times a day, is fully as effect- 
ual as Copaiba or Sandal, and infinitely more pleasant to take (Pf ). Canna- 
bis Indica, relieves pain, diminishes discharge (P) ; occasionally useful (R). 
Colchicum, the wine of the seed has frequently cured gonorrhoea, and was used 
in thirty-minim doses nightly for the relief of chordee by Brodie (B). Ferric 
Chloride, when acute stage has passed and the discharge is degenerating into 
gleet, few remedies are more useful than this tincture, in doses of rr^xv-xx 
thrice daily (Wa). [See Erysipelas for formula.] Alkalies, Citrates or Bicar- 
bonates to render the urine alkaline (R) ; Lithium Carbonate in five-grain 
doses thrice daily, for the same purpose : Alkalies are the chief factor in Otis's 
treatment; Potassium Bicarb., gr. x in a tumbler of water, or in Flaxseed tea, 
or Infusion of Triticum, with gr. xv of Potass. Bromide, if great pain present; 
Vichy Water (Celestin) freely (Otis). Turpentine, in chronic stage, when 
parts are relaxed, moderate doses are of great benefit (B). Cantharis, drop- 
doses may be used (R) ; in the chronic stage (B). Pulsatilla, in subacute and 
gonorrhceal ophthalmia (P). Copaiba, especially adapted to gonorrhoea (B); 
pour it upon half a winegl. of water to which add some bitter tincture (Chap- 
man) ; if given too early in the disease it will aggravate the symptoms (P) ; 
should not be used until pain in urinating is nearly gone, chordee ceased, and 
the discharge is diminishing and of yellow color (Wa) ; is no good, but rather 
injurious, and prolongs the disease (Otis). Sandalwood Oil, valuable in sub- 



672 



GONORRHOEA. 



acute (P) ; a good quality difficult to obtain (Pf ) ; the best internal remedy, 
Copaiba next (St). Cubeb, unlike Copaiba, is given with good effect in acute 
stage ; best results from a mixture of both as in electuary (see formula below) ; 
is not irritating to the stomach, and agrees with some patients better than 
Copaiba (Wa). Balsams of Peru and Tolu, also Buchu, Uva Ursi, Chima- 
phila, Pareira, etc., are among the numerous remedies used for gonorrhoea (R). 
Injections, of Tannin, Copper Sulphate, Iron, Cadmium, Port-wine, Brandy- 
and-water, and 1000 other agents (R) ; injections are very bad, especially in 
the acute stage ; should never be used until the 5th week and then only if the 
case is not progressing (Otis) : true gonorrhoea is never cured in less than four 
weeks (Van Buren and Keyes) ; urethritis is a different disease entirely (Otis). 
Silver Nitrate, a weak solution (gr.j-v to the 3) as injection; in vaginal gon- 
orrhoea a strong solution (3j to the 3) through speculum to every part of the 
canal (B); as abortive injection is useless and dangerous (St). Zinc Salts, a 
weak injection of the Chloride, gr.j to ^vj or viij of Rose-water; or the Sul- 
phate gr. j to the ^, frequently repeated, is probably the best treatment (B) ; 
the best injections are those of the Sulphate or Acetate, gr. yj-xij to ^iv aquas, 
after the acute inflammation subsides (St). Bismuth, the oleate, smeared on a 
sound, and inserted for 5 minutes (Shoemaker) ; with mucilage as an injection, 
excellent in chronic gonorrhoea (Hill). Lead Acetate, the dilute solution of 
the Subacetate, as injection, may be employed at any stage (B). Chloral, a weak 
solution, gr. j-iv to the ^, a very good injection (Hill). Resorcin, a 1 per cent, 
solution makes a useful injection (Wa). Antipyrin, 100 parts, Corrosive Sub- 
limate 1, Distilled Water 10,000, used as injection four times daily and retained 
as long as possible (Vatier). Boric Acid, 3iss, Tinct. Iodine gij, Glycerin ^ij, 
Distilled Water q. s. ad ^iv, as injection morning and night, has given ex- 
cellent results in both acute and in chronic cases when other treatment proved 
inefficient (James). Potassium Permanganate, a solution, 1 to 1000, one or 
two quarts at each sitting, washing out the bladder as well as the urethra 
several times daily, is highly efficient. Alumnol, a 1 to 3 per cent, solution as 
injection, is reported to be efficient. Mercury, excellent results from Corrosive 
Sublimate (Pf) ; gr. %-Yz to ^ viij aquae destill. in subacute and chronic stages, 
as injection thrice daily ; may have gr. ss-j of Zinc Chloride added with bene- 
fit ; is often effectual (Wa). Hydrastis, the infusion best for injection, 3j of 
root to ^ viij aquae (Pf) ; the fluid extract is one of the best injections, properly 
diluted ; or the Muriate of Berberine (Hydrastin) 3j to ^iv mucil. acaciae (B). 
Soluble Bougies made of Iodoform, Eucalyptus and Cacao-butter, are highly 
recommended to cut the disease short (Wa) ; a series of similar preparations, 
having a basis of Gelatin and Glycerin, medicated with the usual astringent 
and sedative drugs, is manufactured by C. L. Mitchell, of Philadelphia, and 
may be obtained of the drug trade. Wrappings of several folds of cotton are 
heating and uncomfortable, also dirty and productive of balanitis, etc. ; pin a 
false front to the shirt for covering (St). Rest, in bed is an absolute desidera- 
tum, especially during the inflammatory stage. Hot water, ioo° F., to the penis 
during urination, extreme cleanliness, milk diet; water freely as a beverage; 
flavored with a few drops of Oil of Gaultheria, or Flaxseed tea, or Infusion of 
Triticum with Potassium Bicarbonate. Sexual thoughts to be entirely avoided 
(Otis). Alcohol, as a beverage, or any other stimulant, must be avoided entirely 
(R). [Compare Chordee, Gleet, Orchitis, Rheumatism Gonorrhceal, 
Urethritis, Urethral Stricture, Vaginitis.] 



Prescriptions. 



For Infernal Use. • 
U . Potassii Citratis, . . . . Hj ss-j. 
Spt. Liraonis, . . . . . Zss. 

Syr. Simplicis, Sij. 

Aquae, ^j. 

M. Sig. — Dessertsp. largely diluted, 3 
or 4 times daily. As alkali for the increas- 
ing stage. (Otis.) 



For Local Use 
r£ . Zinci Sulphatis, . . . 
Plumbi Acetatis, . . 
Ammonii Chloridi, 

Aluminis, 

Aquae Rosae, . . . 
M. Sig. — Injection to 
acute symptoms subside. 



. . gr. vj. 

. . gr. viij. 

. . gr. iv. 

• • gr- v. 

• • lY 

be used after 



GOUT. 



673 



For Internal Use. 

The Black Paste. 

R. Pulv. Cubebse, E ll i' 

Copaibae, SJ SS > 

Aluminis, 2 ij. 

Sacchari Albi, 3J. 

Magnesiae, 3J SS - 

Olei Cubebae, gj. 

Olei Gaultheriae, .... ^j. 

M. fiat electuarium. Sig. — A piece the 

size of a walnut after each meal. (Otis.) 



M. 



Oleoresinae Cubebae, . . . spv. 
Potassii Bromidi, . . . . ^j. 

Olei Sassafras, n\x. 

Syr. Acaciae, 5 ij. 

Aquae, q. s. ad %\). 

Sig. — Dessertsp. 3 or 4 times daily. 
(/. Wm. White.) 



[For Alkaline Emulsion of Copaiba see 
ante, page 534.] 



For Local Use. 

R. Resorcini, 3J. 

Ac. Borici, gr. xx. 

Zinci Acetatis, gx%-) 

Aquae Destil., . . . . ,25 iv. 

M. Sig. — Dessertsp. as injection. 

R • Pulv. Iodoformi, . . . . ^ ss. 

Ac. Carbolici, 5J ij. 

Glycerini, Sij. 

Aquae Destil., . . q. s. #^3 viij. 
M. Sig. — Teasp. as injection. 



R . Zinci Sulphatis, gr. viij. 

Liq Plumbi Subacet. Dil., 5 iv. 
M. Sig. — Use as an injection. 



R . Zinci Chloridi, gr. j. 

Aquae Rosae, ...... ^ vj— viij. 

M. Sig. — Use as injection. 



[For Injection Brou and others, see ante, 
page 540.] 



Gout. 

Piperazin, the best solvent for uric acid ; promptly reduces the redness and 
swelling of the joints in acute gout; remarkably relieves the paroxysm, and 
promotes elimination of uric acid and urates ; should be given in doses of 15 
grains daily, dissolved in a pint or more of carbonated water. Lysidin, is still 
more powerfully solvent on uric acid (see page 391) ; tried in cases of chronic 
gout with exacerbations with excellent results (Grawitz). Phenocoll, when much 
pain and fever; combined with Piperazin, gr. xv of each daily in a pint or more 
of carbonated water, is very efficient treatment. Morphine, hypodermically, as 
close to the affected joint as possible outside of the red areola, is miraculous in 
giving immediate relief. Antipyrin, remarkably efficient for relieving the pain 
as well as prophylactic against future attacks (Marshall). Aconite, may cer- 
tainly relieve pain (P). Belladonna, the best remedy to effectually and speedily 
soothe pain, also in gout of the stomach ; 5-rr^ doses efficacious (P). Potassium 
Iodide, especially when pain is worse at night (R). Colchicum is merely pallia- 
tive ; a large dose (3j) of the wine often removes the severest pain in an hour 
or two, and soon after the swelling and heat subside (R) ; it is especially useful 
in acute and rheumatic gout (B) ; is not specific, nor a lasting or final remedy 
for gout, but acts very directly on the pain and inflammation of acute attacks 
(P) ; is useful in the bronchitis, asthma, dyspepsia, urticaria, etc., of gouty sub- 
jects (R) ; Colchicine Salicylate, is highly efficient in chronic gout (see page 
249). Strontium Salicylate, in chronic gouty conditions, appears to be the most 
valuable drug that we have (W). Sodium Salicylate, 10 grains every 2 hours 
internally, also 3\] to ^vij of warm water as lotion on lint covered with oiled 
silk, in acute gout, is very efficient treatment. Cascara Sagrada, is said to pro- 
mote the elimination of uric acid to a remarkable extent. Coffee, a tincture of 
green coffee promotes elimination of the poison of gout from the system. Vera- 
trine, as ointment to painful joints (R). Sulphides, as baths in chronic gout, or 
fumigation with Sulphurous Acid, and bed-clothes exposed to its strong fumes 
(R) ; Sulphur waters certainly benefit (B). Iodine, painted around joints in 
chronic gout (R). Strychnine, hypodermically for later stage of gout paralysis 
(R). Lithium, the Bromide internally and a strong solution of Lithia to the 
joints (B) ; the Bromide is the most efficient agent in combating the disease 

43 



6/4 



GUMS. 



(Aulde) ; the Carbonate (gr. v to the ^) on lint around gouty enlargements, 
joints, etc. (R). Chirata, for the dyspepsia of gouty subjects. Guaiacum, has 
long had high repute, and may be given for a long time without injury (Wa). 
Rhubarb with an alkali, regularly during intervals, very serviceable (Halford). 
Manganese, Syrup. Ferri et Mang. Iodidi (tt\,x-3ss) for the cachectic state (B). 
Alkalies, to relieve indigestion, especially Lithium Salts ; alkaline mineral 
waters have long had a deserved reputation (B) ; Magnesia and its Carbonates 
often of great service ; the latter dissolved in excess of C0 2 an elegant form 
of administration (Wa). Alkaline Poultice, Linseed meal 9 parts to one of 
Sodium Bicarb, is a useful application (R). Turkish Baths, are useful in chronic 
gout (R). Carbonated Water freely, has an exceedingly beneficial influence. 
Oxygen, is used with benefit in cases of deficient oxidation (Br). Aliment, 
farinaceous vegetables and acid fruits ; avoid animal or saccharine food ; Milk- 
cure has improved cases, and apparently removed the diathesis (B) ; Cod-liver 
oil in chronic gout (R) ; entire abstinence from alcoholic beverages is best ; the 
worst wines are port, sherry and madeira. Local Measures, the affected limb 
should be raised, and surrounded by hot, moist flannels ; wrap the hands in 
flannel dripping with water, and cover with water-proof bag, to dissolve gouty 
deposits. [Compare Arthritis, Lith^emia.] 



Prescr, 
Scudamore' s Mixture {Modified). 

R. Vini Colchici Radicis, . . Ij. 

Magnesii Sulphatis, . . . 3J. 

Magnesiae Optimse, . . Zij. 

Aquae Menth. Pip., . . . ^x. 
M. Sig. — Tablesp. every hour until it 
operates on the bowels. 



iptions. 

R . Vini Colchici Seminis, . . ^ ss. 
Tinct. Digitalis, . . . . spj- 
Liq. Potassii Citratis, . . 3 ijss. 
M. Sig. — A teasp. in water every six 

hours. 



R. Colchicinae, gr. j. 

Ext. Colocynthidis Co., . 3"ss. 

Quininae Sulphat., .... ^iij. 
Ft. pil. no. lx. Sig. — One pill every 
four hours. (B.) 



R . Lithii Citratis, 

Magnesii Carbonat., . aa ^j. 
M. et div. in pulv. no. 1. (50)- 
Sig. — One powder in water thrice daily. 

In chronic gout. 



R 



M. 



Lallemand 's Specific. 

Ext. Colchici Acet. (B. P.), 

Ext. Opii Aquosi, . . aa gr. xv. 

Potass. Iodidi, 3"iv. 

Potass. Acetatis, . . . . gij. 
Aquae Destill., . . . • • 5 iijss. 

Vini Albi, gss. 

Sig. — 20 drops thrice daily. 



R. Lithii Bromidi, ^j. 

Liq. Potas. Citrat., . . . 3 iv. 

Syr. Tolutan., Jij. 

M. Sig. — A teasp. in plenty of water 
after each meal. {Aulde. ) 



Gums. 

Myrrh, the tincture for spongy and ulcerated gums (P) ; 3"ij-iv in Jiv of 
water or Infusion of Cinchona, is highly serviceable as a gargle or mouth-wash 
(Wa). Alum, for spongy and ill-conditioned gums, tending to recede from the 
teeth, whether of mercurial or scorbutic origin (Wa). Catechu, a piece dis- 
solved slowly in the mouth is often of service in similar conditions (Wa). 
Rhatany, the powder as a dentifrice, keeps gums in good order (P). Potassium 
Chlorate, gr. ij every four hours for a child of one year, for inflammation of 
gums in teething (Wa). Carbolic Acid, gr. iij ad ^j aquae, as lotion in diseases 
of the gums (Hilditch). Pomegranate, the bark an excellent basis for gargles 
in relaxed gums (P). Potassium Iodide, gr. x thrice daily, for periostitis of 
alveolar processes, marked by looseness of teeth, pain and swelling of gums 
(Graves). Iodine, gr. j ad ^j aquas, applied by a camel's-hair brush, after each 
meal, for retraction of gums with loosening of the teeth (Stille). Tannin, the 



HAIR HAY-FEVER. 



75 



glycerite, for spongy and bleeding gums (B). Carbolate of Iodine, when fetor, 
(B). Benzoin, the tincture a good application (B). [Compare Scurvy, 
Teeth.J 

Prescriptions. 
R . Aluminis, 3 ss. | R • Tinct. Orris, 

Tinct. Myrrhae, . . . . . 5J. Spt. Rosae, 

Tinct. Cinchonae, . . . . giv. Alcoholis, aa^iv. 

Mel. Rosae, %]. 01. Araygd. Amar., . . . gtt. ij. 

Vini Albi, v5 vn j- M. Sig. — Violet Mouth-wash. 

M. Sig. — Mouth-wash. (Piesse.) 



Hair. 

Rosemary, encourages the growth of hair, mitigates baldness, and is supposed 
to prevent uncurling in a damp atmosphere (P). Hydrogen Dioxide, and 
other preparations of oxygen, are used to " blonde " the hair, for purposes of 
fashion (Wilson). Hair-dyes, comprise Potassium Permanganate, Pyrogallic 
Acid, Black Oxide of Lead, which are temporary, and the Black Oxide of Silver, 
which is permanent in its action (Wilson). Depilatories usually consist of 
powders containing Quicklime 3 parts, Sodium Sulphide 1, and Starch 4: a 
powerful depilatory is Barium Sulphide made into a thin paste with Starch 
(Wilson) : another contains Yellow Sulphide of Arsenic, gr. xx, Quicklime, ^ss, 
Starch, 3'j : a very effective one is Barium Sulphide and Zinc Oxide (B). 
Sarsaparilla is stated by Teste to possess the curious property of changing red 
hair to a light flaxen color, when taken internally for three months. [Compare 
Alopecia, Syphilis, Tinea Tonsurans, etc.] 



Prescriptions 

R. Sodii Boratis, 3**. 

Aq. Ammoniae, tj. 

Spt. Myrciae, ...... 5ij. 

Aq. Rosae, 5 x iij- 

M. Sig. — Shampoo Hair Wash. 



B . Ac. Salicylici, gr. xl. 

Tinct. Benzoini, gss. 

Alcoholis, Glycerini, . . aa^viij. 



&. 01. Ricini, ^jss. 

01. Bergamottae, .... 3Jss. 

01. Cinnamomi, 

01. Caryophylli, . . . aa ttlvij. 

01. Lavandulae, T^xl. 

Tinct. Cantharidis, . . . 3J. 

Aq. Ammonise, gij. 

Alcoholis, . . . . q. s. adO]. 



M. Sig. — Hair Wash. I M. Sig. — Hair Tonic. 



Hay-Fever. 

Arsenic, especially valuable when disease is more of catarrhal than of asth- 
matic type, 3 minim doses of Liquor Arsenicalis (Mackenzie) ; as cigarettes, 2 
or 3 daily. [See Asthma for formula.] Belladonna, when nasal secretion is 
very profuse (B). Euphrasia, of decided benefit for the catarrhal symptoms 
(Pf ). Quinine, very useful after the more acute symptoms have subsided (R) ; 
injected into the nares checks catarrhal discharge and spasmodic symptoms 
(P) ; a solution of the Hydrochlorate, gr. iv-viij ad Jj aquae, applied locally to 
nasal mucous membrane by a spray-producer or a brush, will arrest the disease 
if confined to the nares and fauces (B). Ipecacuanha, in hay-asthma (R) ; 
is of great value, though the smallest closes cause similar effects (P). Aconite 
is better than Arsenic in true hay-fever (R) ; has been used with the best results 
(P). Grindelia benefits cases of asthmatic type (B). Iodides are very ser- 
viceable, locally and internally ; large doses until some iodism observed ; may 
be combined with Arsenic (B). Opium, especially as Morphine, of great value 
in any stage, but great danger of the opium-habit (B) ; the tincture in doses of 
Tr^ij-iij every 2 hours for three doses, then mj every 2 hours until the discharge 
abates, has given excellent results (Wa). Black Coffee is highly recommended 
(P). Cocaine, a 5 to 20 per cent, solution of the Hydrochlorate, brushed over 



676 



HEADACHE. 



the nasal mucous membrane after drying it as far as possible, is the most effi- 
cient palliative yet obtained (K) ; a 4 per cent, solution dropped from a medi- 
cine-dropper well into anterior nares, the head being thrown well backward, or 
sprayed up the nostrils from a small atomizer; gives immediate relief, and 
though not curative it prevents so much suffering and distress that in no case 
should it be left untried (Da C). Ignatia, the tincture has seemed to benefit 
some cases, and to favorably influence the course of the disorder (Da C). 
Lobelia, has been found an efficient remedy (Wa). Tobacco, smoking helps 
some and aggravates the symptoms in other instances; internally ad nauteam 
it helps, but there are better and safer remedies (Wa). Removal to the sea- 
coast, or a barren, mountainous district, gives the only relief to some sub- 
jects ; though many of the worst cases, hitherto unaffected by medicine, are 
now relieved by the local application of Cocaine. [Compare Asthma, 
Catarrh, Conjunctivitis, Influenza.] 



P)-escriptions. 



M 



For Internal Use. 

Potassii Iodidi, ^j. 

Liq. Potass. Arsenit., . . Z). 

Aquae Cinnam., 3 1V - 

Sig. — Teasp. every 4 hours. 



# . Ext. Hyoscyami, 
Potassii Iodidi, . 




• gr.xij. 

• 3J- 




Potassii Bicarb., 




• 3>J- 




Ext 


Glycyrrhizae 


Pur., . 


• v> iv ' 




Aq. 

M. Sig 

relieved. 


Anisi, . . . 
. — Dessertsp 


every 4 


• 3 1VSS - 

hours un 
( Webej 


til 
•) 



R. Liq Potassii Arsenit. , . . ^j. 
Tinct. Belladonnas, . . . gij. 
M. Sig — 5 to 10 drops after meals, as 
a prophylactic. 



R . Tinct. Euphrasia?, .... %jss. 
Aq. Camphorae, . q.s. ad ^ij. 
M. Sig. — Teasp. four times daily, for 
the catarrh. 



For Local Use. 



R 



Tinct. Iodi, 3J. 

Ac. Carbol., gtt. x. 

Aq. Destill., ^ iv. 

M. Sig. — For local use with atomizer 
or post-nasal syringe. 



R. Mentholi, 

Ac. Carbol., .... 

Zinci Oxidi, .... 

01. Amygd. Dulcis, . 

Cerati Simplicis, . . 
M. Sig. — Apply thoroughly to the nos- 
trils every few hours. 



3J- 
gss. 

|jss. 
8 li- 



ft 



Quininae Bisulph., ... ziij. 

Aquae, it' v - 

M. Sig — Irrigate the nares, after 
cleansing with a weak alkaline solution. 



R 



Cocainae Hydrochlor. , . . gr. vj. 

Aquae Destill., 3 ij. 

M. Sig. — 5 per cent, solution. A few 
drops to be instilled into nares while head 
is lowered. {Da Costa.) 



Headache, Bilious-sick. 

Antipyrin, the most valuable single remedy for headaches ; an 8-grain dose 
in dyspeptic headache, in a little water, at commencement of attack, the patient 
lying down in a dark room ; a second dose one hour after is generally enough, 
but a third or fourth may be required : sleep generally follows, and there are 
no unpleasant after-effects. Acetanilid, in 4-grain dose, equally effective. Nux 
Vomica, gtt. j of tinct. frequently, when acute gastric catarrh, with headache 
and nausea (R) ; gtt. j every 10 minutes, soon after meals, often gives maiked 
relief in sick-headache not of neurotic origin (Smith) ; drop doses every 10 min- 
utes for an hour cure sick-headache, especially when accompanied by bilious- 
ness (M). Strychnine, with Alom and Belladonna, in minute granules, for 
bilious headache from obstinate constipation, effective if given several times a 
day for a week or ten days (Roy). Belladonna, the extract in doses of gr. sVtVj 
in similar form. Iris, blinding headache in right supraorbital region, with 
nausea and vomiting, usually the result of hepatic derangement ; rr\j every half- 
hour for three doses, usually relieves promptly (Pf ). Bryonia, ordinary bilious 



HEADACHE. 



6 77 



sick-headache with vomiting (P). Picrotoxin, gr. ^ by stomach, in periodical 
form (B). Chamomile, a popular remedy (R). Salol, is one of the most effi- 
cient remedies. Podophyllum, in sick headache, with dark bilious diarrhoea, 
or when constipation with dark evacuations (R). Sanguinaria, when due to 
stomach derangement, a few doses relieve (P). Hydrastis, from constipated 
bowels (P). Mercury, as Blue Pill, to prevent or mitigate ; or small doses (gr. 
tW) of 'he Bichloride when headache with light-colored diarrhoea (R). Ammo- 
nium Chloride is an efficient remedy in most forms (Wa). Sodium Phosphate, 
a useful laxative in so-called bilious sick headache (B). Potassium Bromide, a 
large dose in ordinary or sick headiches (R). Ginger, in paste, as counter- 
irritant (P). Water, as cold or hot affusion, or ice-bag to head ; hot sometimes 
best; the purgative waters (as Friedrichshall) before breakfast in a cup of hot 
water (R) ; a brisk saline purgative, or small doses of Epsom salts thrice 
dailv, very effectual for frontal headache with constipation (Br). Nitro-muri- 
atic Acid, 10 drops of the dilute acid in a winegl. of water, before each meal, 
often an effectual remedy (Br). Charcoal, two teaspoonfuls stirred in half- 
glass of water, as a draught, is an efficient remedy for sick-headache with sour 
stomach and flatulence, etc. [Compare Hemicrania.] 



Prescriptions. 



R 



Ammonii Chloridi, . . . giij. 
Morphinae Acetatis, . . . gr. j. 
Caffeinae Citratis, . . . . 3 ss. 
Spt. Ammonii Aromat, . £_j. 

Elix. Guaranae, 5 iv. 

Aquas Rosae, ?> lv - 

M. Sig — Dessertsp. every quarter-hour 
until relieved. (Carpenter.) 



R. Podophylli Resinae, . . . gr. ij. 
Tinct. Zingiberis, . . . . £ij. 
Alcoholis, . . . q. s. ad g]. 
M Sig. — Teasp. in a winegl. of water 
every night at bed-time, or every second, 
third or fourth night as required. 

(Dobell.) 



Headache, Congestive. 

Antipyrin or Acetanilid (see preceding article). Aconite, to reduce the cir- 
culation (R). Veratrum Viride, at menstrual periods (R). Belladonna, relieves 
cerebral congestion, and distress from light and sound (P); pain over brows 
and in eyeballs, often due to stomach or uterine derangements, especially in 
young women; rujij of tinct. every three hours (R). Potassium Bromide, a 
large dose (gr. xv-xx) in ordinary or sick headaches (R) ; Bromides are useful 
when nervous svstem has been irritated, but when exhausted they do harm 
(Himmond). Calomel, gr. J^, every hour for ten or twelve doses, will relieve 
the headache of syphilis occurring at night (Tr). Cannabis Indicais given with 
uniformly good results in the headache of the climacteric. Potassium Iodide, 
throbbing, intolerance of light, pain passing from back of neck over vertex to 
brow, nocturnal, tender scalp, almost unbearable; ten-grain doses ter die will 
cure (R). Hydrastis, when constipated bowels (P). Amyl Nitrite, for head- 
aches with severe flushing heats at menstruation or climacteric, ^V^o a sufficient 
dose (R). Mustard, in hot foot-bath, or as poultice to nape of neck in various 
forms of headache (R). Water, cold water poured gently over forehead, some- 
times wa>-m water better (R) ; a very hot foot-bath often effectually relieves 
(Wa). Purgatives are often beneficial, especially when congestive headache 
arises from suppression of hemorrhoidal discharge, or in persons of phlegmatic 
habit ; Aloes best (Wa) ; or Colocvnth, as derivative, when cerebral hvpersemia 
(Da C). 

Prescriptions. 

R. Spt. Ammon'se, ..... ;|j. 



R. Ext. Colocynthidis Co., . gr. xij. 

Pulv. Capsici, gr. iv. 

Ext. Gentianae, gr. xxiv. 

Ft. pil. no. xij. Sig. — One pill thrice 
da'ly ; also a 25-grain dose of Sodum Bro- 
mide nightly, at bedtime. (Da Costa.) 



Spt. Camphorae, . . . . 3 ss. 
M. Sig. — For a quart of water, in which 
a handful of common salt has been dis- 
solved. Cork tightly > and use locally on 
lint as an evaporating lotion. 



678 HEADACHE. 

Headache, Nervous. 

Antipyrin, is efficient [see under Headache, Bilious-Sick]. Acetanilid, 
is very efficient in headache from fatigue (Brodnax) ; as routine remedies for 
the relief of headache these agents are much more valuable than bromides 
and caffeine (Whitla). Phenacetin, is used with success (M). Cannabis 
Indica, ten-minim doses of the tincture thrice daily in the intervals, often 
curative in bad cases of neuralgic headache; or % to ^-grain doses of the 
extract (P). [See under Hemicrania.] Belladonna, n\jij of tinct. every 3 
hours, when pain over brows and in eyeballs, especially when at menstrual 
periods ; also when from over-study or fatigue (R). Nux Vomica, if with 
gastric symptoms (R) ; is better than Strychnine, and should be given in 
quarter-grain doses of the extract after meals, combined with Iron and Quinine 
if patient is chlorotic (Hammond). Bromides, are useful when the nervous 
system has been irritated, but harmful when it is exhausted (Hammond). 
Silver Nitrate, half-grain doses with minute doses of Pil. Coloc. Comp., in- 
valuable in headaches of hysterical women and especially stomach headaches 
of delicate and literary men (Wa). Ignatia, removes clavus hystericus (Pf). 
Ammonia, the Aromatic Spirit (3ss-3ij) or the Carbonate (gr. v-x) in nervous 
headache (B); the Hydrochlorate (gr. x-xx) in bilious and hysterical head- 
aches, especially in hard-worked and delicate young women (Wa). Amyl 
Nitrite, inhaled, when extreme pallor of face (B). Arsenic, throbbing supra- 
orbital headache (R) '; as a nerve tonic stands next in value to Zinc (Hammond). 
Cimicifuga, in nervous or hysterical women, especially at menstrual periods 
(R) ; in rheumatic and menstrual headaches (P). Coffee and Tea, when from 
nervousness or exhaustion (R) ; Coffee especially useful (P). Caffeine Citrate, 
one to two-grain doses, in capsule, every half-hour, a very effectual remedy for 
nervous and sick-headache but causes insomnia if used in the evening. 
Guarana, a very effective palliative, gr. xx every half-hour for three doses (P) ; 
n\,xv of the fluid extract every quarter-hour increased to m^xl will often relieve 
periodical headaches not of malarial origin (Smith). Sodium Salicylate, in 
small doses, gr. ij-iij every quarter-hour, is very efficient in neuralgic headache 
(Br). Phosphorus, as dilute Phosphoric Acid, in doses of ttlxxx well diluted, 
thrice daily; or Zinc Phosphide.gr. y^in pill, ter die, very useful in most 
forms of nervous headache (Hammond). Cajuput Oil, well rubbed in twice 
daily (P). Menthol, locally to forehead in frontal headache ( Wa). Potassium 
Cyanide, locally in reflex headaches, as gastric, cardiac, pulmonary, menstrual 
(B). Valerian is of great value in excitable persons (P). Camphor, a satu- 
rated solution in Eau-de-Cologne rubbed on head, when headache of uterine 
origin (R) ; in hysterical females, internally, with Magnesium Carbonate (P). 
Podophyllum, purgative doses often give relief when near menstrual periods, 
with constipation and dark stools (R). Zinc Oxide, two- to five-gr. doses useful 
(R) ; a remedy of great value (Hammond). Bismuth, the Subcarbonate, in 
two-grain doses after each meal, often better than Zinc, especially where 
gastric disturbance (Hammond). Ether Spray, for frontal headache, after 
acute illness or fatigue (R). Chloroform, ttvxv-xxx of the spirit internally, often 
effective (Wa). Galvanism, sometimes valuable ; the constant current always, 
avoiding too great intensity lest amaurosis ensue (Hammond). [Compare 
Hemicrania, Neuralgia.] 

Prescriptions. 

R. Extracti Nucis Vom., . . gr. iij. 

Ferri Reducti, gr. xij. 

Quininae Sulphatis, . . . gr. vj. 
Ft. pil. no. xij. Sig. — One after each 
meal. (Hammond.) 



R . Potassii Cyanidi, . . . . gr. x-xx. 
Aquae Laurocerasi, . . . ^ iv. 
M. Sig. — Apply locally on a compress 
for l X to x /l an hour. (B. ) 



R. Zinci Phosphidi, . . . . gr. iij. 
Ext. Nucis Vom. , . . . . gr. x. 

Confect. Rosae, q. s. 

M. et div. in pil. no. xxx. 
Sig. — One pill after each meal. 

(Fordyce Barker.) 



R. Ext. Cannabis Ind. Fl., . ^ss. 

Pulv. Acaciae, 3 v. 

Syr. Aurantii Cort., . . jfij. 

Aquae, q s. ad £v]. 

M. Sig. — Teasp. every 3 hours. 



HEART AFFECTIONS. 679 

Heart Affections. 

Potassium Iodide, the true remedy for the heart ; especially applicable in 
non-compensatory mitral or myocardial diseases, and where there is cardiac 
debility ; restoring energy and vascular tension at first ; then by dilating, later 
on, all the arterioles, it frees the heart from resistance, and enables it to re- 
cover its contractile power ; also dilating the coronary arteries it furnishes 
nutrition to the heart itself (See). Strychnine, in medicinal doses, is said to 
strengthen the heart-beats (R). Nux Vomica, gave speedy relief in several 
cases of heart-failure in which death was imminent ; small doses every x /z hour 
for four successive doses, then every hour (Bowie) ; in a case of cardiac hyper- 
trophy and mitral insufficiency, in which death was imminent from heart- 
failure, one drop of the tincture in a teasp. of water every 5 minutes for 10 
doses, then every 10 minutes for 3 doses, continuing at longer intervals, com- 
pletely restored the cardiac force, and dispelled the accompanying cardiac 
asthma (Macfarlan). Digitalis, acts as a stimulant tonic (P) ; small doses for 
sedative action ; tonic or physiological doses to create hypertrophy in dilata- 
tion (Tr) ; irregularity of pulse is best indication (R) ; irritable heart (Da C) ; 
the tincture, given without water, is the best preparation ; especially indicated 
in weak heart acting rapidly because of its weakness, and in valvular disease 
(Wa). Helleborein, as a substitute for Digitalis (see page 300). Chloral, is 
generally contraindicated in heart affections, but may be used with benefit in 
neurotic palpitation and in pseudo-angina pectoris. Convallaria Majalis, will 
usually succeed in all cases in which Digitalis is useful, acting similarly to that 
drug, but with less reliability ; is useful in aortic disease and in others where 
Digitalis cannot be used (Wa) ; valuable in all forms of heart disease where 
there is oedema of tissues (See). Morphine, next to Digitalis, is in general the 
most indispensable remedy in the treatment of severe heart disease, being by 
far the most efficient agent for the dyspnoea (Striimpell) ; hypodermically, is 
employed in many cardiac disorders with marked advantage, especially in 
dyspnoea and angina with diseased coronary arteries, mitral regurgitation with 
its dyspnoea and insomnia, aortic disease, etc. Cimicifuga, safer than Digitalis 
in fatty heart (B) ; its action is strongly stimulating and tonic ; it relieves exces- 
sive dyspnoea when weak heart (P). Cactus, is highly esteemed in functional 
cardiac affections. Caffeine, an excellent cardiac stimulant, and diuretic, gr. 
ij-v of the Citrate every three hours (Da C). Arsenic, for dyspnoea from weak 
heart (R) ; in all cardiac neuroses it is especially valuable when combined with 
Iron and Strychnine, and is regarded as indispensable in all forms of weak 
heart accompanied by pain (Wa). Aconite, in the highest degree serviceable 
to diminish excitement or irritability ; it is more a remedy for functional de- 
rangement than for organic disease (Wa); in pericarditis (R) ; in nervous pal- 
pitations and hypertrophy (P) ; the heart seldom affected in rheumatic fever 
if Aconite be used from the start (P). Veratrum Viride, as cardiac depressant 
(B) ; in chronic cardiac diseases where excessive hypertrophy, i. e. when Digi- 
talis is contraindicated (W). Iron, useful in various forms, especially anaemic 
disorders and palpitation ; also in dilatation and fatty heart, and mitral regur- 
gitation (B). Hyoscyamus, in functional derangement from emotion, is speci- 
ally indicated ; requires large doses (rr^xl-lx), or gr. ^ of Hyoscyamine 
Sulphate hypodermically (Wa). Amyl Nitrite relieves heart pains resisting all 
other treatment (W). Blisters, flying blisters over the praecordial region, to 
stimulate action in extreme weakness (R). Alcohol, as Brandy when heart 
suddenly enfeebled by fright, loss of blood, etc. (R). Ether, n\,xx hypodermic- 
ally, repeated soon, is a very promptly-acting stimulant in sudden heart- 
failure ; the compound spirit in 5j doses for less urgent cases. Schott Cure, as 
practised at Neuheim, is a combination of saline baths, containing C0 2 in so- 
lution, and a series of graduated gentle exercises ; the best results therefrom 
are obtained in cases of cardiac dilatation due to overwork or worry, but it is 
also useful in fatty infiltration of the heart (not fatty degeneration) accompany- 
ing general obesity (M). [Compare Angina Pectoris, Dropsy, Endocar- 
ditis, Pericarditis, Syncope, and the five following articles.] 



680 HEART AFFECTIONS. 



Prescriptions. 



H- Ext. ErgotseFl., .... ^iijss. 
Tinct. Digitalis, . . . . ^ss. 
M. Sig. — Teasp. thrice daily'in enlarged 
heart without valvular lesion. 



R. Spt. ^Etheris Comp., 

Liq. Morpbinse Sulphatis, 

(U. S. P., 1870), aagj. 
Teasp. as required for dyspnoea. 



Heart, Dilated. 

Digitalis, where much dilatation, and hypertrophy of left ventricle without 
valvular disease ; is not contraindicated when aortic disease (R) ; use in physio- 
logical doses (Tr) ; in simple dilatation gives most favorable results ( W) ; very 
useful in mitral disease, when dilatation of the left ventricle (P) ; gives miracu- 
lous relief, is not sufficiently appreciated, but requires skilful administration ; 
use the infusion in preference to other preparations, a tablespoonful thrice daily, 
watching its effects (Da C). Scoparius, the infusion (Broom-tea), to maintain 
the kidney action if Digitalis is not sufficient (Da C). Purgation, brisk, free, 
watery stools, next to Digitalis is the best treatment (Da C). Morphine, hy- 
podermically, gr. %- l /6 two or three times a week in dilated heart with dyspnoea 
(B). Amyl Nitrite, dyspnoea from dilatation (R) ; is useful when great dysp- 
noea, the cardiac asthma (P). Ether, the Compound Spirit an excellent remedy 
for the dyspnoea (Da C). Mercury, a classical pill and a very efficient one as 
a diuretic in dropsy from cardiac disease is the combination of gr. j each of 
Pulv. Digitalis, Pulv. Scillae and Hydrarg. cum Creta (Foster). Schott Cure, 
in dilatation due to overwork or worry (see preceding page). 



Heart, Fatty. 

Strychnine, often the first remedy to do good ; unduly pushed will produce 
nervous worry and be injurious (P) ; is the remedy with Iron, nourishing but 
not fat-making diet, and wine to keep up the tone of the blood (Da C). Ergot, 
in occasional doses has been given with apparent benefit (Wa). Iron, the 
tincture of the Chloride in small doses for a longtime, has been of remarkable 
benefit (Wa). Cimicifuga, safer than Digitalis (B) ; the latter should not be 
used (Wa). Digitalis, ot no value except for very temporary use and for some 
special indication (Da C). Chloral, must be entirely debarred (Id). Ether, the 
compound spirit for sudden attacks of pain or dyspnoea (Id). Amyl Nitrite, 
for the same indications (Id). Stimulants, freely used, in an acute attack of 
any kind, afford the only chance (Id). Schott Cure, useful in fatty infiltration 
(not fatty degeneration) accompanying general obesity (M). 



Heart, Hypertrophied. 

Aconite, often better than Digitalis (R) ; dangerous in hypertrophy of left 
side, with diseased valves, but useful in simple hypertrophy (P) ; for over- 
action, with hypertrophy (B) ; the one remedy which can be depended on; 
small doses for months, say gtt. j of a good tincture ter die, to lower the heart 
gradually and keep it low (Da C). Digitalis, very useful in pure hypertrophy due 
to valvular disease or excessive muscular exertion (R) ; the primary action 
(small doses) required, as it creates hypertrophy when given in physiological 
or tonic doses (Tr). Veratrum Viride, as a cardiac depressant (gtt. v ter die) 
will relieve in simple hypertrophy, and irritable heart from abuse of tobacco, 
inadmissible when valvular lesions exist (B) ; gives the best results, next after 
Aconite (Da C). Lead Acetate, for violent palpitations, in some instances effi- 
cient (Wa). Amyl Nitrite, for dyspnoea, syncope (R). Ergot, in enlarged heart 
without valvular lesion ; may be combined with Digitalis (B). Potassium 
Iodide, small doses long continued benefit some cases (Wa). Camphor, in 



HEART AFFECTIONS. 



68 I 



doses of gr. iij-xij daily for tumultuous palpitations and dyspnoea of hyper- 
trophy with dilatation (W.i). Iron is necessary where anaemia exists (Da C). 
Quiet Life of great importance, no stair-climbing, no long walks; rest in bed 
often of service for days at a time, moderate diet, avoiding fattening foods, 
meat, and stimulants (Da C). 



Heart, Palpitation of. 

Aconite, for the fluttering heart of nervous persons, and nervous palpitations 
(R) ; for over-action, with hvpertrophy (B) ; for palpitation with simple hyper- 
trophy (1'). Hydrocyanic Acid, when from dyspepsia (F). Iron, when palpitation 
due to anaemia, a very frequent cause ; other causes are tobacco, coffee, tea, etc., 
to excess, dyspepsia, venery, excessive exercise (Da C). Spigelia Anthelmia, 
when due to mitral and aortic disease, with much dyspnoea (P). Digitalis, in 
small doses as sedative (Tr) ; combined with Iron in palpitation with valvular 
disease, or given alone in very severe cases (Wa) ; suits a large number of 
cases, especially for temporary purposes (Da C) ; the onlv remedy of positive 
service for the actual palpitation (Richardson). Camphor, recommended in 
nervous palpitations (R). Veratrine, as ointment to chest, when rapid, irregular 
pulse, hurried breathing, dropsy and lividity, palpitation, inahilitv to lie down 
(R). Nux Vomica, of great value in nervous palpitation. Bromides, in flut- 
tering heart (B) ; are useful when tolerated by the stomach (Da C). Hyos- 
cyamus, in nervous, and violent palpitations from excited state of the brain (P); 
in large doses, for functional disturbance arising from emotion (Wa). Bella- 
donna, in small doses, when irregularity of rhythm ; may also be applied exter- 
nally (Da C). Valerian nervous palpitation, with dyspnoea (P). Eucalyptus, 
palpitation and weak heart (R). Galvanization, of cervical sympathetic and 
pneumogastric (B). Hot Foot-bath relieves palpitations (R). Milk-cure, has 
been beneficial in irregular action (B). Ice, to the cardiac region, has benefited 
many cases; is of chief value when patient can be kept in bed, which some- 
times becomes necessary (Da C). 

Prescriptions. 



R . Pulv. Digitalis, gr. xx. 

Pulv. Colchici Sem. , . . gr. xl. 
Sodii Bicarb., gr. lx. 

M. et div. in chart, no. xl. Sig. — One 
powder at first 3 or 4 times daily, gradually 
reduced to one at bedtime. For irregular 
cardiac action. (Bowditck.) 



R. Tinct. Digitalis, . . . . £ij. 
Spt. Etheris Nitrosi, . . . Hjj. 
Liq. Ammonii Acet., q.s. ad"^ iv. 
M. Sig. — A dessertsp. every 4 hours. 
If prolonged insomnia with, palpitation add 
of Morph. Sulph. gr. T X g to each dose. 

(Richardson. ) 



Heart, Valvular Disease. 

Nux Vomica, the tincture in one-drop doses every 5 minutes, remarkably 
efficient in heart-failure, even with death impending (Bowie); also for the 
asthma (Macfarlan). [See under Heart Affections.] Digitalis, in aortic 
regurgitation (R) ; most effective in mitral insufficiency (P) ; in rapid action 
with low arterial tension; and in mitral disease ; infusion best, tablesp. doses 
twice daily (B) ; TT\j of tinct. every yi hour or hour, often gives more relief than 
larger doses (Smith) ; when heart is weak and struggling (Da C). Cactus, is 
especially recommended in complicated aortic regurgitation, as it does not 
prolong the diastole like Digitalis, but stimulates the cardiac action. Morphine, 
hypodermically for the dyspnoea, is better in mitral than in aortic disease (R) ; 
the agent above all others in aortic insufficiency, combating the two great 
symptoms therein, the cerebral anaemia and the dyspnoea; is to aortic regur- 
gitation what Digitalis is to mitral (Dujardin-Beaumetz). Aconite, useful for 
the palpitation, but dangerous in hypertrophy of left side with diseased valves 
(P) ; for cases presenting excessive growth and strong action, diminishes the 



682 HECTIC FEVER HEMATEMESIS. 

blood-pressure in the arterial system, and gives great relief (Da C). Veratrum 
Viride, has similar applicability, but is more apt to nauseate ; an admirable 
sedative, and one which does not sicken is a mixture of Tinct. Aconiti, Tt\j, 
Tinct. Verat. Vir., rc\,iij, Tinct. Zingib., Tt\,vij (Da C). Strophanthus, is a 
cardiac tonic like Digitalis, but does not contract the vessels nearly as 
much (Br). Nitroglycerin, is the best of all remedies when actual cardiac 
pain ; it lessens blood-pressure and diminishes the resistance the heart has to 
overcome (Da C). Caffeine, as a tonic and diuretic, of especial value in cases 
where urine is scanty, with cardiac pains, headache and dyspnoea, and weak 
heart ; gr. ij of the Citrate every three hours (Id). Adonidine, in doses of gr. ^ 
to£ thrice daily, acts excellently as a cardiac regulator (Id). Barium Chloride, 
gr. y 1 ^ in pill three or four times daily, is diuretic, lessens cardiac pain, increases 
tone in the vessels, and is a good general and cardiac tonic (Id). Purging, with 
Jalap, etc., in engorgement of right side of heart (R); occasionally useful (Da C). 
Treatment is directed chiefly to the dilatation or hypertrophy resulting from 
the valvular disease ; the simplest rule is to use judgment as to when the heart 
needs strengthening by Digitalis or reducing by Aconite or Veratrum Viride 
(Da C). [Compare Endocarditis.] 



Hectic Fever. 

Quinine, in large doses, gr. xv-xx daily, if stomach and intestines do not 
rebel (P) ; given before the paroxysm, to limit it (Roberts). Antipyrin, is better 
than Quinine, but must be used in much smaller dosage than ordinarily em- 
ployed, say gr. iv or v about yi hour before fever rises, then doses of gr. ij 
hourly as long as temp, remains above 100.5 ; this daily, will give excellent 
results in the hectic of phthisis (Pibram). Phenacetin, is safer and equally 
efficient. Phenocoll, as an antipyretic, is used with marked success. Aconite, 
in small doses, a remedy of much value in the irritative fever of phthisis (Da C). 
Morphine and other anodynes, are of especial value, given in full doses toward 
bed-time (Gross). Prunus Virginiana, the bark has been found useful, espe- 
cially when irritable cough (P). Calcium Phosphate, is especially useful (R). 
Calumba, excellent for tonic effects (P). Digitalis, the tincture, combined with 
Tinct. Ferri Chloridi, abates the temperature and diminishes the sweats (B). 
Iron, the Mistura Ferri Composita has obtained great celebrity, especially when 
much debility and anaemia (Wa) ; the Sulphate and Tincture of the Chloride 
are of especial value in the treatment of hectic (Gross). Ipecacuanha, a few 
grains of Dover's powder at bed-time, will stop the profuse perspirations (Wa). 
Salicin, for profuse perspirations (Wa) ; as antipyretic. [Compare Perspira- 
tion, Phthisis.] 

Prescriptions . 

R. Tinct. Digitalis, giij. I R. Quinines Sulph., .... gjss. 

Tinct. Ferri Chloridi, . .3 V. Elix. Taraxaci, Jiv. 

M. Sig. — 15 drops 3 or 4 times- a day. M. Sig. — Teaspoonful every hour for 

(B.) I six hours. 



Hematemesis. 

Ipecacuanha, is decidedly effective in small doses, also when hematemesis 
is vicarious of menstruation (P, Wa). Hamamelis, ttlj-ij of tinct. every 2 or 3 
hours (R) ; effective from its Tannin (B). Alum, serviceable in passive hemor- 
rhage ; Iron better (B). Turpentine, especially in passive hemorrhage with 
debility (R) ; and in hemorrhagic transudations on the free mucous surfaces, 
hematemesis, etc. (B). Ergot, has often cured when other means failed (P) ; 
most valuable ; in urgent cases Ergotin in 2 to 5 gr. doses hypodermically 
(R). Iron, the Subsulphate (Monsel's solution) or Pernitrate, the best remedies ; 
gtt. j-ij frequently, diluted with ice-water (B). Lead Acetate, especially in 
gastric ulcer, gr. ss-v (B). Tannic Acid, gr. x-xx, when from gastric ulcer or 



HEMATOCELE HEMATURIA. 683 

obstructive disease of liver (B). Gallic Acid, an extremely useful agent ; 
is best used in combination with dilute Sulphuric Acid (Wa). Ice, in small 
pieces swallowed, a most useful agent, with perfect rest for stomach ; when 
hematemesis from that organ, nutrient enemata must be employed; iced 
champagne to arrest faintness, if persistent ; when moderate the bleeding need 
not give cause for alarm. 

Prescriptions. 

R. Olei Terebinth., .... giij. 

Ext. Digitalis Fluid., . . 7,). 

Mucil. Acaciae, % ss. 

Aq. Menth. Pip., .... ^j. 
M. Sig. — Teasp. every 3 hours. 



R . Ac. Gallici, ^j. 

Ext. Ergotse Aquosi, 

Digitalis, . . . . . aa gr, xx. 
M. et div. in pil. no. xx. Sig. — One 
every 4 hours. 



Hematocele, Pelvic. 

Opium, or Morphine, if needed for pain, with absolute rest in bed, and a 
moderately tight abdominal bandage (E). Hemostatics, as Gallic Acid, Lead, 
Turpentine, etc., to arrest the hemorrhage, if it be still going on, combined with 
opiates, and the use of ice-bags or cold lotions to the abdomen or pervaginam. 
Tonics, as Iron and Quinine, while resolution of the extravasation is going on. 
Bromides and Iodides, to quiet the action of the ovaries, if the hemorrhage 
recurs at different periods. Potassium Iodide, as an absorbent, may be given 
with Quinine (Braxton Hicks). Iodized Cotton, an excellent application to the 
cervix uteri in cases of hematocele (Wa). Leeches, should be applied early 
in cases of peri-uterine hematocele ; later, except to check inflammation, they 
are inadmissible (Wa). Mercury, gr. fa of the Bichloride thrice daily, with 
Iron and Ergot, conjoined with vaginal injections of hot water morning and 
evening ; later in lieu of the mercurial the Syrup of Ferrous Iodide in 20-drop 
doses thrice daily, was thoroughly efficient treatment in one very bad case of 
retro-uterine hematocele (Hengst). Surgical interference has many advocates 
but is criminal in a large majority of the cases (E). If the case does not end 
in resolution it will terminate in pelvic abscess. 



R. Iodi, |j. 

Potassii Iodidi, 5ij- 

Glycerini, 3 viij. 



Prescription. 

Mix and saturate 8 oz. of cotton with the 
mixture ; then carefully dry, and label 
" Iodized Cotton." 



Hematuria. 

Turpentine, when with constitutional debility (B) ; in very small doses (R) ; 
often is very efficacious (P). [See under Hematemesis, for formula.] Hama- 
melis, has arrested severe cases (R). Chimaphila, controls hematuria (P). 
Gallic Acid, the most uniformly successful remedy (B); gr. x-xx every hour or 
two (Da C). Sulphuric Acid, alone or with Gallic Acid, is an efficient remedy 
(Da C). Acetic Acid, in a case of alarming hemorrhage from the bladder, 
which occurred after an operation for vesico-vaginal fistula, and resisted all 
other means, an injection of apple-vinegar and ice-water, equal parts, suc- 
ceeded in arresting it (Ghent). Quinine, large doses necessary ; cures when 
intermittent or from malarial infection (B) ; useful in some cases of intermittent 
hematuria (R). Myrtol, has been used with success in hematuria not due to 
acute congestion (B). Iron, the tincture of the Chloride, ttlx-xx several times 
daily ; in this affection the best form of Iron for internal use (Wa). Ipecacu- 
anha, exercises a powerful influence (Wa). [See under Hematemesis.] Ergot, 
by stomach or subcutaneously ; may be combined with Ipecac, Krameria, or 
other astringents (B). Ergotin, hypodermically, is far superior for efficacy and 
rapidity of operation (Wa). Matico, the infusion, in doses of ^ij every 2 or 3 



684 



HEMERALOPIA — HEMICRANIA. 



hours, is fully equal to Gallic Acid, Lead, etc. (Thompson). Ammonium Ben- 
zoate, in 5 -grain doses, for the albuminuria and hematuria of scarlatina 
(Hillier). Cannabis Indica, is especially indicated in dysuria and strangury 
when there is bloody urine (R). Camphor, in 2 to 5 grain doses is said to 
promptly remove the renal hyperaemia with bloody, coagulable urine, caused 
by Cantharis, Turpentine, Oil of Mustard, Copaiba, etc. (R). Ice in rectum or 
to perineum, for vesical hemorrhage (Thompson). 



Prescriptions. 



R 



Acidi Gallici, 3 ss. 

Ac. Sulphurici Dil., . . . %). 

Tinct. Opii Deodor., . . 7]. 

Infusi Digitalis, E lv - 

Sig. — Tablesp. every 4 hours or 
oftener. In hematuria, menorrhagia, pur- 
pura hemorrhagica, and the hemorrhagic 
diathesis. (D.) 



M. 



R . Ext. Ergotae Fluidi, 

Tinct. Krameriae, . . . aa t ^j. 
M. Sig. — A teasp. every hour or two. 



R. Ext. Ergotse (Squibb), . . %]. 

Aqu;^ • I)- 

M. Sig. — For hypodermic use ; TT^x 
contain gr. j. 



Hemeralopia and Nyctalopia. 

Strychnine, night-blindness; small doses, gradually increased, of service 
(Wa). Mercury, Hydrarg. Chlor. Corr. gr. ij, ad ^j aquae, dropped into the eye 
twice daily, wiih blister on each temple, and mild aperients, has cured hemera- 
lopia (S nith). Quinine, in as large doses as can be borne, after cathartic and 
emetic, for night- and day-blindness (Howard). Blisters, small, \}i inches in 
diameter, close to external canthus of the eye (Bampfield). Electricity, occa- 
sionally useful (Wa). Rest, protection of eyes from bright light, constitutional 
remedies, as indicated by state of general health, change of climate, speedily 
cure hemeralopia. It is sometimes merely a symptom of pigmentary degenera- 
tion of the retina, or a feature of scurvy. 



Hemicrania. 

Antipyrin, the most valuable single remedy for headache, especially in 
migraine and those cases for which Ergot and Amyl Nitrite are indicated ;" 5 
grains at beginning of the attack often sufficient (Birdsall) ; of great value in 
true migraine, employed in twenty cases with unfailing benefit; less useful in 
the malarial or dyspeptic forms, and useless in uraemic (Thompson) ; one dose 
of gr. xx, or 2 doses of gr. x each, yi hour apart, given in the prodromal 
period, or at the very beginning of a paroxysm, will invariably cut it short 
within an hour (Sprimon, Ungar, etc.). Acetanilid, the mysterious and striking 
powers of these two agents are best demonstrated in severe migraine (Whitla). 
Phenacetin, has been given with great benefit, in doses of 2 grains with yi 
grain of Caffeine Citrate, for migraine. Belladonna, when due to vaso-motor 
spasm, the face being pallid (B); the tincture in small and repeated doses if 
the disease be of reflex character (H). Iris, in blinding form, from hepatic 
trouble, right supra-orbital region ; n\j every half-hour for 3 doses, usually 
relieves promptly (Pf). Cannabis Indica, one of the most valuable remedies 
for megrim or sick headache, apparently acting on the nervous centre whence 
the disorder springs ; is most useful in the intervals to prevent the attacks, and 
especially when the paroxysms are becoming more frequent; it may be com- 
bined in pill with either Iron or Aloes (K) ; of especial value in the con- 
gestive form, the tincture in repeated doses until physiological action 
is induced (H) ; gr. y^ of the extract before each meal, increased gradu- 
ally to yi or % grain, in the intervals, kept up for 3 months (Seguin) ; 
gr. )/% of the solid extract night and morning, very efficient in migraine, if used 
continuously for some time (Hare). Camphor, gr. iij-v, with xx or xxx-grain 
dose of Magnesium Carbonate, is very useful, especially in hysterical females 



HEMIOPIA. 



685 



(P). Croton-chloral, in milder forms without severe vomiting, headache 
being predominant ; the Bromides are useful after it (R) ; rarely of any use, 
but if given it should be in 20-grain doses twice daily (H) ; Guarana, is useful 
(B), a very effective palliative ; gr. xx every ]/ z hour, for three hours (P); its 
efficacy diminishes by degrees, attacks usually becoming longer (Tr); 3tj of 
fluid extract in course of an hour or two, to anticipate the attack when expected 
(Seguin). Caffeine, in typical migraine; gr.j hypodermically (P) ; is espe- 
cially adapted when chronic gastric catarrh, gr.j every half-hour (B) ; the 
Citrate in grain doses every hour for some time before a paroxysm (Wa) ; gr.j 
every half-hour often gives marked relief (Smith). Valerian, of especial value 
when hemicrania in excitable temperaments, and after profuse or painful 
menstruation (P). Ammonium Chloride, is exceptionally serviceable ; seldom 
fails to cut short an attack (Austin) ; x-xv gr. doses (R) ; as a diffusible 
stimulant is very efficient, gr. xx up to Z] every hour during the attack (H). 
Sodium Chloride, in small doses, proved very efficient in six positive cases 
attended by gastric distress (Rabon). Podophyllin or Mercury, when of bilious 
origin (R). Bromides, for true migraine; Raspail's Eau Sedative locally, gives 
great relief (B ) ; when due to uterine disorder (R). Potassium Bromide, 
very serviceable in the paroxysm, also in continuous form (R). Eucalyptus, 
in cerebral anaemia (B). Digitalin, gr. fa bis die in granules for congestive 
hemicrania (B). Ergot, if due to miliary aneurisms of intercranial arterioles ; 
also in congestive migraine and in nearly all kinds (B). Menthol, locally in 
frontal headache due to migraine, is said to be very efficient (Wa). [See for- 
mula below.] Piscidia, is highly recommended (Wa) ; efficient in doses of £ij 
of the fluid extract (Ford). Arsenic, for cerebral congestion and hemicrania 
(B) ; for throbbing pain in one brow (R) ; often has the best effect: Watson 
believed that gtt. iv-vj of Liq. Arsenicahs, 3 or 4 times a day, with due attention 
to the bowels, would cure 9 out of every 10 cases (Wa). Aconitine or Vera- 
trine, ointment over brow (R) ; Aconitine internally is of great service (Seguin). 
Phosphorus, is strongly recommended (R). Amyl Nitrite, by inhalation, in 
migraine with pallor of face (R). Sanguinaria, a few doses very successful, 
when migraine is due to gastric derangement (P). Ignatia, removes clavus 
hystericus (Pf ). Nux Vomica, when of gastric origin (R). Cimicifuga, is 
strongly recommended (P). Rubber Bandage, applied tightly from eyes up, 
protecting the temporal arteries by pads, or a dry muslin bandage wetted after 
being put on (Weir Mitchell). Acupuncture, the needle run down to the cra- 
nium will give relief in clavus hystericus, when nothing else will do so (Pan- 
coast). [Compare Headache, Bilious Sick, and Nervous.] 



Prescriptions. 



R 



Quininse Sulphatis, . . . 5 ss. 

Pulv. Belladonnae, . . . . gr. x. 

Ext. Digitalis, gr. xv. 

Ext Valerianae, 3 ss. 

Mellis, q. s. 

Ft. pil. no. xl. Sig. — 2 to 10 pills daily, 
gradually increased, during three or four 
days before the expected attack. 



R-. Mentholi, gj. 

Alcoholis, ^j. 

01. Caryophylli, 

01. Cinnamomi, . . . aa TTlxx. 

M. Sig. — A.pply with finger over seat 
of pain. 



R- . Ammonii Chloridi, . . . £vj. 

Ammonii Bromidi, . . . g iv. 

Spt. Etheris Nitrosi, . . ^j. 

Syr. Pruni Virgin., . . . j|iij. 

Aquae, q. s. ad t ^vj. 

M. Sig. — Dessertsp. 3 or 4 times daily, 
conjoined with the use of RaspaW s Eau 
Sedative (see page 122), locally. 



R. 



Aconitinae (Duquesnel), . gr. y^. 
Alcoholis, 

Glycerini, aa %]. 

Aq. Menth. Pip., . q. s. ad 31'j. 
M. Sig — Teasp. thrice daily. 

(Segttiii. 



Hemiopia. 

When established, hemiopia offers little hope of cure, though it has no ten- 
dency to progress. In hemiopia scintillans, Potassium Bromide, gr. xl-lx 



686 



HEMIPLEGIA HEMOPTYSIS. 



daily, or a band of such metal as idiosyncrasy of the patient may decide, with 
stimulants to ward off the aura ; Quinine, Iron, Hydropathy, when Potassium 
Bromide fails (De Wecker). 

Hemiplegia. 

Strychnine, is most useful when members are relaxed ; hypodermically, 
when paralysis incomplete, and the muscles flaccid but not wasted (B). [See 
Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally 
proves effectual (Wa). Galvanism, constant current to the brain or cord, 
faradic to the muscles opposite those contracted (Hammond). Physostigma, 
prevents muscle wasting, and hence is given with benefit to hemiplegics; gr. 
3 1 - 1 1 of the extract repeated frequently (R). Massage, in hemiplegia and 
other forms of paralysis due to intercranial lesions, when cold and blue skin, 
wasting and contracted muscles, ulcerations, etc. (B). Cocculus, in hysterical, 
epileptic and choreic hemiplegia, acts well ; also in hemiplegia from cold (P). 
[Compare Paralysis Facial.] 



Hemoptysis. 

Atropine, gr. j^j hypodermically, is remarkably efficient in stopping the 
bleeding in phthisical hemoptysis (Squibb). Gallic Acid, exceedingly effective 
(P) ; may be combined with Ergotin and Digitalis. [See Hematemesis and 
Hematuria for formulae.] Lead Acetate, with Opium (B) ; proves signally 
useful (Wa). Ergot, the fluid extract in 30 to 40 minim doses, every 3 or 4 
hours, or hourly in severe cases ; or Ergotin hypodermically for urgent cases, 
in 2 to 3 grain doses (R). Opium, should be freely used for the attendant 
excitement (W). Chloral, is used with benefit, its vaso-dilator power probably 
acting as a derivative, and its sedative influence allaying excitement. Ipecac- 
uanha, has been highly praised (R) ; in emetic doses arrests hemoptysis (Tr), 
though in poisonous doses produces it (P) ; a well-founded case is recorded 
where Ergot and Gallic Acid utterly failed, and Ipecac was effectual ; but it 
must be pushed to the nauseating point, in order to effect the control (Squibb). 
Turpentine, in drachm doses every 3 hours, may cause unpleasant symptoms 
which soon disappear on its discontinuance (R) ; has proved very efficient (P) ; 
after other hemostatics fail it is worthy of trial (Wa). Alum is serviceable in 
purely atonic hemorrhages (Wa) ; in 10 grain doses every 2 hours (B). Oil of 
Erigeron, is very efficient when no fever or other signs of constitutional irrita- 
tion (Wa). Hamamelis,rnJ-ij of tincture, every 2 or 3 hours (R) ; tt\AJ- x °f 
fresh tincture several times a day (Pf ). Ferric Acetate, a little added to water 
so as to taste, this constantly sipped (R) : Iron spray will often arrest (B). 
Digitalis, has undoubted power over hemoptysis (B) ; small doses daily (P) : 
infusion in large doses (R). Arnica, of great service, if from violence (P). 
Aconite, employed with best results (P). Sodium Chloride, half a teaspoonful 
of common salt, taken dry, repeated till nausea (R). Sulphuric Acid, the dilute 
acid a useful adjunct to other treatment (Wa). Spinal Hot-water Bag, to cer- 
vical or upper dorsal vertebrae (R). Auxiliaries, Cold externally, acidulated 
drinks, perfect rest, and antiphlogistic diet (Wa). 



Prescriptions. 



R. Ext. ErgotseFl., .... ^jss. 
Ext. Ipecac. Fl., 
Tinct. Opii Deod., . . aa gij. 
M. Sig. — Teasp. every ]/ z hour. 



R- . Plumbi Acetat. , gr. xx. 

Pulv. Digitalis, gr. x. 

Pulv. Opii, gr. v. 

M. ft. pil. no. x. Sig. — One every 4 
hours. (B.) 



R. Aluminis, gj. 

Sacch. Alb., 3 ss. 

Pulv. Ipecac. Comp., . . gr. xx. 
M. ft. pulv. no. vj. Sig. — One powder 
every 2 hours. [Skoda.) 



& . Liq. Ferri Subsulph. , . . Tiycx. 
Aquae, ......... jfij. 

M. Sig. — Use as spray by inhalation for 
5 minutes every hour. 



HEMORRHAGE. 687 



Hemorrhage, Hemorrhagic Diathesis. 

Sulphuric Acid, sometimes very effective in uterine hemorrhage (B). Dilute 
Vinegar 10 leech-bites, piles, cuts, etc. (R). Apple-vinegar as injection for vesical 
hemorrhage. [See under Hematuria.] Iron, when hemorrhagic diathesis due 
to anaemia ; the tincture of the Chloride preferred (B) ; this tincture as a styptic 
(Wa); 1 or 2 teaspoonfuls of the concentrated solution in a glass of water an 
excellent hemostatic (Tr) ; the Acetate, just enough to make water taste, in 
hemorrhage of lungs and kidneys (R). Ergot, in uterine hemorrhage of any 
kind, and many forms of hemorrhage, Ergot or Ergotin of great value (P) ; 
not to be relied on alone (B). Antipyrin, is a most efficient hemostatic ; a 4 
per cent, solution checks general oozing from a bleeding surface ; as a styptic 
it constricts the small vessels without causing an external clot to break down 
(Park). Alum, is sanctioned by high authority (B) ; dusted on in slight cases 
(R) ; in uterine and traumatic hemorrhage, when small vessels open (Tr). 
Hamamelis, rr\J — ij of tincture every 2 or 3 hours, effective in many forms (R). 
Ipecacuanha, produces hemorrhage in poisonous doses, yet has great energy 
in arresting it (P) ; exercises a powerful influence on internal hemorrhage 
generally, and in exhaustion therefrom ; gr. j— ij every % hour (Wa) ; in emetic 
doses serviceable (Tr). Turpentine, few agents more useful in the passive 
forms (B) ; small closes in hematuria (R) ; for serious hemoptysis, and hemorr- 
hage of typhoid (P). Belladonna, hemorrhage from rectal ulcers (P). Digitalis, 
in uterine, and many other forms, of great value (P) ; with restoratives has 
undoubted power in the hemorrhagic diathesis (B). [See Hemoptysis.] Bone- 
marrow, in hemophilia due to anaemia (see page 133). Gallic and Tannic Acid, 
in all passive hemorrhages, especially in that of the bladder (P) ; Tannic Acid 
for local use, Gallic for systemic effects upon remote parts : when hemorrhage 
occurs in relaxed and debilitated constitutions, Gallic Acid may be combined 
with Ergot and Digitalis (B). Matico, proves useful in many cases, especially 
menorrhagia, hematuria, and hemoptysis (Wa). Nux Vomica, in hemorrhagic 
diathesis, especially when occurring in anaemic subjects ; also the Syrup of Iron, 
Quinine, and Strychnine Phosphates ; no prescription more generally useful 
(B). Aconite, to reduce the circulation, in epistaxis, hemoptysis, etc. (P). 
Cinchona, internally very efficient in some forms of hemorrhage (Tr). Copper 
Sulphate, in stick, solution or ointment, to arrest hemorrhage from small vessels 
(R). Arnica, in ecchymoses from mechanical violence (P). Rhatany, the 
extract, one of the most powerful hemostatics (Tr). Haematoxylon, is devoid 
of irritant qualities and is therefore well adapted to check the diarrhoeas and 
hemorrhages of young children. Grape-cure, as tonic for convalescents (P). 
Alcohol, in hemorrhagic diathesis, to elevate the arterial tension (B); Brandy, 
Wine, when heart suddenly enfeebled by hemorrhage (R). Venesection, will 
promptly 'arrest pulmonary hemorrhage (B). Styptics, are either needless or 
inefficient, hence practically useless in general surgery; hemorrhage should be 
controlled by either pressure or ligation (Roberts). Hot Water, sponged over 
a bleeding surface, is the best agent to stop hemorrhage (Gross). Transfusion, 
when death imminent (B). Ice, internally in wounds or hemorrhage of lungs, 
or from stomach ; small pieces frequently (R). Rest, perfect rest is often 
indispensable, especially in hematemesis, in which nutrient enemata may be 
required. [Compare Dysentery, Ecchymosis, Epistaxis, Hematemesis, 
Hemoptysis, Hemorrhoids, Hematuria, Hemorrhage Post-partum, 
Intestinal, Menorrhagia, Metrorrhagia, Purpura, Wounds, etc.] 



Prescriptions 
Pancoast ' 's Styptic. 
R. Potassii Carbonat., . . . 3 ij. 

Saponis, 2-HJ 

Alcoholis, 3'ij- 

Mix and use as a styptic especially for 



R. Ext. Ipecac. FL, . , . . 3: ij- 
Ext. Ergotae Fl. , . . . . 3 iv. 
Ext. Digitalis FL, . . . . 3 ij. 

M. Sig. — Half teasp. to a teasp. at a 
dose, repeated as required. An excellent 



operations about the face. {Jos. Pancoast.) j anti-hemorrhagic combination. (B.) 



688 



R 



Pagliari 's Styptic. 



HEMORRHAGE. 

and put up in stoppered bottles. 



V1IJ. 

J- 



Tinct. Benzoini, . . . . g \ 

Aluminis, lb. 

Aquae, lb. x. 

Boil 6 hours in a glazed earthenware 
vessel, adding hot water in lieu of that 
vaporized, and keeping well stirred; filter, 



Be ■ Infusi Digitalis, ^ij. 

Ext. Erg tae Fluidi, 

Tinct. Krameriae, . . . aa Jj. 
M. Sig. — A tablesp. as required in 
hemorrhagic conditions generally. (B.) 



Hemorrhage, Intestinal. 

Turpentine, should be used (B) ; especially in that of typhoid (P). [See Hema- 
teme.->is, for formula.] Belladonna, for irritable and bleeding rectal ulcers (P). 
Iodine, in passive form, gtt. j-ij of tinct. frequently repeated, of great service 
(B). Sulphuric Acid, is serviceable (B). Lead Acetate, often of great service, 
especially when used as an enema (Jenner). Tannin, one of the most ser- 
viceable remedies for the intestinal hemorrhage ot typhoid fever (B). Ham- 
amelis, very effective in intestinal hemorrhage, owing to its large proportion 
of Tannin (B). Ergot is most valuable; may be given hypodermically in 
urgent cases (R). Gallic Acid, gr. xv with gtt. iij-iv of Laudanum, in a winegl. 
of iced water every 2 or 3 hours in the hemorrhage of typhoid (Jenner). 
Opium, a valuable adjunct to astringents, alliying the nervous exutement 
(Wa) ; most useful (Da C). [Compare Hemorrhoids, Dysentery, Typhoid.] 



Hemorrhage, Post-partum. 

Atropine, hypodermically, is remarkably efficient. [See under Abortion.] 
Hamamelis, for persistent oozing (R). Ipecacuanha, in flooding after delivery 
(R). Iron, Monsel's solution, j to iij of water, strong enough and safe as 
injection (B); the Perchloride diluted (R). Amyl Nitrite, tt^v bv inhal ition, 
has stopped a hemorrhage promptly and permanently (Kerr). Ergot, a full 
dose of the fluid extract as soon as birth is completed, as a prophylactic (Play- 
fair) ; hypodermically in urgent cases, gr. ij of Bonjean's Ergotin deeply into 
the tissues of the arm (Wa) ; £ss doses of the fluid extract every 2 to 4 hours 
in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, 
especially when tediously prolonged (P). Digitalis, the infusion best ; a 
tablesp. bis die, or in urgent cases every half hour for 4 doses (B). Nux 
Vomica, gtt. xx ; Ext. Ergotae Fl. gtt. xxx ; each hour for 2 or 3 do-es (B). 
Opium, the tincture 3j with Brandy, in profuse flooding (R). Vinegar, a 
handkerchief soaked in vinegar and carried into the uterus, will often check 
a severe hemorrhage (Landis) ; is antiseptic, astringent and sufficiently irrita- 
ting to produce contraction, yet not so irritating as to cause subsequent mis- 
chief, and always acts promptly (Penrose). Tamponade by absorbent cotton, 
plugs of linen, etc., is indicated in hemorrhage trom abortion or pi icenta 
pnevia (Parvin) ; never tampon after delivery ! you might as well hang the 
woman by the neck (Wallace). Auxiliary Measures of importance are firm 
pressure on the uterus, compression of the abdominal aorta, the plug, and if 
necessary intra uterine injections (Wa). Hot Water, no to 122 F., injected 
into uterus, extremely successful in checking post-partum hemorrhage (Att- 
hill) ; the most prompt and certain method, and the least unpleasant to the 
patient (Parnsh). [See also Dr. Cameron in Canada Med. and Surg. Jour., 
March, 1878, with record of 16 cases so treated.] Ice, to abdomen or within 
the womb (B); into womb or rectum (R); as a prophylactic against hem- 
orrhage and to secure firm contraction of the uterus, a good method is to 
grasp the womb through the abdominal parietes with a hand kept cold by 
frequent immersion in a pan of broken ice, while waiting for the expulsion of 
the placenta ; while one hand is kept on the uterus the other may be immersed 
in the ice. Transfusion of milk into veins may be necessary in cases of col- 
lapse (Thomas). 



HEMORRHOIDS. 689 



Hemorrhoids. 

Galls, as ointment, very useful ; the official Unguentum Gallae, or Galls com- 
bined with Lead and Opium (R). [See formula below.] Iron, a solution of 
the subsulphate as wash to bleeding piles, which should then be well oiled (B) ; 
or an ointment of the same (Basic Ferric Sulphate) gr. xv to the 3, locally night 
and morning, with gr. j of the salt thrice daily by mouth ; gives excellent 
results. Hamamelis, by mouth, also as lotion or injection in bleeding piles (R) ; 
is employed with satisfaction; tt\,ij-x of tincture several times a day; also as enema 
or suppository (Pf ). Nux Vomica, emphatically beneficial (P). Sulphur, gr. v-x, 
with 3j Confec. Sennas, as laxative (R) ; exercises a most soothing influence 
(Wa). Sulphides, especially Blue Lick water (B). Podophyllum, as cathartic 
for hemorrhoids of recent formation, bleeding from stasis in portal circulation 
(B). Aloes, causes congestion of pelvic viscera, yet Fordyce Barker shows it 
to be curative in piles, especially in recent ones, as after delivery (B) ; to greatly 
relieve bowels (R) ; cures by removing constipation (P). Hydrastis, as lotion 
or ointment to external piles, of great value ; n^v of tincture ter die internally 
at same time (P). Ergot, with or without Nux Vomica, in dilated hemorrhoidal 
veins without new tissue, given by the stomach and used locally will often cure 
(B). [See Diarrhcea for formula.] Stillingia, will remove permanently when 
due to constipation, and temporarily when from hepatic obstruction (B). Senna, 
to procure soft and easy evacuations use the Confectio Sennae at bedtime, gr. cxx 
in a bolus (B). Iodoform, the ointment, and in suppository (B). Nitric Acid, 
as caustic, followed by free use of Olive Oil (B) ; ^ss-Jj ad Oss of water as 
lotion for bleeding piles (R). Hyoscyamus or Stramonium, leaves bruised, 
or ointment, locally, for pain (P). Linseed Oil, boiled, in doses of ^ij twice 
daily, has quite a reputation as a remedy for piles (W). Alum, to painful 
bleeding piles, a crystal trimmed and passed into rectum, or as an ointment 
(B). Ice, to painful, bleeding piles, or cold water injected daily (B) ; locally 
for pain after operation (R). Leeches, directly to swollen, irreducible, and 
painful piles (B). Alkaline Mineral Waters, excellent (B). Carbolic Acid, 3 
parts to 1 of Olive Oil, a few drops injected into the tumor ; a favorite and suc- 
cessful treatment by itinerants (Andrews) ; uncertain in all cases and in many 
fraught with danger (Gross) : a good procedure : use 4 drops each of pure Car- 
bolic Acid and Glycerin , and inject one tumor at a time (Hunt). Grape-cure, is 
used with success (B). Saline Purgatives, notably Epsom salts, combined with 
Sulphuric Acid, will often stop the hemorrhage (B). [See Dysentery for 
formula.] Diet, etc., avoid stimulants, indigestible food and over-eating ; during 
an attack use little animal food. Petroleum soap when piles protrude, with cold 
or tepid water ablutions. Injections, Oj of cold or tepid water, are very useful. 
Stool should be at night. Surgical Methods are : the ligature for internal hemor- 
rhoids, excision for external ones. Ligation, is the proper treatment for the 
former, all other methods of operating radically being now discarded asunsur- 
gical and dangerous to life (Gross). Thermo-Cautery is used by Smith of Lon- 
don and many other surgeons, but is apt to leave behind fissures and ulcers, 
which are with difficulty healed. Prevention, soft seats favor the production of 
piles, as also of uterine disorders, by pressure on the arteries as they emerge 
from the pelvis, tending to drive the blood into the interior of that cavity 
(Holden). 



Prescriptions. 



R. Iodoformi, gj. 

Balsam. Peruv., gij. 

Magnes. Calcin., .... Jjj. 

Cetacei, 3 ss - 

01. Theobromse, . . . . q.s. 



$. Ext. Colocynth. Co., . . . gr. xxx. 
Ext. Nucis Vom., . . . . gr. vj. 
Hydr. Chlor. Mitis, 
Ext. Hyoscyami, . . . aa gr. xij. 
M. et div. in pil. no. xij. 



M. et fiant suppositoria xij. Sig. — One j Sig. — One as required for sluggish bowels. 
twice daily. [Potter. ) \ [Barker.) 

44 



690 



HEPATALGIA HEPATIC CONGESTION. 



R . Pulv. Gallse, gr. xx. 

Pulv. Opii, . gr. x. 

Ung. Plumbi Subacet. , . . gr. xl. 

Ung. Simplicis, ^j. 

M. et. ft. unguentum. Sig. — Ointment 
for piles . ( (Esterlen. ) 

R. Pulv. Gallse, 

Pulv. Opii, 

Plumbi Acetat, . . . . aagr. xx. 

Ung. Picis Liquidae, 

Cerati Simplicis, . . . aa 5 ss. 
M. et. ft. unguentum. Sig. — Apply night 
and morning after bathing parts with cold 
water. 



R. Ext. Opii, gr. x. 

Pulv. Stramonii, . . . . 3J. 

Pulv. Tabaci, gss. 

Ung. Simplicis, gss. 

M. Sig. — Ointment for piles. 

[ShoeriiakerJ) 



B 



M 



Ac. Carbolici, gij. 

Ac. Tannici, ^j. 

Alcoholis, ziv. 

Glycerini, l|ij. 

, Sig. — Hypodermic injection for piles. 
(Girard.) 



Hepatalgia. 

Ammonium Chloride, 20 to 30 grains every 4 hours, is highly efficacious 
(Anstie). Bryonia, worthy of commendation in many liver affections (P). Nux 
Vomica, has been found of much benefit; dose should be small, gr. yi^ to^\ 
twice or three times a day (P). Quinine, would naturally be thought of in 
malarial subjects, but does not afford any relief (Anstie). 



Hepatic Cirrhosis. 

Diuretin, for the dropsy. [See under Dropsy.] Nitric Acid, in long-stand- 
ing diseases, as this will augment flow of bile after liver has struck work from 
mercury (R); the mineral acids do not benefit (B). Arsenic, small doses 
perseveringly, give good results in improving the nutrition of the organ (B). 
Aurum, the Bromide of Gold and Arsenic has been used with benefit (Barclay) ; 
the Chloride of Gold and Sodium, in doses of gr. -fo, as an hepatic alterative, 
may be used conjointly with Sodium Phosphate (B). Sodium Phosphate is said 
to produce good results (Da C) ; has power to retard the sclerosis, and may 
possibly arrest the changes and restore a state of comparatively normal func- 
tion (B). Iodides, are the best remedies for the first stage (B) ; Potassium 
Iodide is highly recommended by some authorities (Da C) ; the great measures 
in the treatment of this affection are Potassium Iodide, hydrotherapy, and a 
milk diet (Lanceraux). Stillingia and Alkaline Mineral Waters, are important 
in the first stage (B) ; Alkalies early, especially Carlsbad water, with total ab- 
stinence from alcoholic beverages (Legg). Mercury, Corrosive Sublimate in 
small doses, gr. -fa thrice daily, for a long time, does benefit the condition, and 
has possibly cured a few cases (Da C). Tapping becomes necessary for the 
dropsy, though purgation and diuresis may help to lessen it (Id). Diet, should 
be easily digested, especially milk, avoiding starches and fats, and quitting al- 
cohol (Id). [Compare Ascites.] 



Hepatic Congestion. 

Nitric Acid, in chronic congestion, will augment flow of bile after liver has 
struck work from excessive use of mercury (R). Nitro-Muriatic Acid, is found 
useful in India, with the acid bath (^iij ad gall, j) to hypochondrium (B) ; 
formerly held high rank but is now superseded by Ammonium Chloride ; the 
acid baths being now rarely employed (Fayrer). [See page 528 for formula.] 
Sulphur, as Sulphates in purgative natural waters, small doses often repeated; 
Potassium Sulphate is occasionally poisonous (R). Chelidonium, as deob- 
struent (P) ; energetically affects the liver (Pf). Iodine, tincture and ointment 



HEPATIC CONGESTION. 



69I 



locally for hepatic engorgement after malarial attack ; also Ammonium Iodide 
in moderate frequent doses, in functional derangement from malarial disease 
(B). Sodium Phosphate, 3j-ij, 3 or 4 times daily, in plenty of water, as a 
purgative (B). Ammonium Chloride, in passive congestion, and chronic tor- 
pidity, is well worthy of attention ; gr. xx every 4 hours (Wa) ; an excellent 
remedy (Da C). Turpentine, epithems, hot, often found very beneficial (Wa). 
Quinine, gr. xv-xx with Morphine, gr. X~K> m tne acute congestion due to 
climatic or malarial causes, no remedy so efficient (B). Bryonia, is worthy of 
commendation in liver affections of various kinds (P). Iris, really serviceable 
when stools clay-colored and skin jaundiced (B) ; is one of the best aperients 
in hepatic derangement (P). Mercury, valuable only as a purgative ; its use 
restricted to cases where there is deficiency or excess of bile (B) ; a full Calo- 
mel purgative is of utility in cases of congestion (Wa). Podophyllum, the 
resin in congestion of the portal circulation, is especially useful (B) ; gr. l /6-% 
doses every six hours will speedily relieve symptoms (P). Sanguinaria, is 
useful in hepatic engorgement without organic disease (P). Colchicum, in 
hepatic congestion and dropsy; an active remedy in congestion of the liver 
(B). Resin-bearing Purgatives, as Rhubarb, Podophyllum, Iris, Euonymus, 
etc., are all actively cholagogue. [See list on page 48.] Ipecacuanha, decidedly 
stimulant to the flow of bile (B) ; is the Indian treatment now for the local 
liver, given in large doses for a week or two (Da C). Taraxacum, has had a 
reputation, but I cannot recommend it (Id). Aliment, no starches or fats ; 
give milk, eggs, oysters, beef broth, whitefish, etc. (B). Cold Water Belt 
around the abdomen, covered with oiled silk, gives great comfort in chronic 
cases (Da C). [Compare Biliousness, Jaundice, etc.] 



Prescriptions. 



R. Elaterii, , . gr. j. 

Spt. ^Etheris Nitrosi, . . Jij. 
Tinct. Scillae, 

Tinct. Colchici, .... aa;f ss. 
Syrupi Simplicis, . . . . ^j. 
M. Sig. — Teaspoonful thrice daily. 



(B.) 



R 



Hydrarg. Chlor. Mitis, . . gr. vj. 

Pulv. Ipecac, gr. j. 

Sodii Bicarb., gr. x. 

Div. in pulv. no. ij. Sig. — One at bed- 
time, followed by the following : — 

R. Ac. Nitro-hydrochlor. Dil., j^-iij. 
Elix. Taraxaci Co., . . ad Jvj. 
M. Sig. — Dessertspoonful before meals, 
and a milk diet. 



R . Ext. Taraxaci, gr. lxxij. 

Ext. Aloes, gr. xxiv. 

Ext. Colchici Rad. , 
Pulv. Ipecac, . . . .aagr. xij. 
M. et div. in pil. no. xxiv. 
Sig. — 2 nightly in chronic enlargement 
and torpidity. [Martin.) 



R . Sanguinariaa, . 


. . gr. viij. 


Podophyllini, . . . . 


• • gr- iij- 


Ext. Hyoscyami, . . 


. . gr. nj. 


Saponis, 


. . gr. viij. 


M. et div. in pil. no. xx. 




Sig. — 2 to 4 pills daily. 


In hepatic tor- 


por without organic disease. 


{Phillips.) 



R . Pil. Hydrargyri, 

Pulv. Aloes Socot., 
Pulv. Rhei, 
Ext. Hyoscyami, . 
M. et div. in pil. no. vj. 



aagr. vj. 



Sig. — 2 pills every other night. 



R 


Cinchonidinse Su 
Euonymini, 
Leptandrini, 
Juglandini, 


ph., 






Irisini, . . . 




. aagj. 




Podophyllini, 








Ext. Belladonnse, 








Ext. Hyoscyami, 




. aagr. x. 




M. et div. in pil. no 


lx. 






Sig. — One pill thrice 


daily 


In obstinate 


He 


;patic torpor. 




[Blackwood. ) 


R 


Euonymini, . . 




• • gr- xij. 




Ext. Hyoscyami, 




• • gr- vj. 




M. et div. in pil. no 


vi- 






Sig. — One at bedtime, 


followed next 


m 


orning by a full dose of an 


aperient min- 


ei 


al water. 







R . Potass. Bicarb. , 

Potass. Citratis, . . . . aa^j. 

Syrupi Simplicis, . . . . jvj. 

M. Sig. — A teaspoonful to a tablesp. 

with a similar quantity of lemon-juice, in 

]/ z glass of water ; the whole to be drank 

while effervescing. ( Wood. ) 



692 HEPATIC DISEASES HEPATITIS. 

Hepatic Diseases. 

Ammonium Chloride is highly serviceable in all cases of liver disease, 
whether due to organic changes or to functional derangement ; especially indi- 
cated after the more acute symptoms have abated (Wa). Nitro-hydrochloric 
Acid, formerly held high rank, but is now superseded by Ammonium Chloride 
(Wa) ; even the acid baths, so long considered of great importance, are now 
but little, if ever, used in India (Fayrer). Nitric Acid acts in some way bene- 
ficially on long-standing liver-diseases, as in chronic congestion and cirrhosis 
(R) ; with vegetable bitters, long continued, useful in waxy liver (Wa). 
Podophyllum has a high reputation in a variety of liver diseases (P) ; is actively 
cholagogue (R). Mercury, mercurial purgatives are used for both deficiency 
and excess of bile ; harmful in many acute forms of hepatic disease, and gen- 
erally are of doubtful propriety in liver affections (B); in hepatic congestion a 
full Calomel purge is of great benefit (Wa). Red Mercuric Iodide, as oint- 
ment, gr. j to 3v, gives best results in malarial enlargement of the liver (W). 
Calomel is used in inflammatory disorders of the liver, but is less suited to par- 
enchymatous than to serous inflammations (Da C). Ipecacuanha promotes the 
flow of bile (B) ; may be used in small doses with great advantage in func- 
tional derangement of the organ (Wa). Resinous Purgatives, as Leptandra, 
Iris, Euonymus, Rheum, etc., are decidedly cholagogue (B). Euonymin is of 
great value in torpid liver and its accompanying headache (W). Bryonia is 
worthy of commendation in liver affections of various kinds (P). Chelidonium 
powerfully affects the liver (Pf). Taraxacum is highly recommended in all 
chronic affections of the liver, especially in indolent enlargement and incipient 
scirrhus (Watson). Sodium Phosphate is cholagogue, and extremely useful in 
liver affections, especially the jaundice of children and hepatic calculi (Thudi- 
cum). Phosphorus specifically affects the liver, and used early in acute yellow 
atrophy may have an action of antagonism upon the disease (B). Potassium 
Salts, as depuratives, are of decided value, especially the Citrate, in hepatic 
torpor and other affections (W). Sulphur, the sulphurous mineral waters, pro- 
longed, give excellent results in liver disorders (B). Alkaline Waters are very 
serviceable (B) ; especially the sulphur waters ; Glauber's salt in their place 
(Da C). Chlorine Water has been employed with benefit in chronic hepatic 
affections, in doses of 3ss-ij j n ^jjj or iv of water (W). Iron preparations, 
long continued, in amyloid degeneration (Da C). Gentian, and other bitter 
tonics, in functional disorder ; also Nux Vomica occasionally, but use Mer- 
curials and Podophyllum sparingly (Da C). Iodine and Iodides in waxy en- 
largement, simple hypertrophy and chronic congestion, of great value (Wa) ; 
Potassium Iodide alternately with Ferrous Iodide in waxy liver (Frerichs) ; a 
few drops injected into hydatids (B). Sanguinaria is of great value in hysteria 
from chronic hepatitis, and in hepatic engorgement without organic disease (P). 
Stillingia for torpid liver and jaundice following ague, in the first stage of cir- 
rhosis, and in ascites from hepatic changes (B). Malt Liquors are harmful in 
all chronic affections, especially in fatty liver (B). Galvano-puncture for hy- 
datids, the negative needle into the hydatid (B). [Compare Lists of Agents 
acting on the Liver, page 48 ; also, the articles in this section entitled Bilious- 
ness, Calculi, Cancer, Hepatalgia, Hepatic Congestion, Hepatic Cir- 
rhosis, Hepatitis, Jaundice] 

Hepatitis and Hepatic Abscess. 

Ammonium Chloride, is almost a specific in hepatitis and abscess of the liver 
(Stewart) ; often preventing the latter disorder, and in many instances curing 
it (Wa). Quinine, in large doses for the acute parenchymatous inflammation 
(Da C) ; in medium doses persistently for a long time has done excellent ser- 
vice in chronic suppurative hepatitis without abscess but with frequent exac- 
erbations. Tartar Emetic, gr. %-%, every two or three hours, with Opium or 
Calomel as indicated by symptoms ; of especial value early in the acute attack 



HERNIA HERPES. 693 

(Wa). Leeches to margin of the anus in the acute type (B) ; to unload the 
portal system (Wa). Mercury is used, but is better suited to serous inflamma- 
tions than to parenchymatous ones (W). Chelidonium has been used with 
benefit in both acute and chronic hepatitis (F). Alkalies and Colchicum, 
when the affection is of a gouty nature (Wa). Sulphites are recommended in 
chronic forms (Da C). Sinapisms and Linseed poultices over the hepatic 
region in acute hepatitis (Wa). Saline Purgatives, as the Sulphate of Sodium 
or Magnesium, to increase the watery exudation from the mucous membrane 
of the intestines, in acute hepatitis (Wa). Nitro- Hydrochloric Acid, for some 
time, in the chronic form tending to abscess (Da C). Aspiration, when pus 
forms; early operation the rule of practice; has induced many recoveries 
(Id). [Compare Jaundice.] 

Hernia. 

Opium, or Morphine hypodermically to narcotism, often obviates the neces- 
sity of an operation in strangulated hernia (Wa). Chloroform, of evident bene- 
fit (Wa) ; inhaled to assist reduction (R) ; has superseded the use of Tobacco 
and Lobelia in strangulated hernia (P). Coffee, large doses, has certainly a 
remarkable influence in aiding or causing reduction of strangulated hernia 
(Wa). Thyroid Extract, causes herniae to vanish in a few weeks or months 
when due to accumulation of myxcedematous or fatty material in the abdominal 
cavity, and should be tried in hernial protrusions from any part of the abdomen 
before resorting to surgical means (Parker). Oak Bark extract, as injection 
into the tissues, for a radical cure by stimulating the occlusion of the rings 
(Heaton's radical cure) : a similar operation was patented by Dr. Gage in 1840, 
the Oil of Cloves being the injection used; Professor Pan coast injected tincture 
of Iodine for the same purpose. Operations for radical cure all unsatisfactory ; 
a properly adjusted truss is the best remedy for a reducible hernia, answering 
the purpose of a retentive apparatus, and often permanently curing the disease 
by the steady, gentle and uniform pressure of its block (Gross). Ice Poultice 
is of use if no strangulation of gut or omentum (Wa). Sternutatory, as snuff 
or Ipecac, to cause sneezing while patient lies on his shoulders with elevated 
hips and legs over the back of a chair, frequently successful after taxis has 
failed to effect reduction ; in this position the action of gravity, aided by the 
sudden action of the diaphragm, tends to draw inwards the posterior portion of 
the escaped gut, which is the part most difficult to manage by taxis. Cold 
Douche, with taxis properly performed and the position above described, will 
reduce 90 per cent, of the cases of strangulated hernia within a few minutes ; 
the cold water should be poured from a height on the tumor while taxis is being 
performed (Raiford). 

Herpes. 

Ferrum Arsenate, in doses of gr. £ daily, will effect the cure of a herpetic 
affection in the adult, however extensive or long established (Duparc). Mer- 
cury, Calomel ointment, 3j to the ^, is one of the best mercurial preparations 
(Pereira). Potassium Carbonate, as lotion, gr. xxx to Oj, to allay irritation 
(Wa) ; or as ointment, gr. xx to 3jj, smeared over eruption at night, and 
washed off in the morning with a solution, gr. xxx to Oj (Neligan). Myrtol, 
is curative of herpes (B). Glycerin, diluted, is a serviceable application in 
herpes labialis (Wa). Ergot, the Oil prepared by the action of Benzin upon 
Ergot, which, upon evaporation of the solvent, makes a valuable application in 
herpes genitalium and other skin affections (Shoemaker). Alum, in herpes 
praeputialis, a solution of Z] to ,^j aquae, applied on lint to the glans penis, is 
generally effectual (Wa). Collodion, the flexible form, is applicable to various 
kinds of herpes (Wa). Magnesium Citrate, as a cooling laxative, with soothing 
and protective lotions and ointments, and the Liquor Picis Alkalinus, diluted 
10 to 20 times for the itching (Bulkley). Astringent Lotions, of Tannin or 
Zinc Sulphate, in herpes praeputialis, to render the parts less sensitive (Da C). 
[For Herpes Circinatus see Tinea Circinata.] 



694 HERPES ZOSTER HICCOUGH. 

Prescriptions, 

R . Tragacanthae, 7, ij-iv. I R . Acidi Carbolici, gtt. v-xv. 

Liq. Calcis, 5iv. Pulv. Calamine Praep., 

Glycerini, ^j. Zinci Oxidi, aa ^ss-j. 

Aquas Rosse, ^iij. Ung. Aq. Rosae, . . . . gj. 

M. Sig. — A soft jelly for local use as i M. et ft. unguentum. 

ointment. A soothing and protective application. 



Herpes Zoster. 

Rhus Toxicodendron, very readily subdues, especially when burning or itch- 
ing (P). Aconite and Opium, locally for pain (Wa). Morphine, the oleate ex- 
ternally without friction (R) ; hypodermically to mitigate the pain (Anstie). 
Celandine has been recommended (P). Dulcamara, has an old reputation (P). 
Silver Nitrate, painted on the warning patch of erythema, before or as soon as 
vesicles begin to form (R) ; as a local application is reported on favorably (Wa). 
Veratrine, as ointment (gr. xx-xl to the ^), in neuralgia following shingles (R). 
Zinc Phosphide, gr. ]/$ every 3 hours, is said to control the pain and abort 
the eruption (Hughes). Grindelia, is reputed to relieve the pain (Stille). Mer- 
cury, the Ung. Hydrarg. Ammoniat. is said to relieve the pain and irritation re- 
markably (Wa). Blisters, for subsequent neuralgia (R). Hot Fomentations 
will often disperse (R). Baths daily, exercise out of doors, abundant nutritious 
food. Flexible Collodion, constantly reapplied to exclude air (Anstie). Gal- 
vanization of the affected intercostal nerves, the positive pole over their points 
of emergence, the negative brushed over the terminal filaments of the skin (B). 
Starch, dusted over the eruption, and on a muslin band sewed tightly around 
the body to protect it from the friction of the clothes, gives the greatest relief 
(Bulkley). Rest, absolute, when eruption is extensive (Fournier). 



Prescriptions. 



R- . Zinci Phosphidi, 

Ext. Nucis Vomicae, . . aa gr. x. 

M. et div. in pil. no. xxx. 

Sig. — One pill every 2 to 4 hours, as 
nerve tonic. (Biclkley.) 

R. Liq. Sodii Hypochlorite 



R. Bismuthi Subnitratis, . . £iv. 
Hydr. Chlor. Mitis, 

Zinci Oxidi, aa gj. 

M. ft. pulvis. Sig. — To be dusted on 
cotton-wool, and applied to the ulcerated 

Aquae, |jij. ! vesicles, after washing with the solution of 

M. Sig. — Wash for ulcerated vesicles. \ Sodium Hypochlorite. (Ponmier.) 



Hiccough. 

Morphine, hypodermically, often arrests hiccough (R) ; an injection of Mor- 
phine and Atropine together has stopped a most violent hiccough in which 
morphine alone and other agents had proved unavailing. Nux Vomica, in 5 
or 10 minim doses of the tincture, with npcv of dilute Nitric Acid ; a short 
course frequently curative (P). Chloroform, combined with Opium (R). Pepper 
gr. ij-x, to stop hiccough (P). Laurel-water, a useful remedy, ttLv (P). Cam- 
phor, has been recommended (R). Mustard, Z] infused in ^iv of hot water has 
cured most obstinate cases (R). Pilocarpine, gr. -^ of the Muriate, has cured 
bad cases which resisted all other means (Ortille). Ether, as spray to the epi- 
gastrium for ten minutes, then to the site of the phrenic in the neck (Regoni) ; 
or the spirit, rr^xx-xxx in some aromatic water, given internally, will often ar- 
rest the spasm immediately (Wa). Zinc Valerianate, gr. ^ , with a small por- 
tion of Extr. Belladonnas, cured a severe case of fifteen days' duration (Danet). 
Nitro-glycerin, sometimes arrests (R). In mild cases deep inspirations, hold- 
ing breath as long as possible, or a firm belt around epigastrium (T). 



HYDROCELE HYDROPHOBIA HYDROTHORAX. 695 



Hydrocele. 

Iodine, injection of the tincture 1, water 2, into the sac to excite obliterative 
inflammation, the usual procedure for radical cure after tapping the sac (Wa) ; 
may be used full strength, or with equal part of water; the latter the safest 
method in ordinary cases, but relapses are not infrequent (Gross). Carbolic 
Acid, £ss, with a minute quantity of water or glycerin to render it fluid, injected 
into sac and manipulated to bring all portions under its action, after which 
rest in bed and support to scrotum (Levis) ; a very efficient method for radical 
cure, but may cause erosion of vessels and hemorrhage into sac (Gross). Am- 
monium Chloride, as discutient lotion to the scrotum in hydrocele of children 
(Wa). Galvano-puncture, a current of 20 to 40 elements, by two needle elec- 
trodes, will invariably cure (B). Operations for radical cure include that by 
iron-wire sutures to excite adhesive inflammation (Simpson) ; and the incision 
of the hydrocele under antiseptic precautions (Volkman) ; the same end may 
be obtained by the simpler methods of injection noted above (Gross). [Com- 
pare Dropsy, Orchitis.] 



Hydrocephalus, Chronic. 

Mercury, holds a high place in the opinion of many ; Calomel gr. l /i-)/z 
twice daily, with mercurial inunction to the shaved head, or the latter alone ; 
child to wear a woolen cap ; this treatment for 30 or 40 days (Wa). Ferrous 
Iodide, with Cod-liver Oil, always gives good results among the poor (Wa). 
Iodine, as lotions. [See Meningitis Tubercular.] Potassium Iodide, may 
arrest progress (Wa) ; is of value certainly ; appears to have power of promot- 
ing absorption (Wa). Cod-liver Oil, sometimes improves the condition, espe- 
cially in scrofulous children (Wa). [Compare Dropsy.] 



Hydrophobia. 

Belladonna, in all hypersemic states of the brain and spinal cord, is one of 
the very best remedies (P). Stramonium, is used by Brahmins in India with 
apparent success. Glonoin, may be of benefit (Wa). Nicotine, rightly used, 
will probably prove to be our best remedy (B). Amyl Nitrite, should be fairly 
tried (B). Hydrastinine, is used with benefit, in grain doses of the Hydro- 
chlorate, hypodermically. Curare, is encouraging, gr. y z injected, 7 doses in 
5)^ hours, dispelled the symptoms, but replaced them by paralysis of the limbs 
continuing for over 2 months (Ros) ; has seemed to antagonize the convulsive 
phenomena (B). Morphine, chiefly palliative ; for deep injection into the teta- 
nized muscles (B). [See Tetanus.] Coniine, is indicated ; has not succeeded 
(B). Cauterization, with hot iron or Caustic Potash after cleansing wound, 
which should be kept open by Unguentum Basilicon for 5-6 weeks (Ros) ; with 
Silver Nitrate sharpened to a point, and applied freely to every sinuosity of the 
wound as preventive (Wa). Excision, the safer practice (Wa). Baths, warm 
and hot, produce calm (Ros). Rabies Toxin, the Pasteur inoculation with a 
" modified virus," protects the bitten person from the disease. (See page 479.) 
[For the Statistics of this treatment see ante, page 479.] 



Hydrothorax. 

Diuretin, has been employed with benefit. [See under Dropsy.] Digitalis, 
in the purely dropsical form, also in passive pleuritic effusions ; used as a diuretic 
(3j-ij of infusion bis die, or oftener) of great value (R). Elaterium, unques- 
tionably of value as a derivative, though many fear it (P). Jaborandi, pro- 
duces good results (B). Iodine, 3j of tincture injected in returning hydro- 
thorax (B). Sanguinaria, has been used with the best effects (Wa). Blisters, 



696 HYPOCHONDRIASIS HYSTERIA. 

when effusion has taken place, certainly seem to stimulate the absorbents to 
action (Wa). Dry Cupping, over the chest, gives relief (Da C). Thoracentesis, 
if much distress. [Compare Dropsy.] 



Hypochondriasis. 

Arsenic, in the aged, gives great comfort, especially when combined with 
Opium (B). Ignatia, is useful, the tincture is best (P). Cimicifuga, of singular 
value in puerperal hypochondriasis, and that accompanying spermatorrhoea, 
etc. (P). Aurum, the Chloride, gr. ^ to -^ ter die gives excellent results, when 
depression, vertigo, cerebral anaemia (B) ; Gold is an efficient remedy in hypo- 
chondriasis accompanying hepatic or testicular disease. Valerian, quickly re- 
lieves the flatulence of hypochondriacs (B). Asafcetida, especially indicated in 
cases marked by flatulence and gloom (B). Potassium Bromide, especially 
among female town-dwellers, but also in male (R) ; effects are variable ; re- 
lieves some, not others (Wa). Hyoscyamus, when syphiliphobia (P). Opium, 
stimulant doses of the tincture are of great importance (B). Caffeine, the 
Citrate, gr. j-v, has been used as a cerebral stimulant with advantage (B). 
Alcohol, in hypochondriasis gives temporary relief; should never be given for 
its narcotic or stimulant effects in these cases (W). Cocaine, especially useful 
in cases marked by debility and nervousness, and in mental affections accom- 
panied by depression ; the fluid extract of Coca may be used, either alone or 
in wine (Br). Turkish Baths, are useful for town-dwellers, with soft, flabby 
tissues, and mental depression (R). [Compare Melancholia.] 



Hysteria. 

Antipyrin, for the painful affections of hysteria. Aurum, the Bromide is of 
decided benefit, in doses of gr. % to % (Rosenbach). Arsenic, lessens mobility 
of the nervous system and improves nutrition (B). Opium, gtt. j of Laudanum 
with gtt. ij of the tincture of Nux Vomica, 3 or 4 times a day, for the flushes, 
weight on the head, depression, etc. (R) ; Opium is a useful agent if its identity 
be concealed from the patient, otherwise the opium habit is sure to follow. 
Ignatia, useful in many forms of hysteria, with feeling of suffocation, sensation 
as of a ball rising to the throat, convulsive crying, flatulence, etc. (P). Cam- 
phor, in hysterical excitement (P). Musk, for many anomalous and distressing 
symptoms (R). Chamomile Oil, in the spasmodic and pseudo-neuralgic 
affections of hysterical women, a very excellent remedy (P). Cimicifuga, in 
hysterical chorea, is rapidly curative (P) ; for the headache (R). Asafcetida, 
in hysterical convulsive affections, with flatulence and cough (P) ; arrests 
paroxysm, valuable for flatulence (B) ; removes headache, peculiar sensations 
in head, and flatulence (R). Valerian, has great value, 3ss doses of fluid ex- 
tract (B) ; useful in most cases, especially those of hysterical dyspepsia (P). 
Zinc Valerianate, especially at the climacteric age, for hysterical symptoms 
which can be traced to no particular cause (R). Ergot, with Iron and other 
tonics (see formula below), in cases depending on sub-involution of the 
uterus, with indigestion and anaemia (B). Nux Vomica, of great use in middle- 
aged subjects, when flatulence, weight on head, flushings and perspirations (R). 
Atropine, for hysterical aphonia, gr. T | n to -^ morning and evening (B). Ether, 
for the flatulence, and for the hysterical paroxysm in sudden seizures (B). 
Ammonia, the aromatic spirit for the acidity and eructations (B) ; the fetid spirit 
for flatulent colic, etc., may be given with great advantage in doses of 3ss-j 
(Wa). Potassium Bromide, gives control and prevents paroxysms ; when 
verging on nymphomania large doses required (R). Iron, a course often use- 
ful, especially when anaemia or uterine obstructions (R). Phosphorus, in 
hysterical paralysis (R). Orchitic Extract, is used with benefit. Cerebrinin, is 
employed with good results (Paul). Ovarian Compression, has in many cases 
relieved recent hysterical contractions, and many other similar phenomena 



ICHTHYOSIS IMPETIGO IMPOTENCE. 



697 



(Bourneville). Electricity, for aphonia, paralysis and anaesthesia, and to 
educate the nervous control ; is the sworn enemy of hysteria. Accessory 
Measures, occupation of mind and body; removal from influence of friends; 
complete abandonment of the use of alcohol ; the shower-bath or cold-bath, as 
an educator of the will, as well as to invigorate the body ; excitement to be 
avoided. The word Hysteria should never be applied to the case in the 
patient's hearing. Disorders of vision are often found at the bottom of hysteria ; 
look for hypermetropia and astigmatism. 



Prescriptions. 



R. Ext. Ergotae, 3jj. 

Ferri Sulphatis, gss. 

Ext. Nucis Vomicae, . . . gr. viij. 

Hydr. Chlor. Corros. , . . gr. ss. 
Fiant pil. no. xxx. Sig. — One pill 
thrice daily. For the indigestion and anae- 
mia. (B.) 



R . Tinct. Asafcetidae, 

Tinct. Valerianae Ammon., 
Tinct. Castorei, . . . aa zij. 

Aquae Camph., 5 vr j- 

M. Sig. — A tablespoonful or two every 

hour. 



Ichthyosis. 

Zinc, the ointment or glycerite of the Oxide, especially the latter with a little 
Camphor added to it, is a most useful application (Wa) ; an ointment of the 
Sulphate, Z) to ^j, found very efficient (Wilson). Sodium Bicarbonate, as 
ointment, gr. xv-xxx to the ^, or lotion, 3ij-iij to the pint (Devergie). Copper 
Sulphate, gr. x ad ^j of Unguentum Sambuci, a useful application (Wilson). 
Ulmus, in decoction, used internally, has cured the disease (Wa). Cod-liver 
Oil, applied locally with friction, has proved promptly curative. Warm Baths, 
may generally be employed with benefit (R) ; alkaline and vapor baths, with 
Sapo Mollis; and inunctions of oil or simple ointment to prevent Assuring of 
the new skin (Duhring) ; frequent alkaline baths, with internal and external 
use of oily preparations, as Linseed and Cod-liver oils, yield the best results 
(Bulkley). Thyroid Extract, has been given with benefit. 



Impetigo. 

Salol, locally, as an antiseptic and deodorant powder. Arsenic, is very use- 
ful (see under Eczema); the Iodide in doses of gr. ^ has been employed with 
great success; or Donovan's Solution, ttlv-x (Wa). Nitric Acid, internally, 
frequently benefits (Wa). Glycerite of Tannin, an excellent application (B) ; 
during the day, with poultices at night to remove scabs (R). Quinine, and 
Mineral Acids, when from imperfect digestion (R). Zinc, the ointment of the 
Oxide, after subsidence of inflammation (R). Sulphur, internally, serviceable 
(R). Calcium Chloride, gr. xv-xxx, daily in some vegetable infusion, is well 
spoken of (Wa). Mercury, Citrine Ointment dilute, locally, is an excellent 
application (Wa) ; a very weak White Precipitate Ointment answers best in im- 
petigo contagiosa, with a little Carbolic Acid lotion (1 to 20) if it does not yield 
(Bulkley) : Calomel to cover the floor of the pustules, after opening, evacuating 
and washing them out (Da C). Laurel-water, relieves the itching (P). Grape- 
cure, has proved excellent (P). Flexible Collodium, or Liquor Guttae-perchae, 
to cover the pustules, if located where they are liable to irritation (Da C). 
[Compare Eczema.] 

Impotence. 

Phosphorus, no remedy more efficient ; the pill of Zinc Phosphide the most 
convenient form (B) ; gr. T \ thrice daily. Phosphoric Acid, full doses, with gr. 
ss of Pulvis Cantharidis, an effective combination, especially in impotence of 
old age (B). Aurum Chloride, prevents decline of sexual power (B) ; Gold 



6 9 8 



INFLAMMATION. 



salts are highly praised by several authorities for decline of sexual power in 
men. Kola, as a general tonic. Cantharis, with Iron is beneficial (B) ; in 
large doses (gtt. xx-xxx), with Iron and Phosphoric Acid or Nux Vomica (R) ; 
of doubtful efficacy (Wa). Cubeb, removes functional trouble (B). Nux 
Vomica, drop doses of tincture in atonic impotence (B) ; in large doses when 
spermatorrhoea (R). Sanguinaria, has decided aphrodisiac properties, but is 
useful only in the functional form (B). Serpentaria, in relaxation and feeble 
erections, will often restore power ; gss doses of tincture twice daily (B). Er- 
gotin, hypodermically about the dorsal vein of penis, when its enlargement and 
too rapid emptying is the cause of impotence (B). Cannabis Indica, is a useful 
remedy ; the best combination for functional impotence would be one of Can- 
nabis, Nux Vomica and Ergot (B). Polygonum Hydropiperoides, is a useful 
remedy in the functional form, erections feeble, semen watery and testes soft 
(B). Ferrum Arsenate, acts as a tonic to the organs, and in full doses often 
benefits cases of the functional form (B). Damiana, has been brought forward 
as a genital stimulant, and a remedy for impotence, but there is probably no 
ground for any confidence in such claims (Stille). [Compare Emissions, Sper- 
matorrhoea, also the List of Aphrodisiacs, ante, page 55.] 



Prescriptions. 



R- . Ferri Arsenatis, . 

Ext. Ergotse, . . 

Ft. pil. no. xxx. Sig. 



. . . gr. v. 
. . . gr. xxx. 
•One twice daily 



R- . Ext. Cannabis Indicae, . . gr. x. 

Ext. Ergotse, gr. xl. 

Ext. Nucis Vom., . . . , gr. x. 
Ft. pil. no. xx. Sig. — One pill night 
and morning. 



R 




Quininae Sulph. , 
Strych. Sulph., . 
Ext. Ergotae, . . 
Mas. Ferri Carb. , 






• gr- 

• gr- 

• gr- 


xxx. 

ss. 

XV. 

xlv. 




M 


. Ft. pil. no. xxx. 


S 


K- 


—One pill 2 


or 


3 


times daily. 











R- . Sanguinariae, gr. ij. 

Ext. Ergotse, gr. xx. 

M. Ft. pil. no. xx. Sig. — One pill 
thrice daily. 



R . Tinct. Sanguinariae, . . . giij. 
Ext. Stillingise Fl., ... 3 v. 
M. Sig. — 15 to 20 drops in water, thrice 
daily. 

R . Phosphori, gr. ss. 

Ext. Nucis Vom., . . . . gr. vj. 

Mas. Ferri Carbonat., . . gr. xl. 

Ext. Gentianae, gr. xxx. 

M. Ft. pil. no. xxv. Sig. — One pill 2 
or 3 times daily. 



Inflammation. 

Aconite, is especially indicated in inflammation of the respiratory organs, in 
the eruptive fevers, and all inflammatory states of high temperature and sthenic 
reaction ; not in adynamic states, or continued fevers, except for hyperpyrexia ; 
may be advantageously combined with Opium (B) ; gives most brilliant results 
in many forms (R) : always indicated in early stages of simple inflammatory 
fevers, in all inflammation of serous membranes, pneumonia, tonsillitis, acute 
rheumatism, erysipelas, etc.; is especially adapted to the uses for which bleeding 
was formerly employed (P). Arnica, is antipyretic, large doses (£ss of tinct.) in 
sthenic, small doses (rr\,x) in asthenic inflammation (B) ; in inflammation of 
serous membranes it has given good results (P). Belladonna, in many forms 
no remedy more useful, notably scarlet fever, erysipelas, low fevers; for inflam- 
mation of eyes, boils, carbuncles, etc., Atropine externally, Belladonna inter- 
nally ; when much fever, may be combined with Aconite (B); both locally 
and internally in inflammation of the eye ; is effectual in inflammation which 
threatens to end in abscess (R) ; in erysipelas, inflammatory sore throat, 
encephalitis, gouty and rheumatic inflammation, cystitis, pneumonia, etc. (P). 
Gelsemium, especially for inflammation of lungs and pleurae, and in pneumonia 
(tt^v-x of fl. ext. every two hours) (B) ; in acute stage of gonorrhoea is valuable 
(P). Bryonia, exceedingly valuable in pleurisy and other serous inflamma- 



INFLAMMATION. 699 

tions, especially pericarditis ; after the aconite stage (P). Veratrum Viride, 
when much delirium and arterial excitement, useful at beginning only (B) ; in 
pneumonia, Veratrine is most valuable, also in acute rheumatism and generally 
as an antipyretic (P). Tartar Emetic in frequent minute doses, gr. ^, renders 
incontestable service (B) ; in pneumonia, tonsillitis, pleurisy, bronchitis, and 
other inflammatory affections (R) ; gr. l /e, frequently repeated, has the power 
of completely dissipating early local inflammations (Spender) ; quite as useful 
in arresting local inflammations as Quinine is in malarial fever (Lawrie). Pul- 
satilla, in acute and subacute inflammations with muco-purulent discharges, 
especially of eyes, ears, and nasal passages (P) ; also with Aconite in epididy- 
mitis (Pf ). Mercury, in acute glandular inflammation of throat and neck, in 
ileo-colitis, iritis, syphilitic inflammations of serous membranes, laryngitis (R). 
Silver Nitrate, locally in strong solution, gr. clx to 3J of distilled water, painted 
over surface and beyond, after thorough cleansing and drying ; no agent so 
safe, powerful or efficacious in subduing external inflammation (Higginbotham); 
a strong solution in Nitrous Ether is a most efficient application to check in- 
flammation in superficial parts, as boils, felons, orchitis, synovitis, erysipelas, 
erythema, eczema, etc. (B). Iodine, as liniment in vicinity of local inflamma- 
tion to produce vesication (R). Sulphides, especially that of Calcium (gr. -fa) 
appear often to arrest suppuration ; after formation of pus they hasten matura- 
tion and circumscribe inflammation ; in boils, abscesses, and deep-seated sup- 
puration, they improve the condition and promote healing (R). Antipyrin, 
Kairin, and other antipyretics (see under the title Fever). Alkalies, especi- 
ally Ammonium and Potassium salts, are very valuable in the stage of exuda- 
tion (B). Astringents, locally in inflammations of mucous membranes (R). 
Lead, the Liquor Plumbi Subacetatis Dilutus as a soothing and astringent 
application to inflamed and erysipelatous surfaces (Wa) ; to eczema and other 
inflammatory diseases of the skin (Pf ). Digitalis, the German antipyretic, is 
especially useful in pneumonia, bronchitis, rheumatic fever and scarlet fever 
(B) ; Aconite safer and better (R) ; locally and internally Digitalis is useful in 
inflammations, especially those of joints, of breast, erysipelatous and varicose: 
a fomentation of a teasp. of the dried leaves in half a pint of boiling water, or 
3j of tincture to the same quantity of water, applied by flannels to the part, 
will quickly subdue (Fairbank). Quinine, in peritonitis (Tr) ; is indicated in 
most acute forms, unless objections occur (P) ; has power to arrest inflamma- 
tion in formative stage ; with Morphine and in full doses (gr. xv-xx) may sup- 
press many forms (B). Chloral, excellent when temperature is high, much 
delirium ; gr. v every 3 hours (B). Opium, is important in most inflammations, 
but especially those of serous membranes ; a full dose (gr. ^ of Morphine) at 
first, smaller doses after ; is especially curative in inflammation of intestines 
and peritoneum, and of cerebro-spinal meningitis arachnitis, etc. (R). Saline 
Purgatives, valuable as part of the denutrition treatment, and to diminish 
arterial tension (B). Salicylic Acid is antipyretic, especially in septicemic 
inflammation, and acute rheumatism, erysipelas, pneumonia (B) ; Sodium 
Salicylate more soluble (R). Colchicum, often exercises a happy influence over 
certain acute inflammations, as bronchitis, conjunctivitis, etc., especially if 
occurring in gouty subjects (P). Cocaine, locally in commencing inflamma- 
tions of mucous surfaces, to constrict the blood-vessels of the part (R). Pilo- 
carpus, gives good results in the exudative stage of pleuritis, iritis, keratitis, etc. 
(B). Cold, by Ice in bags, or cold water, a very useful agent. Heat, by hot 
water, fomentations, etc., often much better. Ice, in small pieces in a bladder, 
applied to inflamed part (R). Water, cold and hot baths and packing very 
useful in all inflammations (B). Alcohol, is constantly prescribed, and is of 
value in low states, if symptoms after its administration are ameliorated (B). 
[See Fever.] Poultices, useful in many inflammatory states, but often abused 
(B) ; to check formation of pus and assist in maturation (R). Venesection, 
when pulse hard, strong, full and frequent, a plethoric state of the system and 
great intensity of morbid action; if required, the earlier it is done the better 
(Gross) ; Leeches very useful in many forms where sthenic reaction and ple- 
thora ; value of bloodletting probably due to derivative and counter-irritant 



700 INFLUENZA. 

effects (B) ; a remedy of great power for good or evil, now much neglected 
(Wa) ; local bleeding by leeches, cups, scarification, etc., should generally be 
preceded by some form of general depletion (Gross). Aliment, when no 
inflammation of the digestive tract use milk and beef-tea alternately every 3 
hours ; no starches or fats ; in intestinal inflammation milk, eggs, animal 
broths, oysters, fish, but all food must be used with great caution ; skim-milk 
treatment (B) ; Cod-liver oil in many chronic inflammations, as of heart, lungs, 
kidneys, etc. (R). [Compare the various titles, as Bronchitis, Pleuritis, etc., 
also the list of Antiphlogistics on page 51.] 

Prescriptions. 

[See pages 541 and 542 for Liniment and Lotion formulae.] 

R. Tinct. Aconiti, %]. 

Tinct. Belladon., . . . . gij. R . Antim. et Pot. Tart. , . . gr. ijss. 

M. Sig. — Three or four drops in water Magnesii Sulph., . . . . ^ij. 

every hour. (B.) j Morphinse Sulph. , .... gr. ji^. 



rj . Ammonii Chloridi, . . . g v 
Acidi Acetici, 

Alcoholis, aazx 

Aquae, q. s. ad£x 

M. et fiat lotio. Evaporating and dis- hours. Antimonial and Saline Mixture 



Ac. Sulph. Aromat. , . . . ,£ss. 
Tinct. Verat. Virid., . . ^jss. 

Syr. Zingiberis, %i], 

Aqu^e Destill., ^x. 

M. Sig. — Tablesp. every 2, 4, or 6 



cutient lotion. (Gross.) 

Influenza. 

Menthol, dissolved in Chloroform, as inhalation, to abort an attack of influ- 
enza (see under Catarrh, Acute Nasal), is highly efficient as a prophylactic 
(Wunsche) ; Menthol in 5 to 10 per cent, spray, is highly praised. Cocaine, a 
4 per cent, solution snuffed up the nostrils or sprayed into them, is very efficient 
in the early stage (R). Eucalyptus, the Oil, sprinkled on blotting-paper placed 
around a large room, was considered an efficient prophylactic during the Lon- 
don epidemic of 1891, and was much used in offices, shops, etc. Salol, and 
Salipyrin, as internal remedies, were highly extolled during the epidemic of 1 891. 
Phenacetin, is used with great benefit, both as a prophylactic and a remedy. 
Phenocoll, the Hydrochloride has been used with marked success, in epidemic 
influenza, and for the neuralgic pains thereof. Acetanilid, 2, with Salicylic 
Acid and Ammonium Bromide, each 1 part, forming the mixture called Anti- 
nervin, was used with much success during the recent epidemic in Scotland. 
Quinine, the Hydrochlorate, gr. viij daily as prophylactic, has specific action, 
as shown by experience with hussars at Bonn during the epidemic of 1889-90 
(Grasser) ; the Hydrobromate in 8 to 16 grain doses, if the fever is high (Huch- 
ard) ; Quinine is used with benefit throughout the disease, and especially for 
the neuralgic pains following the acute stage (Wa). Potassium Bicarbonate, 
is more nearly specific than any other remedy ; gr. xxx with tt\,xx of Glycerin 
and Liquor Ammonii Acetatis ^ss, every three hours ; it prevents complications 
when given in time and also prevents sequelae (Calvert). Sodium Salicylate 
in doses of gr. v every half hour for six or eight doses, then every hour until all 
pain has vanished, then every two hours for a day or two, is very efficient 
(Parker). Ammonium Salicylate, is even better than the sodium salt ; add 
Liquor Ammoniae Fort, 3j to Ac. Salicylic, gr. lxxx, to make an 8 ounce mix- 
ture for tablespoon doses (Id). Strychnine, for the underlying weakness and 
depression, the real enemy to fight against in the grippe, Strychnine is the best 
remedy we have (Huchard). Digitalin, crystallized, in dose of gr. -fa, in grip- 
pal pneumonia, in which, though the disease is in the lungs, the danger is to 
the heart (Id). Sodium Benzoate, with Quinine and Caffeine (see formula be- 
low) in the simple form of the grippe (Id). Ammonium, the Liquor Ammonii 
Acetatis, combined with Nitric or Chloric Ether, is often of great service (Wa). 
Sanguinaria, is used with much benefit (Wa). Cimicifuga has been given with 



INSANITY AND DEMENTIA. 



70I 



much success (R). Camphor, in solution, hypodermically (see formula below), 
2 to 4 injections daily, with 3 to 6 of Caffeine and 2 to 3 of Ether, for grippal 
pneumonia (Huchard). Camphoric Acid, in one dose of gr. xx-xxx, dry on the 
tongue, not over 2 hours before the expected time for sweating, is remarkably 
efficient to prevent it. Agaricic Acid, gr. y^- K by mouth, is efficient against 
the sweating of influenza. Bismuth Salicylate, or Naphtol, Betol, Salol, or 
Benzo-naphtol, as intestinal antiseptics, when such are required (Huchard). 
Sulphurous Acid, by fumigation or inhalation, a few drops on boiling water ; or 
as a spray, often controls influenza (R). Benzol vapor, is a reliable pulmonary 
antiseptic, and has been employed with very favorable results (Robertson). 
Benzoin, the compound tincture, 3ss-j, inhaled from a, pint of hot water fre- 
quently (Da C). Tartar Emetic has been recommended strongly, but is too 
depressant (Wa) ; has extraordinary power of aborting local inflammations, 
especially those of the respiratory apparatus. [See under Inflammation.] 
Spiritus Etheris Nitrosi, in doses of o'j-jss, in any convenient vehicle, is a popu- 
lar and efficacious remedy (Wa). Cubeb, 3ss or 5j doses of the tincture in y z 
glass of Linseed-tea thrice daily, for the subsequent cough, often curing like a 
charm (R). Opium, best avoided in early stage, but later for the cough, with 
Ipecac, gives great ease ; Dover's powder, with Nitre and Lobelia, is a good 
form (Wa). Potassium Nitrate, largely diluted as lemonade, 3j-ij in the course 
of the day, proves highly useful (Wa). Boric Acid, as gargle, also borated 
ointment or vaselin to the nasal cavities, and great care taken of the cleanli- 
ness of the mouth ; antisepsis of the nose, mouth and pharynx is very important 
and does much to prevent complications and perhaps broncho-pneumonia 
(Plicque). Coca and Kola, the tinctures, a mixture of equal parts of each, for 
the nervous depression (Id). Hot Fomentations, for the headache (R). Turk- 
ish Baths, have been used with marked advantage (Wa). 



Prescriptions. 



Quininae Hydrobromat. , 

Sodii Benzoat., 

Caffeinae, aagr. xxx. 

M. et ft. pil. no. xxx. 

Sig. — One pill thrice daily. {Huchard. 



R . Ext. Cimicifugae Fl., . . ^ss. 
Tinct. Opii Deodorati, . . 5jj. 

Syr. Tolutani, ,5 x j- 

M. Sig. — Teasp. every four hours. 



3JSS. 



R . Ammonii Chloridi, 

Morphinae Sulph., . . 

Tinct. Sanguinariae, 

Syr. Ipecac, aa^iv. 

Mist. Glycyrrh. Co., 

Aquae, aa^jss. 

M. Sig. — Teasp. as required for the 
cough. Each dose has of Morphine Sul- 
phate gr. I 1 ¥ . 



R. Camphorae, 3 ijss. 

01. Olivae (steriliz.), . . . j^iij. 
M. Sig. — 3 ss hypodermically twice or 
thrice daily. {Huchard.) 

R . Ext. Ipecac. Fl. , . . . . ^ij. 

Tinct. Opii Deodorati, . . giv. 

Tinct. Aconiti, gj. 

M. Sig. — Five to ten drops every two 
hours, for the bronchitis. 



Insanity and Dementia. 

Hyoscine, has strong power as a mental alterative ; is particularly useful in 
that form of mental disturbance which renders the patient violent and abusive, 
restless and domineering, a nuisance to every one who has anything to do with 
him (Weatherly). Duboisine, gr. j-'hs to y 1 - hypodermically twice daily, is 
highly efficient in the treatment of the mental excitability of the insane, induc- 
ing quiet and refreshing sleep , and is not dangerous (Massant). Opium, especi- 
ally Morphine, is injurious in mania, but is useful in melancholia and for cli- 
macteric and senile cases. Chloral, does as much harm as good, is best suited 
to wildly maniacal and erotic patients. Potassium Bromide, is almost dis- 
carded, except for epileptic cases. Conium, is useful, sparingly, for noisy 
patients. Colchicum, for gouty cases, which are numerous ; cure the gout, and 
you may cure the insanity. Shower-bath, suitable for cases due to self-abuse ; 



702 INSOMNIA. 

the wet pack in the mania of hystero-epilepsy. Stimulants rank high, next to 
quiet and absence from home. Thyroid Extract, has been used with apparent 
benefit. Tonics and Hypnotics, should be employed in cases requiring them. 
Food of good quality is essential to the treatment. Kumyss, is an excellent 
food in hysterical dyspepsia and anorexia simulating that of insanity. Moral 
Treatment, is now successfully carried out in many asylums, but is expensive, 
requiring a large staff of trained attendants. With correct management from 
the start, nearly all cases of insanity unattended by paralysis or physical decay 
may be cured (Savage) ; this can be best administered in a well-conducted 
asylum or hospital for the insane, where security and the prospect of recovery 
will be better than in the best home ; the total abolition of any one plan of 
treatment in favor of another would be a great mistake ; more than half of first 
attacks of insanity are recovered from under good management, which is best 
attained under the direction of persons trained in this specialty (H). Recently, 
efforts have been made at the improvement of the insane condition by requir- 
ing them to attend school daily, with remarkably good results. [Compare De- 
lirium, Hypochondriasis, Mania, Melancholia.] 



Insomnia. 

Chloral, is quite unrivaled, being the most direct and generally useful hypnotic 
(B) ; acts best in cases of purely nervous type (Wa) ; in doses of 20 to 30 grains 
is by far the best hypnotic for many forms of insomnia (R) ; is dangerous in 
old drunkards, in whom the heart and vascular system have undergone fatty 
and calcareous degeneration (B) ; in combination with Opium or Morphine it 
acts splendidly in small dose, each ingredient intensifying the hypnotic action 
of the other (Brodnax) ; children bear it well, especially when given with Pare- 
goric. Chloralamid, 30 grains in 3j of whiskey or brandy, in simple or idio- 
pathic insomnia, or that from nervousness, hysteria, chronic alcoholism, but 
not when due to excitement or severe pain. Croton-chloral, is feebler than 
Chloral and less toxic ; as a hypnotic 3j ma y be given (R). Somnal, is a com- 
bination of Chloral, Alcohol and Urethan, and strikingly efficient in the insomnia 
of convalescence from acute disease (Myers). Paraldehyde, in doses of 3j~3 ] ), 
one of the most efficient and safe hypnotics, being free from depressant action 
on the heart and other unpleasant by-effects. Sulphonal, 15 to 30 grains in 
milk, 2 hours before effect is desired ; an admirable hypnotic in many cases, 
but its efficacy decreases with use, and it is of no value in insomnia due to 
pain. Trional, is markedly hypnotic and sedative, acts surely and promptly 
in the insomnia of neurasthenia and organic brain affections ; is better than 
Sulphonal or Chloral in many respects (Schultze). Tetronal, is somewhat less 
hypnotic than Trional, but more of a sedative ; the sleep from either lasts 6 to 
8 hours, and is generally dreamless ; neither are of any use when insomnia is 
due to pain. Potassium Bromide, when from cerebral over-action, gr. xv 
before each meal, and gr. xxx on retiring; has cumulative effect (B); it in- 
creases hypnotic effect of Hyoscyamus, Belladonna, Cannabis Indica, Ether 
and Chloroform (R). Opium, 15 to 20 minims of the tincture, or l /e to ]/ z grain 
of Morphine, the most effective hypnotic when insomnia is due to pain ; in 
combination with Chloral (see above) smaller doses of each are efficient. 
Opiates should be given so as to act at the natural time for sleeping (R). 
Codeine and Narceine are also hypnotic in proper doses. Hyoscyamus, an 
effective substitute for Opium in children, S'j-Jj of tinct. necessary, and with- 
out danger (B) ; when Opium disagrees (R). Hyoscine, produces sleep after a 
brief period of excitement ; gr. y^j- of the hydrobromate hypodermically is ex- 
cellent for the insomnia of the insane. Duboisine, is even more calmative and 
hypnotic than Hyoscine, and is especially useful when high mental excitement 
exists ; gr. y^ to ■£$ or -^ hypodermically, may be combined with gr. y% to % 
of Morphine. Belladonna or Atropine, is hypnotic in some conditions, especi- 
ally when prostration, low arterial tension and contracted pupils. Ignatia, for 
sleeplessness from nervous erethism, better than Morphine (Pf ). Gelsemium, 



INTERMITTENT FEVER. 



703 



in simple wakefulness (B) ; and in that of drunkards, mania and over-excite- 
ment (R). Coffee, insomnia from lowering of nervous power, and chronic 
alcoholism (F). Sumbul, 30 to 40 minims of the tincture, with a little Chloric 
Ether, is very efficient in the insomnia of chronic alcoholism (P). Tartar 
Emetic, with Opium, is effective when insomnia is due to cerebral congestion 
and when Opium stimulates (B). Hypnal (see page 221) is credited with simul- 
taneous hypnotic and analgesic action. Methylal (see page 222) is an efficient 
hypnotic. Hypnone (see page 221), is of moderate hypnotic power, but is said 
to be especially useful in the insomnia of acute alcoholism. Urethan, a pure 
but mild and safe hypnotic, especially useful for children. Resorcin, produces 
quiet sleep in general nervous excitability, and in the insomnia of typhus fever 
and pulmonary tuberculosis. Ether or Chloroform, in full dose (R) ; may be 
used by inhalation when other means of producing sleep have proved unsuc- 
cessful. Phosphorus, when nutrition is inactive, and in the insomnia of the 
aged (B). Humulus, a hop pillow is said to be effective in many cases (P) ; 
the tincture of Lupulin, 5ss-^ss, as a cerebral sedative. Cocaine has been 
used with some success (Wa). Chamomilla, tt\j of the tinct. every quarter- 
hour, an excellent sedative for children (Smith). Cannabin Tannate, in 8-grain 
doses, a good hypnotic (Fronmuller) ; very inefficient (W). Cannabis is very 
uncertain in its action (R). Alcohol, if from cerebral anaemia, a full dose of 
whiskey or brandy ; or in some a glass of ale or beer answers better (B). 
Water, a tepid bath just before retiring often effective ; when head is hot apply 
cold to it, and a tepid bath to the body (B). [Compare Nervousness ; also the 
title Hypnotics, on page 34, and the sub-title Analogues of Chloral on page 
221.] 

Prescriptions. 

R 



R. Paraldefiydi, 3'j ss - 

Alcoholis (99 per cent.), . 3JSS. 

Tinct. Vanillse, £ss. 

Aquae, 5j. 

Syr. Simplicis, . . q.s. ad 3 iv. 
M. Sig. — A teasp. or two every hour 
until sleep is obtained. 

( Yvon -1 s Hypnotic Elixir.') 



R . Potassii Bromidi, 

Chloralis Hydratis, . . aa ^ ss. 

Syr. Pruni Virgin. , . . . Sj. 

Aquae, .... q.s. ad Jiv. 
M. Sig. — Teasp. in a winegl. of water. 
Repeat in one hour if necessary. 



Potassii Bromidi, . . . . 3"iv. 

Chloralis Hydratis, . . giij. 

Tinct. Asafcetidae, . . . . 3"iv. 

Syrupi, :zvj. 

Aquae, q. s. ad 3 vj. 

M. Sig. — Tablesp. every 2 hours until 
sleep is induced. In the insomnia of hys- 
teria. 



R 



Chloralis Hydratis, . 
Potassii Bromidi, . . 
Tinct. Opii, .... 
Syr. Aurantii Cort., . 
Aquae, q. s. 



■ • Eh 

■ ■ %}})■ 

ad z ij . 



M. Sig. — Teasp. at a dose. May be 
repeated if necessary. 



Intermittent Fever. 

Quinine, as prophylactic, gr. v-x each morning in black coffee ; begin with 
gr. v, add gr. j each week (R) ; in ordinary intermittents give 6 or 10 grain doses 
up to 20 or 30 grains, so as to have it all in 4 or 5 hours before the expected 
paroxysm ; give the Sulphate and in solution to get its full action (Da C) ; for 
acute ague, gr. x in sweating stage, and same 5 hours before next paroxysm, 
and gr. x-xv at the septenary periods, until the third has passed ; in pernicious 
form, gr. xx-xl are required, by stomach, rectum or skin, to secure safety of 
patient; best in combination with Morphine, and with continuous administra- 
tion of Arsenic during intermissions ; may be given in solution by rectum, or 
hypodermically (R) ; is almost specific in intermittents when uncomplicated, 
and of recent origin (Wa). Chinoidine may be used as a substitute for Quinine 
in doses twice as large (B). Cinchonine, Cinchonidine, Quinidine, the Sulphates 
of these alkaloids are scarcely, if at all, inferior to Quinine as therapeutical 
agents (Report of the Madras Commission, 1866) ; average dose of each, gr. x 
(Wa). Cinchonidine Salicylate, promises well as an antiperiodic (B). 



704 INTERMITTENT FEVER. 

Arsenic, the best remedy next to Quinine, especially useful in long-standing 
agues of quartan type (R) ; useful as adjunct to Quinine daily to prevent 
relapse ; most important in chronic ague, with Iron ; also as prophylactic small 
doses of Fowler's solution (B). Hydrastine, stands next after Arsenic ; indica- 
tions same as for Quinine (B) ; in doses of gr. ij-ix is strongly recommended 
(P). Pilocarpine, gr. ]/% of the Muriate, in the cold stage, is strongly recom- 
mended by high authority, to excite profuse perspiration and thus lessen the 
attack (Da C). Apiol, when prejudice exists against Quinine; gtt. xv during 
an hour, in divided doses, 4 hours before paroxysm (B) ; is one of the minor 
remedies which often prove successful in mild cases (Wa). Salicin, as substi- 
tute for Quinine, but inferior (B) ; grs. x-xl, in mild cases (P). Opium, as Mor- 
phine, gr. Y<Q-)i hypodermically, not only lessens the chill, but aids the action 
of the antiperiodic ; is to be strongly urged (Da C) ; is useful in the pernicious 
variety, in combination with Quinine (B). Capsicum, the resins of black and 
red pepper, as adjuvants chiefly (B) ; promotes action of Quinine (Pf). Nux 
Vomica, has been used with success, but is now used as adjunct to Quinine 
(B) ; good in convalescence (P); has antiperiodic value not inferior to that of 
Quinine ; gr. ^ of Strychnine equals gr. j of Quinine Sulphate (Wa). Strych- 
nine Arsenite, is highly efficient (see page 357). Methylene Blue is effi- 
cient, and has many advantages over Quinine, especially for very young chil- 
dren (Ferreira). Chloroform, to prevent an impending paroxysm; 3j-3ij of 
the spirit before the chill, or by inhalation (B). Narcotine, gr. ij-v ter die, is 
eminently antiperiodic ; no other drug, except Quinine, cures intermittents so 
rapidly and surely, or with more freedom from disagreeable effects (Wa) ; said 
to be superior to Quinine (R). Nitric Acid, full doses every 4-6 hours (B). 
Sodium Chloride, in large doses during the apyrexia, 3viij-xij, may occasion- 
ally prove efficacious (Wa). Eucalyptus, during convalescence (B) ; has been 
successfully used in treatment of ague, Sj-ij of a tincture (Wa). Carbolic Acid, 
in 4-grain doses with Infusion of Ginger, cured a series of 8 cases which had 
resisted Quinine (Wa) ; its value established ; ttlss— ij in mint- water or gr. % in 
rr^xx of water, hypodermically (Tessier) ; combined with Iodine is of great value 
in chronic malaria, and in acute cases after Quinine has stopped the paroxysm 
(B). Mercury, uncalled for in ordinary cases ; but Hydrarg. cum Creta Qui- 
nine and Rhubarb of service in obstinate intermittents of children in tropical 
regions (Wa). Sodium Hyposulphite, gr. xv-xx every two hours is said to 
cure (R). Cascarilla, Chamomile, Quassia, are used (R). Gentian, is valued 
chiefly as a vehicle (P). Ammonium Picrate, proved wonderfully effective in 
India, where 10,000 cases were treated therewith (Clark).' Lemon, in decoc- 
tion, exceedingly efficient in preventing recurrence of the paroxysms after they 
have been broken up by the use of Quinine (Crudeli). Emetics, may cure 
many cases ; one each morning will assist the action of Quinine ; Ipecacuanha 
preferred to Antimony (R) ; only at commencement, inadmissible if gastric 
irritation (Wa). Antimony, at the onset and continuously in mild, uncompli- 
cated cases ; Tartar Emetic, gr. l /i- l /6 every 2 hours, has been followed by 
complete cures (Moore). Guaiacol, locally to skin, as an antipyretic (see page 
257). Antipyrin, is useless (Falkenheim). Resorcin, and similar agents, have 
no specific action, merely controlling the pyrexia (Wa). Warburg's Tincture 
is a remedy of great power, but produces such severe diaphoresis as to be 
dangerous to adynamic subjects (Maclean). Purgatives, in the intermission, 
before using the antiperiodic, is good practice ; Podophyllum, Colocynth or 
Jalap (Da C). Iron, is valuable in chronic cases ; the system should be thor- 
oughly saturated with it (Da C). Ergot, for the enlarged spleen (Da C). 
[Compare Malaria; also the List of Antiperiodics on page 51.] 



R. Acidi Carbolici ^j. 

Tinct. Iodi Comp., . . . Sjiij. 
M. Sig. — 4 drops every 4 hours in suf- 
ficient water. (B.] 



Pi'escriptions. 

R . Massae Ferri Carb., . . . 3J. 

Acidi Arsenosi, g r -j- 

M. Ft. pil. no. xx. Sig. — One pill 
thrice daily in chronic ague. (B.) 



INTERTRIGO INTUSSUSCEPTION. 



70S 



R. Quininae Sulphatis, . . . gr. xxxij. 

Mucil. Acaciae, gij. 

Syr. Eriodyctii Aromat. 
(Parke, Davis & Co.), vel 

Mist. Glycyrrhizae Co. , vel 

Velatine, . . . . q. s. ad %'\). 
M. Fiat emulsum. Sig. — A teasp. 
contains gr. ij of Quin. Sulph. Suspension 
of the Quinine without dissolving it makes 
the bitter taste less perceptible (Squire), 
and the Syrup of Yerba Santa covers the 
taste well. {Potter.) 

R . Quininae Sulphatis, . . . gr. xl. 

Ferri Sulph. Exsiccat., . . gr. xx. 

Acidi Arsenosi, gr. j. 

M. Ft. pil. no. xx. Sig. — One pill 
thrice daily. (B.) 



. . Quininae Sulphatis, . 


. gr. xxx. 


Capsici, 


. gr. xv. 


Opii Pulveris, . . . 


. gr. iij. 


M. Ft. pil. no. xx. Sig.- 


— One pill to 


ve pills as required. 


(Piffard.) 



U . Quininae Sulphatis, . . . gj. 

Ac. Hydrobrom. Dil., . . ^ij. 

Aquae, 3 xiv. 

M. Sig. — A teasp. contains gr. iij^/ of 
Quin. Sulph. The acid directed prevents 
the unpleasant cerebral action. (B.) 



R . Quininae Sulphatis, 

Pulv. Acaciae, . . . . aa % ss. 

Syr. Zingiberis, ^iv. 

M. Sig. — A teasp. contains one grain of 
Quin. Sulph. A good formula for children, 
the quinine being suspended, not dissolved. 



R 



. gr. lxxx. 

. q. s. 



Quininae Sulphatis, 
Ac. Sulphurici Diluti, 
Spt. Etheris Nitrosi, . . . giv. 
Syr. Tolu, Aquae, . q. s. ad ^ij. 
M. Sig. — A teasp. contains gr. v of 
Quin. Sulph. {Da Costa.) 



Intertrigo. 

Acetanilid and Boric Acid, equal parts, dusted thickly over the surface, in 
the intertrigo of infants or adults, separating the surfaces which rub with ab- 
sorbent cotton (Brodnax). Bismuth, the Nitrate or Carbonate, as dusting pow- 
der (R). Tannin, the glycerite is excellent (P). Camphor, added to dusting 
powders, to allay heat and itching (R). Lime-water, to obviate results of irri- 
tating urine (R). Soap, with free ablution when intertrigo caused by acid se- 
cretions ; use greasy applications afterwards (R). Boracic Acid, as ointment, 
5jss to ^j of vaselin, a very useful application (Wa). Glycerin, with Traga- 
canth, etc. [See under Herpes for formula.] Calomel, as ointment, S) to ^j, 
is especially useful (Wa). Zinc Carbonate, as Calamine, a good dusting pow- 
der; so also is the Oxide, or Fuller's Earth. 



Intestinal Obstruction. 

Opium, even ]/ z -grain doses every 4 hours, for 2 to 4 days, arrests dangerous 
symptoms, and brings a painless purgation (Brinton, P). Morphine, endermi- 
cally (Wa). Belladonna, often successfully employed (P) ; gr. %-}i every 
few hours, when from want of tone and partial spasm (Tr). Strychnine, occa- 
sionally beneficial ; cautiously in acute cases (Wa). Mercury, a full dose of 
Calomel, followed in a few hours by Castor Oil, and a Turpentine enema, af- 
fords relief (Wa). Caffeine acts upon the muscular tissue and often proves of 
the utmost value (Wa). Senna, the infusion, in doses of ^j-iij, is an efficient 
purgative (Wa). Purgation to be refrained from (Brinton). Enemata, insuffla- 
tion and surgical measures are often necessary. [Compare Constipation, 
Intussusception, Hernia.] 



Intussusception. 

Belladonna, gr. iv of the extract in enema, has been successfully used(Wa). 
Opium, in full doses carried to narcotism, has been successful in many cases 
(Wa) ; must be used freely to prevent inflammation (Macleod). Effervescent 
Enemata, have been employed with success (B). Tobacco Enema, may over- 
come, and has proved exceedingly effective, but is dangerous ; produces most 

45 



yo6 IRRITABILITY IRITIS JAUNDICE. 

depressing nausea ; not safe to use more than ^iv of an infusion of 3j to Oj (B). 
Inflation, of intestines with air (Hippocrates), seems a most reasonable 
mechanical remedy. Irrigation, by hydrostatic pressure is resorted to with 
success ; requires care and gentleness (B) ; hot water (Wa) ; Ox-gall, gr. x-xxx 
in the solution used, is especially efficient in cases arising from partial paresis 
of the bowels (Hawkins) : the knee-chest position is the best during irrigation 
or inflation. [Compare Hernia, Typhlitis.] 

Irritability. 

Ignatia, in small doses diminishes, in large doses excites irritability of cere- 
bro-spinal axis ; the remedy par excelle?ice (Pf ). Chloral, gr. v, 2 or 3 times a 
day, in irritability with nervousness and restlessness (R). Chamomilla, is an 
excellent sedative for children, in doses of n\j of the tincture every ^ hour 
(Smith). Opium, gives calm to the nervous system if used in medium doses. 
Strychnine, in functional irritability of the nervous system. [Compare Insom- 
nia, Nervousness.] 

Iritis. 

Belladonna, locally and internally (R) ; rr\,v every 3 hours, also as lotion (3j 
of extract to ^iv aquae), is of great value (P). Atropine, solution (gr. iv to the 
3") has a wide field of utility as mydriatic (B) ; should never be omitted (C) ; 
is essential in the treatment of every form, should be applied early in the case 
and persevered in throughout its continuance (Lawson). Mercury, when of 
syphilitic origin, as it usually is (B) ; the Bichloride is of great service (R); in 
plastic iritis of original severity, or in cases aggravated by improper treatment, 
Mercury is imperative, gr. ij of Blue Pill twice a day, until blue line on gums 
(C). Aurum, the Bromide of Gold, Arsenic and Mercury has been admin- 
istered with evident advantage (E. A. Wood). Duboisine, as substitute for 
Atropine, is more rapid for effecting dilatation, less irritating to the conjunctiva, 
and has less permanent after-effects (B). Turpentine, in so-called rheumatic 
iritis is very successfully used ; small repeated doses (P). Opium, when 
much pain, an indispensable adjuvant, or Morphine hypodermically (C). 
Copaiba, Z\] in mucilage, thrice daily, gives excellent results in iritis and 
sclerotitis, diminishing pain in 24 to 48 hours, and restoring sight (Hall). Quinine 
and Iron, when the patient is feeble or anaemic. Irritants, or astringents 
should never be employed (C). Surgical, paracentesis when increased ten- 
sion, corelysis when only one or two adjacent adhesions ; iridectomy ; com- 
plete functional rest to the eyes, by Atropine and a bandage with compression 
pad, an absolute necessity during the whole period of treatment (C). [Com- 
pare Syphilis.] 

Prescriptions. 



R. Hydrarg. Chlor. Corr., . gr. j. 

Potassii Iodidi, z], 

Tinct. Calumbee, . . . . Jij. 
Aquae Destil., . . q. s. ad 3 vj. 
M. Sig. — A dessertspoonful, in a wine- 
glass of water, 2 or 3 times daily. 

[Lawson. ) 



R. 01. Terebinth., ziij. 

Syr. Acaciae, 3J SS * 

Aquae Cinnamomi, . . . 3 ss. 
M. Sig. — Teasp. 4 times daily. 

R. Extracti Belladon., . . . gj. 
Ung. Hydrargyri, . . . . :fvj. 
M. Sig. — For inunction to brow. 



Jaundice. 

Salol, is one of the most efficient remedies in catarrhal jaundice. Mercury, 
in attacks with depression, sickness and coated tongue, gr. l /6-yi of Gray Pow- 
der taken at onset, and repeated three or four times a day, very valuable (R) ; 
as purgative in jaundice from both deficiency and excess of bile, singularly 
enough (B) ; Gray Powder with Ipecac, followed next morning by Castor Oil, 



JOINT AFFECTIONS. JOJ 

is well adapted to the jaundice of infancy and childhood (Wa) ; Mercurials 
and Podophyllum are better avoided, especially in obstructive jaundice, unless 
very marked indications for them exist (Da C). Celandine, was formerly 
employed as a deobstruent (P) ; energetically affects the liver (Pf). Hydrastis, 
useful if continued for some time, in jaundice from catarrh of ducts (B). 
Arsenic, has been used with success in jaundice from catarrh of bile ducts after 
catarrh of duodenum ; better for jaundice of malarial origin (B). Nitro- 
Hydrochloric Acid, internally, and acid bath to right hypochondrium ; tempera- 
ture of bath 96 , ^iij to gall, j (B) ; when jaundice depends on torpor of the 
liver, or is catarrhal in origin (W) ; during convalescence, rr\,v-x of the dilute 
acid in £j of a compound elixir of Taraxacum before each meal (Da C). 
Quinine, when due to malarial miasm, or when periodic (B). Euonymin, an 
hepatic stimulant of especial power (B). Podophyllum, in catarrhal and mala- 
rial jaundice (B) ; when stools exhibit no trace of bile, one dose has cured 
(Wa) ; is best avoided, unless markedly indicated (Da C). Sodium Phosphate, 
no remedy superior in jaundice from catarrh of gall-ducts ; 3j doses every four 
hours for adults: gr. x-xx for children (B). Manganese, in jaundice from 
malarial origin or catarrh of biliary passages (B). Aloes, for simple jaundice of 
an atonic kind (B) ; when hypochondriasis (P). Rhubarb, for the above mala- 
dies in children, white or clay-colored pasty stools, skin jaundiced (B). Saline 
Purgatives, as Rochelle salt, to depurate the upper bowel ; with alkaline 
baths, diaphoretics and diuretics (Da C). Ammonium Iodide, gr. j-iij in water 
every 2 or 3 hours in catarrh of bile ducts and jaundice ; also Ammonium 
Chloride, with fluid extract of Taraxacum (B) ; in 20-grain doses every 4 hours, 
produces a decided change (Wa). Stillingia, relieves jaundice and torpid liver 
following intermittent fever (B). Dulcamara, employed with advantage (P). 
Iris, in malarial jaundice and that from duodenal catarrh (B). Alkaline Min- 
eral Waters, especially in catarrh of duodenum or bile-ducts (B). Potassium 
Salts, the Chlorate in chronic or asthenic jaundice ; the Sulphate the most 
useful saline purgative in jaundice (Wa). Aliment, no starches or fats ; use 
milk, eggs, oysters, beef broth, broiled or raw beefsteak, or whitefish (B) : plenty 
of green vegetables at each meal ; use cold water freely, avoid all high season- 
ing in food, and all liquors. [Compare Hepatic Cirrhosis, Hepatic Dis- 
eases, Calculi.] 



Joint Affections. 

Phenacetin, for the pyrexia of polyarthritis ; is efficiently antipyretic and safe. 
Aconite, for pains in inflamed joints (R) ; the liniment locally in chronic arthri- 
tic swellings (Wa). Mercury, the oleate in chronic inflammation of the knee 
(R) : Ung. Hydrarg. Ammoniat., diluted, 1 to 4 at first, then 1 to 8, by gentle 
friction 2 or 3 times daily, in chronic articular inflammations, by far the best 
application (P). Rhus Toxicodendron, internally and as lotion, is invaluable 
for subacute stiffness and aching of joints after acute rheumatic fever (P). 
Iodine, 3hj-vj ad Glycerini ^iij, Aq. destil. %iv, in numerous obstinate cases 
of joint affections consequent on rheumatism (Wa). Ferrous Iodide, with 
Iodine, locally, in scrofulous affections of the bones and joints (Wa). Iodoform 
has been used with satisfactory results, in scrofulous affections of the joints and 
bones, by many continental authorities (Wa). Salicylic Acid, 3j with 3iv of 
Lanolin, and 01. Olivae, q. s. to make a paste, applied locally and covered with 
cotton, or rubbed in once daily for 3 or 4 days, then omitted for a week, and 
again renewed, is of proven value in many obstinate cases of stiff knees, pains 
from so-called rheumatism, painful ankle and wrist joints, etc. (Aulde). 
Arsenic, often serviceable in rheumatoid arthritis and nodosities of joints; large 
doses continued are necessary (R). Alcohol, and water, equal parts, an excel- 
lent evaporating lotion (B). Silver Nitrate, a strong solution in Nitrous Ether is 
the most efficient application to check inflammation in small joints if applied 
early to adjacent vascular parts (B). Cod-liver Oil, in strumous subjects (R); 
the remedy on which most reliance may be placed in scrofulous joint affections 



708 KERATITIS LABOR. 

(Wa). Cold Douche, Galvanism, Turkish Baths, for stiff joints (R). Digitalis, 
as fomentation, jjj of tincture to 0)4 boiling water, applied on flannel, has 
proved very efficient in acute inflammations of joints (Fairbank). Turpentine, 
the liniment a serviceable application in chronic enlargement of the joints 
(Wa). Sulphuric Acid, as irritant ointment, 3j of acid to %j of lard, very bene- 
ficial in chronic diseases of joints (Wa). [Compare Arthritis, Bursitis, 
Coxalgia, Gout, Rheumatism, Synovitis.] 



Keratitis. 

Atropine, renders great service by contracting the vessels (B) ; by instillation, 
with enforced disuse, and a protective bandage, should be regarded as meas- 
ures of course (C). Mercuric and Ferric Chlorides, with Cod-liver Oil, will 
accomplish all that medicine can do for interstitial keratitis in syphilitic sub- 
jects (C). Calcium Sulphide, proves most useful in doses of gr. -^ to X» thrice 
daily, in sugar-of-milk trituration (Snell). Arsenic, Potassium Iodide or Bro- 
mide, Iron or Quinine, for constitutional effects in vascular keratitis ; also 
counter-irritation by Iodine painted on the temples until soreness (C). Ferric 
Chloride, successfully employed in panniform keratitis ; a large drop of the 
solution dropped from a quill every second or third day (Wa) . Physostigmine, 
lowers intra-ocular tension (B). Astringents or Irritants, as Alcohol in any 
form, Zinc Sulphate, Silver Nitrate, etc., are entirely inadmissible (C). Iridec- 
tomy, is often beneficial in severe vascular keratitis (C). Pressure-Bandage, 
in severe suppurative forms, limits extent. Water, cold when inflammatory 
symptoms marked ; hot (90-100 F.) in non-inflammatory form, to excite inflam- 
matory reaction ; should be discontinued when marked injection. [Compare 
Corneal Opacities.] 



Prescription. 



R. Hydrarg. Chlor. Corr., . . gr. j. 

Ammonii Chloridi, . . . gr. vj. 

Tinct. Belladonna, . . . 3 i j . 

Aquae Destillatse, . . . . 3 viij. 
M. et fiat, collyrium. 



Sig. — A teasp. in a winegl. of tepid 
water, to be applied frequently with a 
pledget of lint on the closed lids. In 
phlyctenular keratitis of children. 

( Turnbull. ) 



Labor. 

Ergot, only when uterine inertia, and after the first stage has passed ; is 
dangerous if any obstacle in front ; dangerous to child by paralysis of fcetal 
heart (B) ; is best given when head has passed the brim of pelvis (Wa). 
Anaesthetics, in protracted and painful labor ; cautiously with primiparae (B) ; 
increase the risk of post-partum hemorrhage (W). Chloroform, not to com- 
plete anaesthesia, lest uterine action be interrupted ; usually begin its inhalation 
when os is dilated (Simpson). Chloral, of great value to relieve pain ; does 
not interfere with the exhibition of chloroform ; should be given in 15-grain 
doses every }( -hour till effect produced (Wa) ; the best of all remedies for rigid, 
undilatable cervix, gr. xv every 20 minutes for 3 doses, perhaps a 4th after an 
hour's interval (Play fair). Ethyl Bromide, a rapid, sure and safe anaesthetic, 
particularly suited to labor cases (Levis). Opium, facilitates dilatation, pro- 
motes expulsive power of uterus, lessens hemorrhage, stimulates longitudinal 
and oblique fibres of the os (Wa) ; a full dose of Morphine, gr. ^", in tedious 
labors, with severe pains, will aid patient greatly and promote progress of the 
child ; no bad results ensue ; for relief of pains and after-pains, or painful com- 
plications ( Wa) ; hy podermically in rigid os and cervix (R). Cimicifuga, exercises 
special action, similar to that of Ergot ; is less dangerous to life of child and 
soft parts of mother (Wa) ; for mental disturbance and suppressed lochia (R) ; 
as partus accelerator in lieu of Ergot, also to allay nervous excitement after 



LACTATION. 7O9 

labor, and to check post-partum hemorrhage (P). Belladonna, topically to 
uterus of great service in long-protracted labors from rigidity of os and cervix 
(H). Gelsemium, quiets the nagging pains of the first stage ; requires physio- 
logical doses (B) ; relaxes spasm in rigidity of the os (Wa). Acetanilid, eases 
pain and brings on profuse sweat which helps to relax muscular rigidity (Brod- 
nax). Quinine, to strengthen uterine contractions ; used by many in place of 
Ergot (R). Cannabis Indica, the tincture gtt. xxx, as stimulant to uterine con- 
tractions, more prompt, less lasting, than Ergot (Wa). Ipecacuanha, after de- 
livery ; to promote natural functions (R). Cotton-root, as excitant of uterine 
contractions, may be more energetic than Ergot (P). Althaea, the decoction, 
as vaginal injection in difficult labor (P). Sodium Borate, excites activity of 
the uterus, and is well employed in tedious labor, where there is deficiency of 
uterine action (Rigby). Amyl Nitrite, has acted admirably in a case of hour- 
glass contraction of the uterus ; seems to antagonize the action of Ergot 
(Barnes). Oil of Eucalyptus is very valuable in effecting antiseptic midwifery 
(Wa). Mercury, the Bichloride, gr. vijss to a quart of hot water gives a ^-^^ 
solution ; probably the worst of all antiseptics for this purpose ; is too danger- 
ous for obstetrical use (Fleischman). [Compare Abortion, After Pains, 
False Pains, Hemorrhage Post-partum, Lactation, Puerperal Con- 
vulsions, — Mania, — Fever, — Disorders.] 



Lactation. 

Pilocarpine, as a galactagogue, gr. y& in brandy on retiring, the patient to be 
covered well in bed ; is efficient in direct proportion to its diaphoretic and sia- 
logogue effects, these being evanescent, but its galactagogue power remains 
for weeks, an occasional dose only being required to spur up the secretion 
when flagging (Minges) : is a galactagogue, and probably the only example of 
this class we possess (M). Antipyrin, as an anti-galactagogue, 4-grain doses 
every 2 hours have proven highly efficient. Belladonna, internally or 
externally or both, in excessive lactation (R) ; Atropine gr. iv to ^j Aquas 
Rosae on lint around the breast to arrest secretion of milk ; remove when 
fauces become dry and pupils dilated (B). Camphor, locally to arrest the 
secretion; a saturated solution in Olive Oil or Glycerin, is more efficient than 
Belladonna (Wa). Potassium Iodide, in 25 to 30 grain doses internally, for 
the same purpose, is very effectual (Rousset). Calcium Phosphate and Hypo- 
phosphite, in debility from over-lactation (R, Wa). Ammonium Chloride, for 
the intercostal neuralgia of suckling women ; gr. x-xx, every 3 or 4 hours (Wa). 
Quinine, Tannin, are used to arrest the secretion (R). Alcohol, as beer or 
porter, often useful in excessive lactation, not always (R). [Compare Abscess, 
Agalactia, Mastitis, Nipples, also the List of Galactagogues on page 57.] 

Excreted in the Milk, when taken by the nursing woman are : the Oils of 
Anise, Cumin, Dill, Wormwood and Garlic, Turpentine, Copaiba, the active 
principles of Rhubarb, Senna, Scammony, and Castor-oil, Opium, Iodine, 
Indigo, Antimony, Arsenic, Bismuth, Iron, Lead, Mercury, and Zinc. Acids 
given to the mother cause griping in the child. Natural salts, as a rule, and 
the purgative agents above-named, act as purgatives to the child, and Potas- 
sium salts as diuretics. Turpentine, Copaiba and Potassium Iodide given to 
the mother, can be detected in the urine of the child. Opium given to the 
mother may narcotize the child, and Mercurials in the same manner may sali- 
vate it (Br). Atropine, Hyoscyamine, the Salicylates, and Potassium Sulphide, 
have also been found in the milk after their ingestion by the woman. 

Presa'iption for Milk Fever. 

&. Tinct. Aconiti, VC\xx. 

Antim. et Potass. Tart., . gr. ij. Misce. Sig. — A teaspoonful in a wine- 



Spt. Etheris Nitrosi, 

Syr. Simplicis, . . . . aa^j. 

Aquae Aurantii Flor. , . . Jij. 



glassful of sweetened water, every two 
hours. {Fordyce Barker.') 



7IO LARYNGISMUS STRIDULUS LARYNGITIS. 

Laryngismus Stridulus. 

Aconite, checks the spasm and relieves the croupous breathing (R). Anti- 
pyrin, has proven very serviceable. Belladonna, promises to be of value (Wa) ; 
Atropine, gr. y^- in a goblet of water (60 doses), of which a teasp. every hour 
or ^-hour, will give prompt relief (Smith). Bromides, when uncomplicated 
except with convulsions (R) ; full doses will suspend an attack, and moderate 
doses steadily continued will prevent recurrence (B). Ipecacuanha, an 
emetic dose to cut short an attack (B). Lobelia, has been employed (R). 
Chloroform, quickly cures the paroxysm, a few drops on a handkerchief suffi- 
cient (B) ; may often be used with advantage (W). Nitroglycerin, will speedily 
allay the spasm (B). Chloral, gr. v-xv to prevent or arrest (B). Quinine, 
given between attacks to prevent (B) ; a most valuable remedy, in small, 
repeated doses (P). Emetics, Tartar Emetic ; Mercuric Sulphate (gr. iij-v) safer 
and better (R). Conium, is valuable, carried to a point of physiological effect 
(B). Water, wet pack to neck (B) ; cold sponging twice or thrice daily more 
successful than anything else, with out-of-door exercise ; cautiously if hoarse 
voice indicates laryngitis (R). [Compare Croup, Laryngitis.] 



Laryngitis, Acute Catarrhal. 

Aconite, very valuable (R) ; especially indicated in inflammatory states of 
respiratory parts ; gtt. ss-j every half-hour till an impression is made on the 
fever, then every hour or two (B). Antimony, Tartar Emetic, gr. -£$, a very 
excellent remedy internally ; larger doses in cedematous laryngitis, gr. -^ with 
gr. iij of Dover's powder every 2 or 3 hours (Da C). Iodine, inhaled; also as 
counter-irritant painted over neck (B). Morphine, small doses to allay cough 
(A). Sulphurous Acid as spray is vaunted (Wa). Leeches to throat are valu- 
able auxiliaries to general treatment in sthenic cases ; or cupping at the nape 
of the neck (Wa). Rumex, has selective action on the laryngeal mucous 
membrane (see page 421). Zinc or Copper Sulphates, as emetics, in large 
quantities of warm water, where cedema slight (A); a solution of Zinc Sulphate, 
gr. xx to the ^ on sponge to larynx with aid of the laryngoscope if possible to 
use it (Da C). Scarification, by Mackenzie's laryngeal lancet, of great service 
in the cedematous form (Da C). A Purgative and Diaphoretic, with mucilagi- 
nous drinks, if given at the start may be sufficient (Da C). Iron, Monsel's 
solution, 1 part to 2 or 3 of water and glycerin, an excellent local application 
(Da C). Heat, by poultices or fomentations (A) ; hot-water stupes may suc- 
ceed (Wa). Inhalations of hot steam, with Benzoin, the comp. tinct. gtt. x-xv 
to the ^, with gtt. x Tinct. Opii, or Hops, or Conium, of great service (Da C). 
Tracheotomy ought not to be delayed, if inhalations, leeches, and fomenta- 
tions fail (Wa) ; is especially indicated in sudden attacks of cedematous 
laryngitis, as those occurring in Bright's disease (Da C). Ice, steadily applied 
in bags over the larynx, if tracheotomy refused, has succeeded in bad cases ; 
small pieces may be slowly swallowed (Da C). [For Croupous Laryngitis, 
see Croup membranous ; for Spasmodic Laryngitis, see Croup catarrhal ; 
for (Edematous Laryngitis, see Glottis cedema of. Compare also Laryngis- 
mus stridulus, Pharyngitis.] 

Laryngitis, Chronic. 

Iodine, painted over neck as a counter-irritant, and inhalation of its vapor 
(B). Sulphur, as Sulphurous Acid by spray in syphilitic laryngitis, or a 
solution of Sodium Sulphite, $j to the ^ of water (B) ; by inhalation, spray, 
or fumigation (R). Carbolic Acid, where long-standing hyperemia with 
diminished secretion, 3j-ij to the ^ of glycerin is a most successful application 
(Mackenzie). Silver Nitrate, powdered or in solution to chronically inflamed 
larynx (R) ; a solution of gr. x or xx to the %, applied with a brush by the 



LARYNGITIS LARYNGOTOMY. 7 I I 

aid of the laryngoscopic mirror (W) ; formerly much used, but is objectionable 
(B) ; should be used with great caution, and only when a particular point can 
be seen for it with the laryngoscope (Da C). Ferric Chloride, a solution of 3j- 
ij in the ^ of glycerin, as a local application (A). Zinc Chloride, gr. xx-xxx 
to the !§ of glycerin ; alternation of topical remedies is of great value (A). 
Copper Sulphate, gr. xx to the ^ of water, locally twice a week (Da C). Bis- 
muth Subnitrate, by insufflation, is highly recommended in the worst forms of 
laryngitis (Tr). Guaiacum, as lozenges, is useful in mucous laryngitis (A). 
Althaea, as pectoral lozenges to relieve laryngeal irritation (P). Cubeb, the 
berries chewed are very efficient in relaxation of the larynx following a cold or 
long speaking (Wa). Cocaine, a 20 per cent, solution by spray, mop, or brush, 
is very efficient in many laryngeal affections (James). Benzoin, in strumous 
laryngitis (Wa) ; in chronic, Benzoin on hot coals, or inhaled from boiling 
water, is of great service (Tr). Tannin, in chronic catarrh and ulcerations, a 
solution, gr. x-xx to ^iv, applied by hand-ball or steam atomizer (A). Inhala- 
tions, or spray, of the best agents very grateful (B) ; air loaded with vapors of 
Ammonium Muriate by inhaler, said to be used successfully (W) ; vapors from 
boiling Tar, Turpentine, etc., placed on hot water, or better by steam atomizer 
(Da C) ; Chloroform, Hops, Benzoin, etc., by atomization (Walker). Insuffla- 
tion, substances to be in small quantity, mixed with some bland powder (B). 
Functional Rest of the voice often requisite, especially in phthisical and syphilitic 
laryngeal ulceration (A). Chronic Laryngitis, includes many disorders of the 
larynx, which of late years have been differentiated as thickened vocal cords 
(chronic laryngitis proper), laryngeal ulcers, polypi, cysts, cauliflower growths, 
tubercular and syphilitic laryngitis, etc., in all the voice being similarly affected. 
Dysphagia, as a concomitant symptom is constantly indicative of tubercular 
laryngitis (Da C). [Compare Cough, Dysphagia, Syphilis.] 

Laryngitis, Tubercular. 

Cocaine, as pastilles or by insufflation, to relieve pain and dysphagia, espe- 
cially when much ulceration or perichrondritis present ; in the later stages its 
use prolongs life. Resorcin, a strong solution locally, is very beneficial in 
tuberculous and other ulcerations of the larynx (Tymowski). Zinc Sulphate, 
in solution mixed with a 1 or 2 per cent, solution of Cocaine, in the early catarrhal 
stage (Neumann). Silver Nitrate, in powder or solution locally (R). Bismuth 
Subnitrate, by insufflation is highly efficient (Tr). Iodoform, in large insuffla- 
tions has surprising anodyne effect when extensive tubercular ulceration exists 
(Neumann). Iodol, and Boric Acid, equal parts, by insufflation, in less severe 
cases (Id). Antitoxin, Paquin's serum has produced good results (Loeb). 
Menthol, is of great value, relieves pain and is claimed to destroy the local de- 
posits ; a solution of 1 in 10 of pure olive oil brushed freely over the part daily, 
a solution of 1 in 5 being used after the first week. Lactic Acid, is reported by 
many authorities as highly successful, even curative ; a solution of 30 per cent., 
gradually increased to 75 per cent., brushed over the affected surface after 
swabbing with Cocaine, or a few drops injected into the larynx by a laryngeal 
syringe ; is excellent, lasting good results having been obtained thereby 
(Whitla). Scraping the ulcerated spots before applying lactic acid, done by me 
in 200 cases with 28 cures (Ehring). Tracheotomy, where deep and extensive ul- 
cerations exist beyond the reach of local treatment. Diet, thick liquids are more 
easily swallowed than thin ones, and if the patient lies on a couch or bed with 
his head hanging down over the side while swallowing, this is rendered easier 
(Wolfenden) ; feeding should be done by the soft rubber tube when much dys- 
phagia exists which does not yield to cocaine. Dysphagia, as a constant symp- 
tom of chronic laryngitis is indicative of the tubercular form (Da C). 

Laryngotomy. 

Laryngotomy is more quickly and easily performed on the adult than trache- 
otomy, being further from the lungs and less dangerous. It is usually directed 



7.12 LEPROSY — LEUCOCYTH^EMIA. 

to be performed by cutting longitudinally through the skin, then horizontally 
through the crico-thyroid membrane, which may be felt as a soft depression, 
an inch below the pomum Adami. In urgent cases, however, Professor Wood 
recommends a narrow-bladed knife to be passed horizontally through both 
skin and membrane at once, and then to enlarge the opening laterally to the 
required extent. The advantage of having a horizontal incision in the skin is 
the greater openness of the wound when the patient throws up his head under 
a sense of dyspnoea (D). In Laryngo-Tracheotomy, the deep incision is 
carried downwards from the crico-thyroid membrane, through the cricoid 
cartilage and one or two of the upper rings of the trachea (CI). 



Leprosy. 

Anacardium Orientale, (Oil of Cashew), has been much lauded ; investiga- 
tion established that much of its success was due to hygienic measures and 
use of fresh meat as food (P). Arsenic, with 5 or 6 times the quantity of black 
pepper, in esteem in India (Wa). Sarsaparilla, as tonic and alterative is valu- 
able (P). Gurjun Balsam (Wood Oil), as ointment and emulsion, has been 
used with success in alleviating the disease, by Dr. Dougall, Port Blair, Anda- 
man Islands ; the ulcers of 24 lepers healed thereby. Ferri Arsenas, gr. £ 
daily, is used with success (Wa). Mercury, the Oint. of the Red Iodide, diluted 
1 to 10, or gr. j of the salt to %v of unguentum, gives very good results (Wa). 
Europhen, 5 per cent, in oil, cured a case five years ago on the island of 
Madeira (Goldschmidt). Chaulmoogra Oil [see page 218], is credited with a 
few cures and many cases improved ; the oil is mixed with Psoralea corylifolia 
as a liniment, and is also used internally (Wa). Hoang Nan, is considered of 
utility by a number of writers on leprosy, and is given in combination with 
Alum 1, Realgar 2 or 1, and the drug 2 parts, the whole being made into 3- 
grain pills, one pill daily being given at first and gradually increased (Pf ). 
Argenti Nitras, is said to act as a tonic and alterative, and to control leprosy 
for a limited period (Pf ). Ichthyol, used internally and externally, has given 
good results. The Goto Treatment, consists in bathing daily in hot water in 
which are placed bags containing hichiyon bark, taifunshi, sulphur and yoku 
yaku ; internally he gives seiketsuren pills, tincture of the chloride of iron, 
quinine, strychnine, potassium iodide, gentian, columbo, carbonate of soda and 
potash, and Epsom salts (Alvarez) ; but proof is lacking that cure has been 
obtained in any case (Emerson). Toxins and Antitoxins, are being tried in 
various parts of the world, but are not trustworthy, as the bacillus has never been 
cultivated and animals are quite refractory thereto (Goldschmidt). Diet, nutri- 
tious food, with frequent baths and great cleanliness, will do much to prevent 
the manifestations of the disease (R). 



Leucocythsemia. 

Alkaline Hypophosphites, have been used with more or less benefit (Wa). 
Digitalis, in young subjects (B). Nitro-muriatic Baths, should not be neglected, 
with tonics and nutrients (A). Iron, is of little value (B) ; large doses may do 
good in the early stage, with careful diet, and Ergot to contract the spleen (Da 
C). Phosphorus, gr. -fa increased to gr. -^, has proved successful in several 
cases (Wa). Arsenic, in as full doses as can be borne, may be of service, though 
hitherto ineffectual (Gowers) ; produced rapid improvement in a severe case, 
conjoined with Oxygen inhalations, 5 minims of Liquor Arsenicalis being given 
thrice daily, increased by 2 minims every 4 or 5 days until the dose reached 45 
minims (Fred'k Taylor). Oxygen, 30 litres daily by inhalation, with the con- 
joined use of Arsenic (Id). Thymus Extract, has been used with benefit. Gal- 
vanization of the spleen causes improvement of the blood, increasing the num- 
ber of its red corpuscles (Gowers) ; is curative in uncomplicated cases (B). 



LEUCORRHCEA LICHEN. 



713 



Leucorrhcea. 

Hydrastis, the fluid extract undiluted, applied topically, quickly improves in 
uterine and vaginal leucorrhcea (B). Pulsatilla, 5-drop doses ter die for a few 
weeks ; also a teasp. of the tinct. in a pint of cold or tepid water, as vaginal en- 
ema daily, when pain in the loins, depression of spirits, loss of appetite, etc. (P). 
Silver Nitrate, in solution locally, also tampon saturated with 3j each of Alum 
and Bismuth, when leucorrhcea due to granular vaginitis (Parvin). Balsams 
of Peru and Tolu, internally (P). Glycerin, is largely employed for vaginal 
leucorrhcea, and for erosions and ulcerations of the cervix uteri (B) ; the best 
vehicle for other agents (E). Glycozone, applied on small rolls of lint or 
absorbent cotton, after thorough washing of the vagina with solution of Hy- 
drogen Dioxide, 1 to 4 of water, and repeated twice daily (Edson). Borax, 3j 
to Oj of water, as vaginal wash for the leucorrhcea of pregnancy (Parvin). 
Cimicifuga, is said to be useful (P). Copaiba, has been used with success (P). 
Cocculus Indicus when sero-purulent discharge, pain in lumbar region (P). 
Carbolic Acid, diluted, as injection (B) ; for vaginal leucorrhcea (R). Bismuth, 
with mucilage, as injection ; or with Cacao-butter as suppository (B). Copper 
Sulphate, in solution, as injection (R). Tannic Acid, in chronic cases ser- 
viceable as injection, £ss in Sjviij of claret wine (B) ; if os ulcerated, a sup- 
pository of Tannin and Cacao-butter to mouth of uterus (R). Iodo-Tannin, 
an excellent application, 3j of Iodine to 3J of Tannic Acid, a sufficient 
quantity to be packed dry around the cervix (B). Alum and Borax, make a 
useful injection in vaginal leucorrhcea (R). Belladonna, with Tannin as bolus 
when neuralgia or ulceration of the os ; when disease due to over-secretion of 
mucous glands about the os and much pain present inject Sodii Bicarbonat., 
Z] ; Tincturse Belladonnas, gij ; Aquae Oj (R). Potassium or Sodium Bicar- 
bonate, 3} to Oj aquas as injection, especially when discharge alkaline and 
copious (R). Pareira, Uva Ursi, are successfully used (P). Sumbul, recom- 
mended in atonic form (P). Myrrh, with Iron or Aloes, beneficial (P). Ergot, 
said to be useful in some cases (R). Potassium Permanganate, has no special 
advantage ; is used in solution, gr. ij to the ^ (B). Potassium Chlorate, 3j to 
Oj of water as injection in simple cases (Parvin). Iron, the Iodide, internally 
and externally has proven serviceable ; the Mistura Ferri Composita, when 
anaemia and general debility (Wa) : the styptic preparations locally (R). 
Phosphates, for the cachexia (B) : Calcium Phosphate, gr. j-ij several times 
daily, of great value in checking profuse discharge (Wa). Injections, water 
at 6o° F. to prevent recurrence (R) ; hot water injections are the best tonic for 
the pelvic vessels to relieve venous congestion ; use with elevated hips (E). 
[Compare Endometritis, Uterine Ulceration, Vaginitis.] 



Prescriptions . 



R. Aluminis, gj. 

Zinci Sulph. , 3 ss. 

Sodii Boratis, gr. iv. 

Aq. Rosae, -f v hj- 

M. Sig. — Injection. (B.) 



B 



3jss. 



Liq. Plumbi Subacet. 
Ac. Carbolici, . . . . 2;ss. 
M. Sig. — One-fourth to be added to 
pint of water and used as an injection. 



Lichen. 

Antipyrin, internally for the itching, is efficient. Aconite, sometimes useful 
(R). Mercury, Calomel and Mercuric Nitrate Oint. mixed (also Tar Oint. 
added), in patches of obstinate lichen (R). Silver Nitrate, the Nitrous Ether 
solution painted every day or two over the patch (R). Baths, warm or of Sul- 
phides (R) ; sponging with alkaline lotions, diluted Lead-water, fluid extract of 
Grindelia well diluted, or solution of Copper Sulphate, gr. x to the ^ , in miliaria, 
or prickry heat (lichen tropicus) ; with dusting powders of Lycopodium, Zinc 



7H 



LITH^MIA — LOCOMOTOR ATAXIA. 



Oxide or Starch, singly or combined (Hughes). Potassium Citrate, or some 
other refrigerant diuretic, and light, unstimulating food (Da C). [Compare 
Eczema, Strophulus.] 



Lithaemia. 

Piperazin, by far the best agent to promote the elimination of uric acid and 
urates, with which it forms the most soluble of all known uric acid compounds : 
relieves the pruritus of the uric diathesis. Lithium Salts, especially the Citrate, 
gr. xx thrice daily, is very efficient (Da C) ; the Carbonate invaluable (Wa) ; 
the Bromide, in solution of Potassium Citrate given after stomach digestion is 
completed, one of the very best agents (Aulde). Strontium Salicylate, in 
chronic gouty conditions and in lithaemia with intestinal indigestion, the most 
valuable drug that we have (W). Salicylic Acid, or its salts, are most powerful 
solvents and excretents of uric acid (Haig). Lysidin, is still more solvent of 
uric acid than is Piperazin (see page 391). Cascara Sagrada, is believed to 
promote the excretion of uric acid. Colchicum, 15 minim doses of the wine 
twice or thrice daily, are very useful (Wa) ; the combination of Colchicine with 
Methyl Salicylate (Oil of Wintergreen) in capsules (see page 249) is a useful 
remedy. Coffee, a tincture of green coffee is anti-lithic. Pichi, of great value 
in lithaemia with cystitis (Wyman). Arsenic, in small doses, is also useful (Da 
C). Nitric Acid, 10 minim doses of the dilute acid in half-glass of water thrice 
daily, with an occasional dose of Pil. Rhei Compos, at bedtime, is the most 
efficient treatment for the class of patients who will not dietthemselves (Hughes). 
Purgatives, especially alkaline mineral waters, to clear the portal system (Da 
C). Sodium Phosphate, in laxative doses, 3"j thrice daily, gives good results. 
Alkalies, in biliousness ; also the continued use of alkaline waters rich in potas- 
sium salts, for solution of calculi (B). Acids, Hydrochloric often of great ser- 
vice ; also Lactic, when faulty digestion and assimilation (Br). Potassium 
Permanganate, prevents calculi by converting uric acid into urea (B). Buchu, 
combined with an alkali, has been a beneficial remedy (P). Chimaphila is 
believed to check the secretion of lithic acid (P). Aliment, farinaceous vege- 
tables and acid fruits are suitable (B) ; Alcohol in any form is poison to a 
lithaemic (Da C) ; succulent vegetables and fruits, occasional abstinence from 
animal food ; high living, alcoholic liquors, and sedentary habits are injurious ; 
milk diet, and frequent draughts of pure water are recommended ; removal to 
a locality where pure soft water can be procured, is often curative. [Compare 
Calculi, Dyspepsia, Gout.] 

Prescriptions. 



R. Lithii Bromidi, ,l ss_ j- 

Liq. Potassii Citrat., . . . 5iv. 
Syrupi Simplicis, . . . . Jij. 
M. Sig. — A teasp. in a wineglassful or 

more of water, 2 hours after each meal. 

Reduce the dose after a week. 



R. Tinct. Belladonnse, . . . TTLxviij. 

Vini Colchici Rad., . . . zij. 

Liq. Potas. Citrat., q. s. ad giv. 
M. Sig. — A dessertsp. well diluted, 
every 3 hours. 



R. Potassii Nitratis, . . . . 3"j. 

Ext. Pichi Fl., 3j. 

Elixir Simpl. , ^iij. 

M. Sig. — A teasp. every 2 hours. 



R. 



Vini Colchici Rad., . . . 3"ij. 
Ext. Phytolacca Fl., . . 3"j. 
Potassii Acetatis, . . . . ^iij. 

Aquae, q. s. tfd'g'vj. 

M. Sig. — A tablesp. four times daily. 



Locomotor Ataxia. 

Antipyrin or Phenacetin for the lancinating pains ; the former relieves them 
remarkably : the use of Morphine for the pains should be avoided as long as 
possible (Osier). Acetanilid, is admirable for relief of the pains (B). Bella- 
donna and Ergot are highly efficient (Brown-Sequard). Silver Nitrate, when 
motor disturbances are very marked; improved 1 in 20 cases (R); gives the 



LUMBAGO. 715 

best results in doses of gr. % to gr. yi thrice daily, withholding it after a few 
weeks to prevent argyria (Da C) ; the only remedy which has done good in 
progressive locomotor ataxia ; gr. T V~ | two or three times daily, with Sodium 
Hypophosphite, both to be discontinued when blue line appears on gums 
(Althaus). Silver Oxide, may be used instead of the nitrate, in half-grain 
doses (Da C). Aurum, is specially curative in all forms of sclerosis ; the 
Bromide of Gold and Arsenic has been of special service in this form (E. A. 
Wood). Potassium Iodide, Corrosive Sublimate, or Gold and Sodium Chloride, 
all in full doses, often retard the progress of the disease (Da C). Physostigma 
has proved beneficial (R). Phosphorus, useful, but may not cure (B). Hyos- 
cyamine, ameliorative, gr. -£% gradually increased to gr. -^ (B). Electricity, 
the galvanic current relieves pain; faradic stops wasting of muscles (B) ; in 
the stage of irritation the constant current (ascending) through spinal column 
(R). Water, one of the most efficient agents ; friction with a cloth dipped in 
water of 60-65 F., a cold compress to head; 4-8 minute bath of 70-75 
gradually lowered to 6o°, then shower-bath and frictions (R). Rest, as com- 
plete as possible, must be insisted on ; with good, nutritious diet, milk being 
desirable (Da C). Pilocarpine, produces general improvement if given in the 
incipiency, gr. j to ^j of water, of which tt\,xxx twice daily (B). Strychnine, 
gr. -^ in Z) of Syr. Hypophosphitum, thrice daily, when the system is saturated 
with silver (Da C). Suspension daily, by head, has seemed to give relief to 
pain and improve condition: is known as Charcot's treatment, but discovered 
by Matchoukowsky, of Odessa, and carried out systematically by Hessing, of 
Pesth, before Charcot took it up : is now abandoned. Morphine, sooner or 
later becomes necessary for the lancinating pains ; in one case, personally 
known to the author, which had been treated ineffectually by every known 
method, including suspension by Charcot himself, and was rapidly progres- 
sive, the abandonment of the hypodermic syringe for Morphine by mouth, gr. 
xv daily in divided doses, has seemed to result in complete cessation of pro- 
gress, which has now lasted over four years ; the patient is free from pain , 
eats and sleeps well, and attends to business, getting around by aid of a stick 
and some slight assistance from friends when crossing a crowded street. 
Orchitic Extract, also Spermine, have been used with some success. Cere- 
brinin, is reported beneficial (see page 137). 



Lumbago. 

Cimicifuga, is said to be more effectual than any other remedy (R) ; has some- 
times wonderful success; no indications can be given for it ; £ss-ij of fluid 
extract (B) ; is curative (P). Rhus Toxicodendron, in subacute muscular or ten- 
dinous rheumatism, worse at night ; completely relieves some cases (Pf ). 
Veratrum Viride, the tincture useful (R). Aconite, in ^ tt\, doses of tincture 
every two hours, with Linim. Aconiti locally (Wa). Iodides, if referable to 
syphilis, mercury, copper, tin, or lead poisoning (B). Ammonium Muriate, is 
very efficient in myalgic lumbago, gr. xx thrice daily for 2 days or until signs 
of congestion of the nasal mucous membrane appear, then to be replaced by 
Quinine, gr. v, thrice daily for a week (Waugh). Antipyrin, gr. vij, hypo- 
dermically, completely banished it in a very bad case at the Hotel Dieu, Paris. 
Morphine, hypodermically to relieve pain (R) ; gr. ye with Atropine gr. -£$, 
hypodermically, will frequently cure lumbago in two or three hours (Da C). 
Capsicum, a strong infusion applied on lint, and covered with oiled silk, very 
efficient in recent lumbago (R) ; a Capsicum plaster is a very efficient applica- 
tion. Potassium Nitrate, in ten-grain doses hourly or every two hours, when 
urine scanty and high-colored (R). Belladonna, as plaster, very valuable for 
persistent lumbago remaining in a small spot (R). Turpentine, in doses of 
n\,xx-xxx (carefully, lest strangury and nephritis), of greatest value when the 
bowels regular and urine clear and abundant (Wa). Ether Spray, externally 
as freezing mixture (R). Guarana, in 20 to 40 grain doses, removed severe 
chronic lumbago (Rawson). Chloroform Liniment, affords relief (Wa). Canada 



y\6 



LUNG DISEASES. 



Balsam, gr. v-xx, is useful, or Burgundy Pitch, as plaster (P). Acupuncture, 
occasionally gives instant relief (B) ; not when high fever (R). Aquapuncture, 
has been employed with extraordinary success (B). Heat, by hot douche to 
seat of pain (B) ; or by very hot poultices for three hours, then the skin covered 
with flannel and oiled silk ; or a hot flat-iron (R). Galvanism, the constant cur- 
rent (B) ; is highly useful ; faradization almost as successful as acupuncture (R). 
Strapping from the thigh upwards with layers of adhesive plaster which overlap 
each other ; nothing is so instantaneously beneficial. Diet, should be gener- 
ous and nutritive ; Lemon -juice as a beverage. Absolute rest is of great im- 
portance. [Compare Myalgia, Rheumatism.] 



Prescriptions. 



R 



Collodii, 
Tinct. Iodi., 

Spt. Ammoniae, . . . aa part. aeq. 
Sig. — Paint over the part with a camel's- 
hair brush. {Burggraeve.) 



Sh 



R . Ammonii Chloridi 

Ext. Cimicifugse Fl., 
Syr. Simplicis, . . . . aa J|j. 
Aq. Laurocerasi, q. s. ad !|vj. 
M. Sig. — A dessertsp. every four hours 



Lung Diseases. 

Aconite, is indicated in most acute congestions (P) ; is especially indicated 
in inflammatory states of the respiratory organs (R) ; Belladonna, in doses of 
rr\j of the tincture frequently, is of great benefit in pulmonary oedema, to retard 
exudation of serum and to counteract the failure of the heart (Smith). Tere- 
bene, is very valuable in many conditions. Terpin Hydrate, is still more effi- 
cient and more easily administered. [See under Bronchitis.] Ammonium 
Acetate, serviceable not only in bronchitis, but in the whole range of acute 
pulmonary complaints as occurring in children (Dessau). [See under Bron- 
chitis, for formula.] Veratrum Viride renders important service in acute 
parenchymatous congestions (B) ; gr. l /e of resin in pill when temperature and 
pulse are high ; it tends to induce prostration, collapse, etc. (A). Blisters, fly- 
ing blisters to chest, and perhaps along the pneumogastric in hypostatic con- 
gestion (R). Copaiba, exercises a powerful influence over the pulmonary 
mucous membrane, and is beneficial in lung diseases generally, whenattended 
with excessive secretion (Wa). Jaborandi, is serviceable for the attacks of 
breathlessness attendant on lung affections, but must be watched lest collapse 
ensue (Berkart). Liquor Potassse, in doses of rr\,x-xv added to an ordinary 
expectorant mixture, is often attended with good results in congestions of 
bronchi and lungs, chronic bronchitis, plastic bronchitis, etc. (Walshe). Cimi- 
cifuga, is a useful sedative in many irritative affections of the lungs and bron- 
chial tubes, relieving cough, improving appetite, and ameliorating the general 
condition (Wood). Croton Oil, as liniment, is a highly useful counter-irritant 
in many chronic lung diseases, and even in the bronchitis of infancy (Park). 
Cubeb, in small and oft-repeated doses, is efficient in chronic bronchitis and 
other lung affections of old persons, checking the excessive secretion and 
gently stimulating the system (Wa). [Compare Bronchitis, Emphysema, 
Hemoptysis, Phthisis, Pleuritis, Pleurodynia, Pneumonia.] 



Lungs, Gangrene of. 

Creosote, by inhalation, to obviate the fetor (R). Carbolic Acid inhalations, 
are used with marked benefit (Wa). Mineral Acids, especially Nitro-hydro- 
chloric, with Quinine, the main reliances in chronic pulmonary gangrene (A). 
Stimulants, as malt liquors, with general tonic treatment, are necessary (A). 
Ammonium Carbonate, one of the most reliable remedies ; is best given in 
decoction of Cinchona (Wa). Eucalyptus, the Oil with Alcohol, equal parts of 
each, of which 3] as inhalation by steam atomization, is useful (Wa). Turpen- 



LUPUS. /I7 

tine, the spirit on boiling water inhaled for fifteen minutes every two hours, 
successfully employed (Skoda). [Compare Pneumonia, Phthisis.] 



Lupus. 

Arsenic, in chronic cases not of syphilitic origin. Fowler's solution long 
continued exerts a curative influence, and Arsenous Acid locally (B) ; the best 
remedy in lupus of the head and face (Wa) ; the Oleate in ulcerating forms, 
constantly applied, will destroy cell infiltration in a mild and comparatively 
painless manner ;' it is also well employed in the tubercular variety (Id). 
Phosphorus, as an internal remedy, may be used as a substitute for arsenic (B). 
Aurum Arsenate, internally, is said to be serviceable. Aurum salts, locally 
and internally, have proved curative; the Chloride has been used as a caustic 
(P). Iodine is useful in lupus, whether syphilitic or scrofulous, the tincture or 
a glycerin solution locally (Hebra) ; the tincture or liniment applied to the 
edges and around them (R) ; it may also be employed internally. Aristol, is 
an Iodine preparation which has given excellent results locally as a dressing 
(Eichoff). Strontium Iodide, has been used in lupus vulgaris with varied re- 
sults. Calcium Chloride internally, has proved curative, but must be taken 
for a long time. Mercury, in small doses, is one of the constitutional remedies 
which should receive a fair trial (Whitla) ; as ointment in lupus erythemato- 
sus, and in form of Calomel ointment in scrofulous and tubercular lupus of 
children (R) ; internally Calomel in doses of 1 to 2 grains increased to 4 grains, 
will quickly check it (Wa) ; the Emplastrum Hydrargyri is very efficient in 
lupus erythematosus and allied affections (Kohn). Salicylic Acid, is the most 
typical member of the group of agents which have selective action on the new 
growth and destroy it with the least amount of injury to healthy tissue (Whitla) ; 
used as a paste, made by rubbing it with an equal part of Creosote, applied 
daily after using a strong (10 to 20 per cent.) solution of Cocaine over the part ; 
or Unna's plaster mulls, containing these two ingredients, may be used (Id) ; 
as dressing, Salicylic Acid 5, Creosote 5, Glycerinum Saponatum 90, after de- 
struction of the growth, has given good results where no scraping or other op- 
eration was performed (Hebra). Lactic Acid, seeks out the diseased tissue, 
as a dog does game, surely finds it and effectually destroys it (Hortmann) ; the 
concentrated acid should be used, either alone or as a paste made with Kaolin. 
Lead, the Liquor Plumbi, with 1 or 2 of glycerin, in the milder forms, applied 
warm after the removal of the crusts (R). Jequirity, is a good application to 
destroy the diseased tissue by setting up the jequirity inflammation (Shoemaker). 
Sodium Ethylate, on absorbent cotton, is the best of all the caustics, followed 
by Bismuth Oleo-palmitate as a soothing and astringent application (Id). Car- 
bolic Acid, the crystals melted by heat, as a mild escharotic (B) ; its action is 
very superficial. Zinc Sulphate, dried, freely dusted over the surface as a 
caustic, followed by a poultice to remove the slough (B). Silver Nitrate, a 
weak solution gradually strengthened, may be used in superficial forms (R). 
Chromic Acid, in solution, 100 grains to the ^ of distilled water, is an efficient 
escharotic (B). Thyroid Extract, has been used as a stimulant of the cutane- 
ous functional activity with most satisfactory results. Tuberculin, in this dis- 
ease has excited great interest, but the best authorities deny that its use has 
produced a single absolute cure ; yet combined with surgical methods it will give 
good results (Whitla). Scraping off the diseased tissue with Volkmann's spoon 
under anaesthesia, is the most radical and satisfactory of the mechanical pro- 
cedures (Id) : the Paquelin cautery is better than the spoon for removing the 
morbid tissue (Unna). Electrolysis, has given good results in Jackson's hands, 
who reports that the electrolytic action of the current seems to expend itself 
only on the diseased tissue. Cauterization, with the actual cautery at white 
heat, after scraping out as much as possible of the diseased parts, so as to de- 
stroy the lupus cell. Seek to replace the lesion by a cicatrix, to prevent relapse 
in situ, and the development of the disease elsewhere. Internal remedies are 
only useful for the general health, and have no specific action on the disease. 



7 i8 



LYMPHANGEITIS MALARIA. 



R . Iodi, 

Potassiilodidi, . . . . aa j| ss. 

Glycerini, ^j. 

M. Sig. — Locally in lupus. 

{McCall Anderson.) 



Prescriptions. 

R. Hydrargyri Bromidi, . . . ^jss. 
Adipis, 3 v. 

M. ft. unguentum. Sig. — To cover the 
part affected, using Cod-liver Oil freely, 
and the following solution internally. In 
tubercular lupus of the face. {Hardy. ) 



R. 



Ung. Arseni Oleat., . . . gij. 

Ung. Simplicis, ^j. 

M. ft. unguentum. Sig. — Use constantly 
over the affected surface. If pain sets in 
Opium maybe added. {Shoemaker.) 



R . Potassii Iodidi, gr. lxxv. 

Sodii Chloridi, , ^ ss. 

Aq. Destil., ^ viijss. 

M. Sig. — Tablesp. before meals, night 
and morning. {Hardy.) 



Lymphangeitis. 

Belladonna, the extract softened with glycerin and freely applied, is of great 
service ; when pain is severe a poultice may be applied over the extract for a 
few hours only ( Wa). Lead, Liq. Plumbi Subacet. Dilutus, as an external ap- 
plication, constantly applied, to soothe and restrain the inflammation (Wa). 
Iodine, in strong tincture, applied around the glands, to prevent suppuration 
(Roberts). Quinine, or Salicin, with alcoholic stimulants freely, in septic cases 
(Id). [Compare Bubo.] 



Malaria, Chronic. 

Arsenic plays an important role in chronic malarial disease (B) ; diminishes 
splenic engorgement, and combined with Iron is rapidly curative of many af- 
fections due to the paludal miasm (Boudin) ; is a powerful prophylactic against 
malaria, and in chronic malarial poisoning, with frequent return of fever and 
neuralgia, its continued use is of great benefit (Fayrer). Quinine, is less cura- 
tive than when the infection is recent, but in periodical affections depending on 
the malarial cachexia it is of specific value, large doses being required (B). 
Salicylates, of Quinine and Cinchonidine are especially effective in chronic 
malarial disease (B). Iron, the Sulphate has decided antiperiodic power, and 
is particularly successful in anaemic subjects and in those with enlargement of 
the spleen (Wa) ; it improves the anaemia of chronic malaria, and should 
generally be combined with Arsenic (B). Iron and Manganese Iodide, the 
syrup in doses of ttlxx-xxx, is a successful remedy for chronic malarial infection 
(B). Manganese Sulphate, gives excellent results in jaundice of malarial 
origin (B). Cornus, Calumba, and other bitters, are highly efficient, especially 
the first named, in chronic malarial poisoning, and in convalescence after 
malarial fever (B). Carbolic Acid and Iodine combined, are of great value in 
chronic malarial infection ; both are highly antiperiodic, and the latter is the 
best substitute for Quinine and the most active reducer of splenic enlargement 
(Gimwell). Eucalyptus is of high utility to reconstruct the damages in the 
organs of assimilation (B). Nuclein, has been used with benefit (Vaughn). 
Baths, the vapor-bath and Turkish baths are efficient aids to medicinal treatment 
in breaking up chronic cases, and may of themselves cure such by inducing 
profuse perspiration (Da C). [Compare Intermittent Fever, Remittent 
Fever.] 

Prescriptions. 

R. Cinchonidinae Salicylat. , . spj. R. Quininse Sulph., .... gr. xl. 



M 



Cinchonidinae Salicylat. 
Acidi Arsenosi, . . . 
Ferri Sulph. Exsiccat. , 
ft. pulv. no. xx. Sig.- 



• 39- 

• gr- j. 

. gr. xx. 
-One powder 



in wafer thrice daily. 



Ferri Sulph. Exsic, 
Acidi Arsenosi, . . 
M. ft. pil. no. xx. Sig.- 
daily. 



. . gr- 
. . gr. xx. 
. . gr. j. 
-One pill thrice 



MANIA. 



719 



R . Cornus, 

Calumbae, 

Liriodendri, 

Pruni Virginianse, . . . aa^vj. 

Eupatorii, 

Capsici, aa^iv. 

Pulv. et. misce. Sig. — A teasp. in cold 
or warm water, three or four times daily. 
A good tonic tincture may be made from 
the above combination. (B.) 



R. Tinct. Iodi, ^ij. 

Acidi Carbolici, ^j. 

M. Sig. — Two or three drops three or 
four times a day, in water. 



R. Acidi Arsenosi, . . . . gr. j. 
Mass. Ferri Carbonatis, . gj. 
M. ft. pil. no. xx. Sig. — One pill thrice 
daily. 



Mania. 

Stramonium, is of value ; allays irritation and induces tranquil sleep ; in wild 
and furious delirium, but intermittent, also in nymphomania (P) ; many facts 
seem to confirm its reported value (Tr). Daturine, gr. j^-^—^ hypodermically 
in acute mania, but is less useful than Atropine or Hyoscyamme (Wa). Duboi- 
sine, gr. -^ hypodermically in acute mania (Gubler) ; is more sedative and 
hypnotic than the other alkaloids of the group and acts well in doses of gr. 
y^q at first, gradually increased to gr. ^. Belladonna is useful, especially in 
monomania, with fixed hallucinations, though a large dose causes a temporary 
insanity (Tr) ; one of the very best remedies in all hypersemic conditions of the 
brain (P). Hyoscyamus, in violent intermittent forms, to procure sleep and 
calm violent delirium (R) ; delirium with hallucinations but not congestion ; in 
milder and less inflammatory forms also hypochondriacal monomania (P). 
Hyoscine, finds its greatest and most useful application in. the treatment of 
maniacal violence and noisiness, and is a drug for emergencies of this kind 
( Weatherly). [See under Insanity.] Veratrum Viride, successfully combats 
the excitement in acute mania (B). Camphor, has been used successfully ; its 
action is uncertain (P). Opium, and Tartar Emetic are satisfactory for many 
cases ; also Morphine hypodermically to induce sleep (R) ; its narcotic effect is 
of doubtful utility, better in insanity with depression (P) ; will not produce nar- 
cotism in many such cases, even in 2-grain doses. Cannabis Indica, 3j of tinct. 
with 5j of Potassium Bromide, is recommended (R). Bromides are used in 
puerperal mania, that of pregnancy, nymphomania and other forms (R) ; the 
combined use of Potassium Bromide and Tinct. of Cannabis Indica, equal 
parts, 3j of each thrice daily for weeks and months, has proved very efficient 
in acute and periodical mania, senile mania, and other forms (Clouston). 
Chloral, as calmative and hypnotic, has induced mental improvement (B). 
Paraldehyde, as a hypnetic, in doses of 3ss-j, is often decidedly useful (R) : 
larger doses are necessary, an average one is 3iss. Coniine, most suitable to 
acute mania, quiets muscular action ; doses of rr\,ss-iij, or hypodermically, 
beginning with gr. ^ ; with Morphine conjointly injected, is very successful 
(R). Digitalis, 3ss-£j of tinct. valuable in acute and chronic mania, espe- 
cially when complicated with general paresis and epilepsy (Maudsley) ; caution ! 
watch the pulse for any marked intermittence (B) ; a very valuable palliative 
in acute mania (Van der Kolk). Ergot, large doses, 3ss-j of fluid extract, to 
reduce excitement, shorten attacks, widen intervals between them, and prevent 
exhaustion, hence is very useful in recurrent and epileptic forms, and in chronic 
mania with lucid intervals (Crichton Browne). Iron, as a restorative, is fre- 
quently used in chronic mania with benefit, the Tincture of the Chloride in 5- 
10 minim doses (B). Gelsemium, is more useful than Conium in mania with 
great motor excitement and wakefulness ; large doses required, tt^xv-xx of 
tincture. Croton Oil, as a purgative, y\ l /.-% every hour, as revulsive in mania 
from cerebral congestion (R). Cimicifuga, is often efficiently used in cases of 
mania occurring during the puerperal or pregnant condition (R). Chloroform, 
may be necessary to temporarily control very violent cases ; its inhalation need 
not be carried to complete anaesthesia. Galvanism, of the head and cervical 
sympathetic, has produced distinct improvement (B). Cold Douche, in mania- 



720 MASTITIS — MASTODYNIA MEASLES. 

cal delirium, the patient being in a warm bath during the application of the 
douche to the head (R). Removal from home, from sympathetic friends, and 
from surroundings connected with the origin of the malady, is a prime necessity 
to a cure. [Compare Delirium, Insanity, Puerperal Mania.] 



Mastitis. 

Belladonna, Atropine locally (see Lactation), or combined with Morphine 
and Chloral, when much pain (B) ; especially as liniment to check secretion of 
milk when inflammation is imminent (R) ; or when breasts are distended by 
milk (P) : when inflammation has set in, continuous application of Belladonna 
for 24 hours often arrests it ; it is also useful when an abscess has formed ; 
also fomentations in addition, but skin must be dried well before the Bella- 
donna is rubbed in (R) ; rr^v-x of tinct. internally as well (P). Camphor, a 
saturated solution in Glycerin locally, in mammary congestion threatening ab- 
scess (Wa). Phytolacca, has power to arrest inflammation of the mammae and 
to prevent suppuration; the fluid extract in 10-minim doses internally, and the 
solid extract on a cloth to the inflamed breast (B). Conium, the extract in 
small doses several times a day, of striking benefit in mastitis and impending 
abscess of breast (Wa). Calcium Sulphide, internally in mammary abscess ; 
occasionally increases pain (R). Hyoscyamus, as plaster, to relieve painful 
distention from milk (P). Stramonium, fresh leaves as cataplasm to discuss 
indurated milk (P). Iodine, tinct. and ointments to remove indurations of 
breasts after inflammation (B). Mercury and Morphine, the Oleate locally in 
mammary abscess (R). Tobacco leaves, as poultice in abscess (R). Digitalis, 
the infusion locally as fomentation in severe inflammation of the breasts, causes 
it to yield speedily (Fairbank). Ammonium Chloride, Z] in Spt. Rosmarini 
Oj, as lotion on linen rags, kept constantly to the part, especially in induration 
after abscess has suppurated (Wa). Tartar Emetic, in small and frequent 
doses, given early, is beneficial (Wa). Oil frictions in first stage of inflamma- 
tion of breasts, from circumference toward the nipple (L). Rest, by supporting 
mammae with strips of plaster, and bandaging the arm to the side, to prevent 
motion (T). Alcohol, over proof, applied by sponging until part is cold ; re- 
new if high heat returns. Heat, applied by a basin lined with flannel satu- 
rated with hot water, to relieve pain and prevent suppuration. [Compare Ab- 
scess, Lactation.] 

Mastodynia. 

Conium, has specific anodyne action on the mammas and generative organs. 
Cimicifuga, relieves infra-mammary pains of uterine origin in spinsters. Olive 
Oil, 2 parts, to 1 of Tinctura Opii, may be used by gentle friction to painful 
breasts after parturition (Parvin). Non-interference in simple cases of enlarge- 
ment and tenderness, which will spontaneously subside if let alone; in severe 
cases support by strips or bandage, if breast pendulous ; Belladonna ointment 
or liniments ; amputation of the breast has been necessary (T). 



Measles. 

Aconite, for febrile symptoms, and especially to arrest the catarrhal pneu- 
monia (R) ; a valuable remedy (P) ; the best drug when fever is very high, 
JE^-drop doses of the tincture every 2 hours (Da C). Jaborandi, with a hot 
bath, as diaphoretics in cases of delayed eruption (Da C). Asclepias, an 
infusion or decoction freely as a diaphoretic to promote the eruption (W). 
Veratrum Viride, has been employed (R). Pulsatilla, for the catarrhal oph- 
thalmia, nasal and intestinal catarrh ; 3j-ij of tincture to ^iv water as wash 
(P). Ammonium Carbonate, dissolved in a solution of the Acetate, is much 
vaunted ; when feeble circulation, cyanosis, delirium, gr. v-x to ^ss-^j Liq. 



MELANCHOLIA. 721 

Ammonii Acetatis (B) ; gr. iij-vj or vij, every hour or two, in Cinnamon-water 
or milk ; one of the reliable remedies (W). Camphor, the water with Liq. 
Ammon. Acetatis, excellent when cough and catarrh the most urgent symp- 
toms (A). Ipecacuanha, for cough and catarrh, gr. j-ij every 4 or 6 hours (A). 
Antimony, preferred to Ipecac by some (A). Quinine, in small doses (gr. j- 
iij) for the adynamia, or large (gr. xv) for hyperpyrexia and catarrhal pneumo- 
nia (B). Carbolic Acid, has been employed in several hundred cases with 
decided advantage ; most useful at early stage (Wa). Cod-liver Oil and Iron, 
to scrofulous children, a long course of such medication after convalescence 
(Da C). Purgatives, must be given with caution (R) ; the milder purging salts, 
as Magnesium Sulphate, to be preferred (A). Mustard, as bath on sudden retro- 
cession of rash (R) ; often increases the fever without benefiting the pneumonia 
or other complications (A). Water, cold affusion at commencement; packing, 
especially when retrocedent (R) ; hot foot-baths for convulsions (A) ; tepid 
bath with cold douche to head, if cerebral symptoms are severe (Da C). Oil 
Inunctions, Cacao-butter is very grateful and reduces temperature ; also in the 
roseola (B) ; hands and feet to be rubbed with a firm fat to remove heat and 
tightness produced by rash (R). Aliment, low diet and slops; no animal food 
during the whole course (A). Hygiene, dark room, complete disuse of eyes, 
strict cleanliness (A). [For Sequelae see Bronchitis, Cough, Ophthalmia, 
Otorrhcea, Pneumonia, etc.] 

Prescriptions. 

R- . Acidi Carbolici, 

Acidi Acetici, . . . . aa ^j-^jss. R- . Tinct. Tolutanse, .... Zij. 

Tinct. Opii Deodorati, . . ^j. Syr. Senegse, Sss. 

Spt. Chloroformi, .... X). Acidi Acetici, 3J SS - 

Aquae, q. s. ad gviij. Syr. Pruni Virg., . q. s. ad £ iv. 

M. Sig. — A .tablespoonful every 4 M. Sig. — A teaspoonful as required for 

hours, until fever abates. (Ifeith.) cough after convalescence. 



Melancholia. 

Aurum, gives excellent results, gr. ^V to -£$ of the Chloride thrice daily, 
especially when cerebral anaemia coexists (B); the Bromide of Gold and 
Arsenic has rendered good service in many cases, n\,x hypodermically thrice 
daily : Gold is highly recommended in suicidal melancholia. Bromides, 
sometimes afford relief which no other agent will ; no indications (B) ; Potas- 
sium Bromide for townspeople, especially women with unendurable despon- 
dency (R). Arsenic, gives great comfort in the melancholia of aged persons, 
is best when combined with small doses of opium, thus — Liq. Potas. Arsenit. 
TtLij, Tinct. Opii ttLiij-v ter die (B). Opium, in stimulant doses of tincture, 
gives good effects (B) ; especially when paroxysms of acute anguish and des- 
pair, or when suicidal impulse (Wa) : Morphine hypodermically is of great 
benefit in some persons who have a peculiar idiosyncrasy therefor (R). Cam- 
phor has been highly recommended (R). Musk and Castoreum are employed 
in melancholia with benefit (R). Cannabis Indica, sometimes relieves (B). 
Phosphorus, depression from overwork (R). Chloral, as hypnotic, has been 
followed by marked amelioration and cure (Wa). Valerian, in hysterical or 
suicidal melancholia, is often beneficial (Wa). Caffeine has been useful (B). 
Iron, as restorative, the tincture of the Chloride (B). Cocaine, a useful tonic 
and especially beneficial in nervous affections accompanied by depression (Br). 
Cimicifuga, in puerperal or uterine despondency, of singular value (P). Ignatia, 
has soothing effect in great mental depression (P). Orchitic Extract, has been 
used with benefit. Water-cure, shower-bath for 15-20 seconds, or warm-bath, 
95 F. for 30 minutes ; the shower or cold douche may be usefully employed 
in cases where reaction takes place after it (W). [Compare Hypochondriasis, 
Hysteria, Insanity. 1 
46 



722 MENINGITIS. 

Meningitis, Cerebral. 

Aconite, is as serviceable in this as in the other acute inflammations ; during 
the stage of excitation, the tincture, gtt. ij with gtt. v of the tincture of Opium, 
every 2 hours, gives admirable results (B). Belladonna, in all hyperaemic 
conditions of brain and spinal cord one of the very best remedies, especially 
during the period of excitement (P). Hyoscyamus, valuable in subacute form 
(P) ; for nervous irritability during convalescence (A). Gelsemium, extremely 
useful; rr^v of fluid extract every 2 hours (B). Mercury, as ointment gives 
good results in children (A) ; Calomel in small, frequent doses, so as to bring 
the system under it quickly, a most valuable remedy apart from its purgative 
effects (Wa) ; the Unguentum Hydrargyri rubbed in for 30 minutes into the 
skin on the front of the abdomen, groins and arm-pits, repeated after 12 hours 
if no evidences of improvement or salivation ; such unmistakable benefits 
follow the free use of mercury that to withhold this remedy in desperate or ap- 
parently hopeless cases is unjustifiable (Whitla). Potassium Iodide in large 
doses where vomiting and gastric derangement are absent, and in the later 
stages of syphilitic meningitis may be very valuable (Id) ; has cured (Nie- 
meyer). Ergot, the fluid extract in £ss doses with an equal quantity of Potas- 
sium Bromide, every four hours, to diminish the vascular excitement (B). 
Potassium Bromide, in the convulsions following simple meningitis (R). Opium, 
in small doses ; by clinical evidence proved to be the best remedy, especially 
for acute stage before exudation, or during the stage of excitation (B) : when 
collapse, it may sustain the vital powers ; with Tartar Emetic has proved most 
beneficial, but should be used with caution, as it may do great harm (Wa). 
Bryonia, exceedingly valuable for serous inflammations in stage of effusion (P). 
Pulsatilla, valuable in the acute form (B). Purgatives, as soon as possible, 
unless exhaustion ; Calomel and Jalap the most active and searching (A) ; 
Croton Oil as a derivative and revulsive, also locally to the shaven scalp is 
productive of the best results (Wa). Venesection, or arteriotomy (temporal 
artery) gives good results (B) ; when high cerebral excitement and vascular 
action (A). Blisters, on nape of neck if coma, after active symptoms are sub- 
dued (A) : useless, and cause needless suffering (O). Water, cold water for 
hyperpyrexia (C) ; pounded ice in bag or bladder, as a cap to the head (R). 
There are no remedies which in any way control the course of acute meningitis 
(O). [Compare Meningitis, tubercular.] 



Meningitis, Cerebro-Spinal. 

Opium, in small doses is the most effective remedy ; its utility ends when 
effusion occurs and stupor and coma ensue (B) ; large doses (Valleix) ; gr.j 
every hour in very severe cases (S) ; has been used in France and Germany 
with much success (Tr) ; is the best remedy of all, gr. j every hour for 4 days, 
even such doses will not narcotize (Da C). Antipyrin, has rendered good ser- 
vice. Aconite, is useful combined with Opium (B) ; affects the cranio-spinal 
axis from 3d nerve to phrenics, the region where this disease is most manifest 
(Harley). Gelsemium, extremely valuable, r^v of fluid extract every 2 hours, 
to maintain constant physiological effect (B) ; is efficient for the delirium. Bel- 
ladonna, in all hyperaemic conditions of brain and spinal cord, especially dur- 
ing stage of excitement (P). Iron, the tincture of the Chloride, in 20-30 minim 
doses, every two hours, suggested by the similarity of the disease to erysipelas, 
has made many successful cures without leaving any sequela? (Klapp). Bro- 
mides, to guard the Opium and enable the latter to be pushed, 20-grain doses 
every 4 hours (Da C). Hydrocyanic Acid, dilute, rry-ij, with gr. iij-v of Sodium 
Bicarbonate, every 3 or 4 hours for severe vomiting (Delafield). Quinine in 
large doses at the commencement (B) ; has been exhaustively tried in this dis- 
ease and failed (Da C). Potassium Iodide for the sequelae, a long course of 
Iodides during convalescence is the best treatment (Da C). Cold to the spine, 
the most satisfactory treatment (Radcliffe) ; to head and upper spine for 5 



MENINGITIS. 



723 



minutes only at a time, for the headache and tetanic symptoms (Da C). Vene- 
section, or arteriotomy (temporal artery), probably of service, but cautiously 
(B) ; leeches at back of neck and on temples, to relieve the terrible headache, 
if patient is strong and vigorous (Da C). Digitalis, in early stage (Rummel). 
Ergot, one of the best remedies (B). Turpentine, enema, as derivative (B). 
Stimulants, in small quantities (A). Counter-irritation, by actual cautery freely 
applied to back, alleviates pain (A). Water, cold baths or wet pack for hyper- 
pyrexia (B) ; hot-water bottles or sand-bags to trunk and extremities to keep up 
warmth ; bath of 102-106 for short time only, then wrapped in blankets (A). 
Heat to the body, except the head and neck (Da C). Aliment, nutritious and 
suitable food at short intervals, day and night (A) ; tonics with fresh air and 
good diet during convalescence (A). Ventilation, of dwellings, the best sanitary 
precaution when the disease is epidemic (Simon). 



Prescriptions. 



B 



Morphinse Sulph., . . - . gr. ss. 
Ac. Sulphurici Aromat. , . £j. 
Tinct. Cinchonas Co., . ad §yj. 
M. Sig. — Tablesp. every 2 hours, for a 
boy of 12 years old. {Meigs 6° Pepper.) 



3 iv - 



H . Potass. Iodidi, . . . 
Tinct. Gentian. Comp. 
<Syr. Sarsae Co., . . . . aa Sjij. 
M. Sig. — Teasp. thrice daily, to pro- 
mote absorption during convalescence. 



Meningitis, Spinal. 

Aconite, is very useful (B) ; with an Ergot and Opium impression to reduce 
the amount of blood in the vessels of the cord (Da C). Potassium Iodide, in 
the chronic form, with the Bichloride of Mercury when a specific history present 
(Hammond). Belladonna, strongly to be relied on, even when brought on by 
external violence (P). Bryonia, in serous inflammations when effusion, is 
extremely valuable (P). Purging, by Magnesium Sulphate, combined with 
Tinct. Hyoscyami (A). Quinine, when paralysis occurs, in 3-grain doses 
thrice daily, with % -grain doses of Ext. Belladonnas, or 20-30-grain doses of 
Potassium Iodide, and flying blisters along the spine (Da C). Opium, in some 
form, must be used for pain (Bastian). Mercury, gr. -^ of the Bichloride, with 
increasing doses of Potassium Iodide, to promote absorption of inflammatory 
products, if the inflammation subsides (Bastian) ; a mercurial impression often 
benefits the paralysis (Da C). Cold, by ice to spine is deemed necessary, and 
no doubt alleviates the pain, though heat would be a more rational application 
for the inflammation (Bastian). 



Meningitis, Tubercular. 

Potassium Iodide, is the routine remedy to be administered in ordinary typi- 
cal cases, full -and frequently repeated doses are necessary, gr. j every 2 hours 
for a child of 2 years (Whitla). Iodine, lotions to scalp, or inunction of Iodine 
ointment together with Ferrous Iodide and Cod-liver Oil internally, offer the 
best chance of success, although most remedies often fail (Wa). Potassium 
Bromide, combined with the Iodide in double the dose of the latter, is advan- 
tageous (Whitla). Tartar Emetic, the oint. as counter-irritant to scalp in tuber- 
cular meningitis (R) ; in large doses internally was formerly employed (Wa). 
Croton Oil, is said to have removed the excess of fluid from the ventricles (R) : 
as a derivative and revuhive, also locally to the shaven scalp, is productive of 
the best results (Wa). Mercury, Hydrarg. Chlor. Corr., in doses of gr. -fa to T ^, 
has proved successful (Wa) ; Mercury by inunction should be used heroically 
as long as there is any reason to doubt the diagnosis, in the hope that the case 
may be one of simple meningitis (Whitla). Magnesium Carbonate, 3j-ij satu- 
rated with Lemon-juice, every 2 or 3 hours, a useful purgative in hydrocephalus 
(Wa). Turpentine, in doses of tt\,v-x with n\,xx-xl of Castor Oil, or terebin- 
thinate enemas, in incipient hydrocephalus (Wa). Purgatives, in small doses, 



724 MENORRHAGIA. 

every 4 or 6 hours after having overcome the constipation, to maintain action 
for some days ; a single dose of Calomel, followed up by Magnesium Sulphate 
at short intervals ; their value can hardly be overrated (Wa). Leeches, on crown 
of head rather than on temples, when much febrile action ; inadmissible if patient 
is much debilitated ; sometimes serviceable (Wa). Cases of recovery have 
been reported by reliable authorities, but they are extremely rare, and there is 
always a reasonable doubt as to the correctness of the diagnosis. I have 
never seen a case recover which I regarded as tuberculous (O). 



Menorrhagia. 

Opium, has specific action in reducing the uterine circulation and should be 
pushed, even to inducing habit, in severe cases (Lutaud). Ipecacuanha, in full 
emetic doses (Wa) ; is excellent (B) ; Ergot is better (P). Savine, enlarged, 
relaxed, and passively congested uterus (B) ; in 5-10 drop doses of tinct. in 
water every half-hour to three hours, has proved useful (P) ; when menorrhagia 
due to want of tone in uterus (R). Ergot, large spongy uterus ; Bromides bet- 
ter (B) ; Ergotin gr. j or ij in glycerin and water, undoubtedly efficacious as 
hypodermic injection (P) ; in all forms (R) ; minim doses of the fluid extract 
are very beneficial (Smith). Hydrastinine, a powerful uterine vaso-constrictor ; 
very successfully used in grain doses of the Hydrochlorate in 10 per cent, solu- 
tion hypodermically, for a few days before the expected term. Hamamelis, has 
decided influence on venous system ; of high repute (Pf). Arsenic and Iron, 
when from anaemia (B). Cannabis Indica, often successful (R) ; gtt. v-x of 
tinct., thrice daily, productive of extraordinary success (Wa) ; has a stimulant 
action on the uterine muscular fibre, and may be given in combination with 
Ergot (B). Iron, when dependent on anaemia (B). Rue, low vascular tonus ; 
should never be used in the pregnant state (B). Erigeron, the Oil, in 10- 
drop doses, is efficient (Wa). Gossypium, a favorite uterine hemostatic in 
many hospitals, 30-minim doses of the fluid extract every four hours (Parvin). 
Quinine, has been recommended (R) ; after Ergot it is the very best agent, in 
6-grain doses every 3 hours (Parvin). Digitalis, very useful, especially when 
from heart disease, in plethoric subjects (R) ; 3J-jss of infusion as dose will 
arrest menorrhagia when unconnected with any disease (P, R). Aloes, with 
Iron in debilitated and relaxed subjects (B). Cimicifuga, passive, coagulated 
and dark (P) ; for accompanying headache (R). Gallic Acid, is very efficient 
(R). Potassium Chlorate or Bromide, in doses of gr. xv thrice daily, com- 
bined with Ergot, has an almost infallible influence over uterine hemorrhage, 
unless caused by cancer, polypi, adherent placenta, or other similar affections 
(Tait). Bromides, usually arrest promptly (B) ; that of Potassium most useful 
in young women if loss occurs at natural period only ; commence the Bromide 
a week before and discontinue when discharge ceases till a week before the 
next term ; if loss occurs every two or three weeks give Bromides continuously 
in 10-grain doses, but more when organic changes in womb (R, Wa). Am- 
monium Chloride, for headaches (R). Calcium Phosphate, in anaemia from 
excessive menstruation (R). Magnesium Sulphate, very small doses with a 
little dilute Sulphuric Acid and syrup, is exceedingly useful (Wa). Cinnamon, 
the Oil, in drachm doses (R). Mammary Extract, gave signal satisfaction as 
an internal remedy in two cases of menorrhagia with dysmenorrhcea and 
enlarged uterus (Bell). Water, hot water bag to lower dorsal and lumbar ver- 
tebrae (R)'; cold sitz-bath, feet in warm water, especially valuable ; 6o°-6$° F., for 
5-15 minutes, patient then quickly dried and put to bed. [Compare Metror- 
rhagia.] 

Prescriptions. 

R. Ext. Ipecac. Fl , .... gij. I R- . Ext. Ergotae (Squibb' s), . gr. xij. 

Ext. ErgotseFl., . . . . £iv. Ext. Opii, gr. vj. 

Ext. Digitalis FL, . . . . 3 ij. M. et div. in pil. no. xij. 

M. Sig. — Ahalfteasp. to a teasp. as Sig. — One pill every hour, in profuse 

required until emesis occurs. (B.) menstruation of atonic type. 



MENSTRUAL DISORDERS METRORRHAGIA. 725 



Menstrual Disorders. 

Aconite, gtt. j of tinct. every half-hour to hour promptly restores the discharge 
when suddenly suppressed from chill (P, B, R, Wa) ; as emmenagogue (Tr). 
Pulsatilla, often of the greatest value when menses scanty or delayed, or sup- 
pressed by fright or chill (P, B). Ignatia, in suppression of hysteria (P). Savine, 
a powerful uterine tonic ; as emmenagogue certain, powerful, safe (P). Ferrum, 
in anaemic subjects (B). Aloes, as emmenagogue [vide Amenorrhcea]. 
Cocculus Indicus, for irregular menstruation with colicky pains and scanty dis- 
charge ; should be given for a few days prior to and during period (P) ; TtUj-iij 
of a saturated tincture thrice daily. Opium, in suppression from violent mental 
emotions, a valuable remedy (Wa) ; in many menstrual disorders it proves 
invaluable, but must be cautiously administered lest the habit be formed. 
Cimicifuga, relieves heat and pains in the head, flushings in the face, pains in 
back and limbs, etc., when occurring as the result of menstrual perversion 
(Wa). [Compare Amenorrhcea, Dysmenorrhea, Menorrhagia, Climac- 
teric Disorders]. 

Mentagra. 

Mercury, the Oleate, or the Bichloride, gr. ij to ^j of water, applied as lotion 
after each epilation (R) ; Citrine oint. extensively employed (Wa). Sulphu- 
rous Acid, with an equal part of glycerin, an efficient application (Jenner). 
Arsenic, has powerful influence, used internally in doses of nvv of Liquor 
Arsenicalis thrice daily (Wa); the Oleate of Arsenic is an efficient local 
application. Sulphur Iodide, as ointment, 5j to ,li ss » is efficient with 
Donovan's solution internally (Sir E. Wilson). Copper Sulphate, as lotion, £j 
to ^xvj of water, with ^ss of Zinc Sulphate, and ^jss of Aqua Laurocerasi (B). 



Metritis, Acute. 

Opium, by suppositories or enema is more effectual than if administered 
internally (Wa). Aconite, is invaluable in early stage of simple inflammatory 
fevers (P). [Compare Puerperal Fever.] Heat, to the feet, and by large 
poultice to the abdomen ; also hot water vaginal injection literally for hours, if 
possible, repeated at short intervals ; the only means of aborting an attack of 
cellulitis (E), which is the condition generally present in cases which are 
usually supposed to be ones of acute metritis (Playfair). Turpentine, as hot 
epithems; few measures are more generally serviceable (Wa). Linseed Poul- 
tices, produce great relief to pain and favorably affect the course of the 
disease (Duncan). Leeches, to the hypogastric region, may be required in 
patients of full habit. [Compare Puerperal Fever, Puerperal Metritis.] 



Metrorrhagia. 

Opium, has specific action on the uterine circulation (see page 367), and 
should be given freely in intractable cases of metrorrhagia from uterine fibroids 
or cancer, in which the establishment of the opium-habit is often advisable 
(Lutaud). Hydrastinine, a powerful uterine vaso-constrictor ; successfully em- 
ployed in grain doses of the Hydrochlorate in 10 per cent, solution hypodermi- 
cally. Atropine, gr. y^ to -^ hypodermically, in profuse metrorrhagia after 
abortion or of obscure origin ; may require as many as four injections to cause 
cessation of the flow (Squibb). Salipyrin, in doses of gr. xv thrice daily, em- 
ployed in fifty cases of metrorrhagia from various causes, with best results in 
cases following labor or abortion (Orthmann). Ipecacuanha, possesses con- 
siderable energy in arresting flooding (P) ; in full emetic doses, gr. xx in even- 
ing, followed by an acidulated draught in the morning (Wa). Hamamelis, 
when persistent oozing (R). Ergot, the most valuable remedy in full doses 



726 MILIARY FEVER MUSCLE MYALGIA. 

repeated every hour or so (R, P). [See Menorrhagia for formula.] Savine, 
5 to 10-drop doses of tincture in cold water every yi hour to 3 hours (P). Iron, 
styptic preparations as injections (B). [See Hemorrhage, post-partum.J 
Cannabis Indica, often arrests metrorrhagia especially when at climacteric; 
tincture gtt. v-xx ter die (P) ; has had extraordinary success in number and 
rapidity of cures (Wa). Sulphuric Acid, sometimes very effective, especially 
when due to fibroid or polypus ; Ac. Sulphurici DiL, gtt. v-xx, well diluted (B) ; 
long and extensively prescribed (Wa). Cinnamon, is used with good effect 
(P) ; has specific action on the uterus (T). Digitalis, in plethoric subjects ; the 
infusion best, a tablesp. bis die (P) ; the effect is prompt and decided (Wa). 
Magnesium Sulphate, often succeeds (B). Senegin, in 2-grain doses, is suc- 
cessfully employed (P). [Compare Amenorrhgea.] Ice, to abdomen, or 
within the uterus (B) ; Ice in every way the first thing to try (Wa). Rest, abso- 
lutely necessary. Dry Cupping, over sacrum, is found useful (R). [Compare 
Menorrhagia, Uterine Tumors.] 

Prescription. 

R- . Ext. Ergotae Fl., . . . . ^ss. 

Ext. Senec. Aur. FL, M. Sig. — A dessertsp. every % hour 
Ext. Viburn. Prunif. Fl., aa^j. j until relieved, then reduce the dose. Keep 
01. Myristicse, n^xx. the head low, and apply cold over the hypo- 
Syr. Simplicis, . q. s. . ad^y'y gastrium. 



Miliary Fever. 

Aconite, for the hyperpyrexia (R, P). Cooling Drinks, purgatives and anti- 
phlogistics, in mild cases ; malignant ones sometimes occur, and are dangerous 
(A). Lime-water applied by sponging, is very useful ; or a lotion of Zinc Oxide 
suspended in Lime-water, gr. xl to ^j, painted on the affected parts of the skin, 
and permitted to dry thereon (E. Wilson). 



Muscse Volitantes. 

Potassium Iodide, very effectual in curing muscae depending upon hepatic 
derangement (Wa). Valerian, often found curative ( Wa). Muscae Volitantes 
are due to shadows cast on the retina by fibrillae floating in the vitreous body, 
and are most visible to myopic persons ; they do not merit attention unless very 
abundant, or steadily increasing (C). Rest of the eye necessary. Neutral-tint 
glasses may be worn to render the muscse less visible, if troublesome. 



Myalgia. 

Arnica, the best agent for contused muscular fibre ; also for shake, concus- 
sion, shock ; Tr^v-x every 2 or 3 hours in water (P) ; a few drops of tincture in- 
ternally, removes stiffness, after packing with cold, wet sheet (R). Cimicifuga, 
often succeeds wonderfully, as often fails ; no indications for its use (B) ; general 
bruised sensation (R). Ammonium Chloride, in 10 to 20-grain doses, the most 
efficient remedy (Anstie) ; is effective (R). Veratrine, the ointment externally 
may control (B). Belladonna, as liniment, is often successful (R). Gelsemium, 
frequently cures, but large doses are necessary, 11^ v-xx of the fluid extract every 
3 hours (B). Coca, to relieve the sense of fatigue (P). Opium, by frictions or 
poultices (R). Iodine, ointment for pain and tender muscles of the chest, when 
skin may be pinched without pain (R). Xanthoxylum, externally and inter- 
nally, has a deserved reputation (B). Chloroform Liniment, with friction, often 
affords great relief (Wa). Firing, sometimes very beneficial (B). Packing, 
with dripping wet sheet (R). Counter-irritation, by firing, aquapuncture, acu- 
puncture (B). Electricity, the constant current (B). Baths, Turkish, in aching 



MYELITIS MYOPIA M YXCE DEMA NjEVUS. J2'] 

muscles, from over-exertion (R). Poultices, very hot, followed by applications 
of lint and oilskin (R). Rest, is the remedy, of course (Wa) ; rest and support 
to weak muscles is important until they regain their tone ; especially in painful 
muscular affections following prolonged or excessive exertion, or in the sore- 
ness or stiffness which occur during convalescence from any long illness, or 
accompanying general debility, and generally better after repose, but increased 
with fatigue. [Compare Pleurodynia, Lumbago.] 

Myelitis. 

Belladonna, is decidedly effective, especially when disease is brought on by 
external violence (P). Ergot, most successful: large doses are necessary (B). 
Electricity, in chronic, not in recent form (B). Silver Nitrate, in chronic inflam- 
mations of the cord, one of the few remedies which are ever of service ; gr. 
]i~Yz (W). Silver Phosphate, of special value in myelitis with disturbance of 
bladder and rectum (Wa). Sodium Phosphate, hypodermically, was employed 
with great benefit in a case of syringo-myelitis (see page 383). Phosphorus, of 
marked benefit in myelitic paraplegia from excessive venery (W). Water-cure, 
Ice-bag to spine, feet in hot water ; or better, hot douche to spine (B). Cold, 
externally, by Ice-bags, along the spine, with cupping or leeching if much 
localized pain or tenderness ; spoon diet and a sparing amount of stimulants, 
also copious warm enemata to relieve the bowels and act as derivatives. Little, 
if anything, is to be done with mere drugs. Posture should be prone, or on 
side ; absolute rest (Bastian). [Compare Meningitis spinal, Paralysis.] 

Myopia. 

Atropine, by daily instillation, systemically, for the purpose of sacrificing 
either the convergence or the accommodation, in cases where failure of the 
internal recti occurs, the disability assuming the form of muscular asthenopia 
(C). Glasses, properly adjusted, should be worn from the commencement. 
Extraction of the Lens, produces the happiest results in extreme myopia, 
especially when progressive, since by removal of the crystalline lens the refrac- 
tion of a very myopic eye is brought back nearly to emmetropia (Valude). 

Myxcedema. 

Thyroid Extract, or the thyroid gland itself, fed to the patient daily, is now 
the recognized treatment, and produces the best results (see page 131). 

Nsevus. 

Ferrum Chloride, injected, is effectual ; but dangerous when applied thus to 
naevi about the head (Wa). Creosote, pencilled over twice a day, may remove 
naevi (Wa). Chromic Acid, as escharotic, or local application, gr. c ad 3J aquae 
destil. (B). Electrolysis, or galvano-cautery, to remove naevi (B) ; 40 cases so 
treated; the process is certain and safe, leaving a faint cicatrix and no after- 
pain (Knott) ; in my hands has answered well during ten years' use in these 
cases (Marshall). Nitric Acid, strong, as escharotic for small superficial naevi, 
followed by Oleum Olivae (B). Zinc Chloride, Iodide and Nitrate, locally, 
especially the first named (R). Setons, threads passed across the growth in 
various directions, to produce suppuration ; when pus appears the threads 
should be removed. Sodium Ethylate, prepared by adding the metal Sodium, 
piece by piece, to absolute alcohol in a wide-mouthed bottle ; the crystalline 
substance found deposited after effervescence ceases is an excellent caustic for 
naevi ; painted over them it causes a rapid eschar, and usually gives but little 
pain (Richardson). Mercury, the Acid Nitrate an excellent caustic for remov- 
ing moles from the face (Thomas). 



J2% NAILS NASAL AFFECTIONS NAUSEA. 

Nails, Ingrowing. 

Liquor Potassae, a solution, 3ij to %], on cotton-wool applied to margin of 
nail at ulcerated surface, to soften the nail in ingrowing toenail (B). Glycerin, 
or Silver Nitrate, on a fold of lint, to the ulcerated surface (C). Lead Car- 
bonate, a piece softened between the fingers, and applied as plaster beneath 
the fungous cushion, cures in a few days (Tr). Paring the nail, after softening 
in warm water, and cutting a V-shaped incision in centre of nail ; the ingrow- 
ing portion should not be cut. 



Nasal Affections. 

Ammonia, by inhalation, in pain and inflammations of nose and frontal bones 
(R). Potassium Iodide, large doses, gr. xxx-lxxv daily, valuable in syphilitic 
affections of the nose (Wa). Glycerite of Tannin, to excoriations of inside of 
nose, after measles, scarlatina, etc. ; also for impetiginous eruptions of inside, 
most severe where hair grows ; epilation sometimes needful ; also in discharge 
of greenish, black, stinking mucus (R). Glycerite of Starch, or Zinc Ointment, 
applied often, a good supplementary application (R). Hydrastis, in chronic 
catarrhal conditions and nasal ulcers, used internally and externally, with great 
benefit (P). Pulsatilla, may be employed both internally and externally in nasal 
inflammations (P), and in acute inflammation of nose (B). Cod-liver Oil for 
chronic discharge (R). Injections, by nasal douche, are used with benefit in 
catarrhal states (Wa). Zinc Chloride, gr. ij to the Hj, or the Sulpho-carbolate, 
gr. v to the ^, as solutions locally by cotton-wrapped probe to diminish sensi- 
bility of the nasal mucous membrane (Sajous). Cocaine, has many applica- 
tions in treatment of nasal affections ; a 4 per cent, solution by mop or spray 
will empty the engorged venous sinuses, and is very useful in acute catarrh, hay 
fever, etc., also for posterior and anterior rhinoscopy (R). [Compare Acne, 
Catarrh, Epistaxis, Hay Fever, Influenza, Oz^na, Polypus, Sneezing.] 



Nausea. 

Carbolic Acid, or Creosote, is very useful in reflex nausea. Hydrocyanic 
Acid, TOj-iv of the dilute acid in ^j of water, is useful (Beale). Ammonia, 
rt\jij-iv of Liq. Ammoniae in a winegl. of water when the feeling of nausea is 
most troublesome, may cure the ailment (Id). Hydrargyrum, a small dose of 
Blue Pill or Calomel will sometimes cure very obstinate nausea, although many 
other remedies have failed (Id). Cocaine, a 2 per cent, solution sprayed high 
into the nasal passages, so as to reach the terminal filaments of the olfactory 
branches, is specific against nausea, its influence lasting several hours (In- 
graham). Chloroform, mji-v on sugar, will remove some kinds of nausea (B). 

Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in 
that of chronic alcoholism ; very small doses, gr. -£% of powder or Try of wine 
(P). Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick-head- 
ache (P). Cocculus Indicus, in cephalic nausea, violent but ineffectual efforts 
at vomiting (P). Calumba, in nausea of languid stomach with flatulence, has 
considerable reputation (P). Cinnamon or Cloves, will check nausea (P). 
Nutmeg, the simple powder in wine (P). Pimenta, Pepper, Peppermint, re- 
lieve nausea (P). Tartaric Acid, as effervescing draught, with a^few drops of 
Tinct. Opii, Tinct. Calumbae, or Dilute Hydrocyanic Acid added, when from 
morbid gastric irritation (Wa). Bismuth Subnitrate, or the Liquor Bismuthi,. 
when the salt in substance disagrees, is a remedy of established value in 
nausea and vomiting arising from gastric disorders ; may be combined with 
Hydrocyanic Acid (Wa). Counter-irritation, by a mustard poultice applied 
over the region of the stomach and liver for 20 minutes every 3 or 4 days 
(Beale). Heat, hot water on spongio-piline, worn for an hour or two, will fre- 



NECROSIS NERVOUS AFFECTIONS. 729 

quently be found efficacious (Id). Cold, by a compress or ice-bag, over the 
stomach, is often verv useful. [Compare Dyspepsia, Headache bilious- 
sick, Sea-sickness, Vomiting, Vomiting of Pregnancy.] 



Necrosis. 

Sarsaparilla, a very useful medicine in diseases of the bones (P). Rest, in 
a Salter's swing, with poultices, water-dressings or stimulating lotions, to aid the 
work of repair (CI, Hilton). Tonics, nutritious food, baths, good hygiene, all 
are necessary adjuncts to local treatment (Andrews). Acid Solutions, of no 
use as solvents, may be employed with benefit for detergent and alterative 
effects to expedite the sloughing and restorative processes (Gross). Operation 
to remove sequestrum is generally necessary ; or resection of the devitalized 
bone, the latter in young subjects greatly exhausted, where delay would 
endanger life (Gross). Potassa cum Calce introduced into fistulae, to convert 
them into large openings, permitting the removal of diseased bone (Kirk- 
patrick). [Compare Caries, Bone Diseases, Syphilis, Scrofulosis.] 



Nervous Affections. 

Nux Vomica, in one-drop doses of the tincture every 5 minutes, is promptly 
efficient in relieving many affections of reflex neurotic origin, as cough, 
dyspnoea, syncope, palpitation, flatulent dyspepsia, eructations, etc., especially 
when occurring in hysterical subjects (Macfarlan). Arsenic, of especial value 
in nervous affections resulting from malaria, in which large doses are required ; 
Tt\,x of Liq. Arsenicalis, increased to tt\,xxx thrice daily (Wa). Asafcetida, is a 
remedy of much value in nervous affections connected with uterine derange- 
ment, also in dyspeptic hypochondriasis and other nervous affections ; maybe 
combined with bitter tonics and mild aperients (Wa). Potassium Bromide, 
takes precedence in epilepsy, epileptiform convulsions, hysterical convulsions 
and spasms, tetanus, etc. ; is of great value in chorea, insanity, acute mania, 
insomnia, delirium tremens, some forms of neuralgia, and the numerous 
symptoms of vaso-motor disturbance, such as — numbness, coldness, deadness, 
pricking sensations, indefinable but distressing sensations in abdomen, hypo- 
gastrium or epigastrium ; feelings similar to rigors, with anxiety, palpitation or 
fluttering of the heart, — all due to interference with the local circulation (Rey- 
nolds). Valerian and Valerianates, are thought to exercise some special 
influence over nervous affections, especially Zinc Valerianate, in half-grain to 
grain doses in pill, or the Ammoniated Tincture of Valerian, from which every 
good that can be expected from the valerianates will be more certainly 
obtained (W). Sumbul, acts as a nervous stimulant, and is especially effi- 
cacious in neurotic migraine, also in hysteria and the obscure paralytic affec- 
tions associated therewith (Wa). Caffeine, is of signal value in neuralgia, 
hemicrania and other nervous affections (Shaffer) ; grain-doses in solution 
hypodermically afford great relief in dorso-intercostal neuralgia attending 
shingles, insomnia, etc. (Anstie). Cocaine is a powerful nerve stimulant, 
destroying the sense of fatigue, and often evincing marked analgesic power in 
neuralgias ; is effective in melancholia, hypochondriasis, etc., as well as locally 
in nerve pain over a limited area ; it acts as an excitant upon the central 
nervous system (R). Opium, is a remedy of marked value in insanity, melan- 
cholia, mania, and all nervous affections accompanied by pain (W) ; gives 
general repose to both body and mind, is of decided value in diabetes, and pro- 
duces marked improvement in melancholia and despondency (R). Lupulin, 
is peculiarly useful in nervous affections when Opium cannot be tolerated, 
especially in chronic hysteria attended with morbid vigilance, 10-grain doses 
every 6 hours afford great relief, without causing any unpleasant symptoms 
(Eberle). Santonin, in convulsions, epileptiform seizures, and affections 



730 NERVOUSNESS. 

regarded as choreic, etc., the result of reflex irritation from worms (Wa). 
Phosphorus, of occasional utility in affections of the nervous system induced 
by mental exertion or ovar-excitement ; the danger from its use is its liability 
to produce fatty degeneration of the internal organs (Wa). Sodium Phos- 
phate, hypodermically, employed with great benefit in a case of syringo- 
myelitis, also in one of unilateral astasia-abasia ; is considered by Luton to be 
possessed of reconstructive power equal to that of the animal extracts. Orchitic 
Extract, has been used with benefit in several affections of the nervous system 
(see page 136). Physostigma, given for six months or longer, in small doses, 
gr. ^g- of the extract every 3 hours, is useful in many nervous affections, as 
locomotor ataxia, writer's cramp, and paraplegia due to myelitis (Murrell). 
Silver Phosphate, is of special value in sclerosis of the nervous substance and 
in myelitis (Wa). Shower Baths, cold, are often beneficial in nervous affec- 
tions unconnected with disease of the brain. [Compare Diabetes, Hemi- 
crania, Headache nervous, Hemiplegia, Hysteria, Insomnia, Loco- 
motor ataxia, Mania, Melancholia, Myelitis, Neuralgia, Neuras- 
thenia, Neuritis, Nervousness, Paralysis, Paralysis agitans, Spinal 
Paralysis, etc.] 

Nervousness. 

Opium, calms the nervous system and gives general repose to both body and 
mind (R) ; small doses, identity of drug to be carefully concealed lest the opium- 
habit be formed. Antipyrin, is efficient for nervous irritation. Ignatia, in small 
doses better than Morphine for mental excitement and nervous erethism (P) ; 
for the nervous exaltation of cinchonism (Pf). Strychnine, affords relief in 
functional irritability of the nervous system, manifested by restlessness and 
wandering neuralgic pains (B) ; especially useful as a tonic in nervousness 
from over-use of tobacco (H). Potassium Bromide, especially for women who 
are despondent, irritable, and sleepless, from overwork, grief, worry, etc. ; often 
connected with migraine (R) ; gr. ss-j of any Bromide every % hour, is very 
efficient for the nervous disturbances of children (Smith). Valerian, extremely 
useful as a sedative to reflex excitability, calms nervousness, does much good 
in fevers where restlessness, fidgets, anxiety, etc. (P). Aconite, gtt. j of tinct. 
at bedtime, repeated if needful, for restlessness and " fidgets " of men as well 
as women (R). Caffeine, for restlessness due to great lowering of nervous 
power (P). Chamomile, lowers reflex excitability (P) ; minim doses of the 
tincture every 15 minutes an excellent sedative for children (Smith). Resorcin, 
produces quiet sleep in general nervous excitability. Conium, where a great 
deal of motor agitation, especially in the typhoid-like condition with insomnia, 
exaggerated nervousness and delirium often resulting from mental overwork, 
acts charmingly in securing sleep, by removing the motor agitation ; rrvx of a 
fluid extract of the unripe fruit, every ]/ z hour, carefully watched (Madigan). 
Musk, serviceable in nervous affections when due to uterine derangement (Wa). 
Sumbul, often invaluable in restlessness of pregnancy ; rt^xxx-xl of tinct. with 
a little Chloric Ether as draught (P). Camphor, a powerful subduer of reflex ex- 
citability (P). Chloral, where restlessness, debility (R). Chloroform, the 
Spirit internally (R). Hop, the hop-pillow is deserving of trial. Lupulin, 
peculiarly useful when Opium cannot be tolerated (Wa). Water, warm 
sponging to induce sleep and calm restlessness in convalescence ; also, cold 
sponging (R). [Compare Insomnia, Irritability.] 



Strychnine Sulphatis, . . gr. j. 
Quininae Sulphatis, . . . ^j. 
Tinct. Ferri Chloridi, . . 3 v. 
Ac. Phosphor. Dil., 
SyrupiLimonis, .... aa^ij. 
M. Sig. — A teasp. in water thrice daily 



Prescriptions . 

R- . Potassii Bromidi, .... 5j. 
Ext. Guaranae Fl., . . <5J SS - 

Syr. Tolutani, . . . . . . ;§iij. 

Aquae, q. s. ad^w]. 

M. Sig. — Teasp. to a dessertsp. three or 

four times daily. To relieve nervousness. 



NEURALGIA. 73 1 

Neuralgia. 

Antipyrin, is prescribed in all forms of neuralgia (M) ; is highly efficient in 
neuralgia of the 5th nerve associated with neuritis (B). Acetanilid, is used with 
success in facial and intercostal neuralgias (M) ; is highly useful against pain 
due to inflammation of nerves (B). Phenacetin, is specially useful in the 
fugacious and variable neuralgias so common in the hysterical and neurotaxic 
(M) : of the three drugs named Phenacetin is probably the safest and most effi- 
cient in doses of 10 grains. Salipyrin has been employed with excellent 
results ; a dose of gr. viij being often sufficient. Phenocoll, is used successfully, 
especially for the neuralgic pains of epidemic influenza (grippe). Salol, is 
very efficient in some forms. Salicylates, in large doses, cured a case of tic 
douloureux of 12 years' standing (Dercum). Opium, internally, or Morphine 
hypodermically, in the vicinity of the affected nerve, the best treatment; cau- 
tion ! morphine-habit (B) ; gr. -^ to % often relieves and frequently cures after 
a few repetitions (P) ; no remedy promises more speedy and permanent relief 
than Morphine by subcutaneous injection in sciatica, lumbago, tic douloureux 
and other neuralgic affections (Wa). Aconite, when arterial excitement (B) ; 
in congestive neuralgias, and acrodynic of extremities ; has important role (P) ; 
as ointment or liniment, especially when fifth nerve affected ; also in neuralgic 
headache (R) ; a remedy of great value (Wa) ; a perfect physiological remedy 
against neuralgia, especially those forms which are based on congestive or sub- 
inflammatory affections ; but its action is often slow, so that Morphine must be 
given with it as a palliative. Aconitine, with Veratrine as an ointment locally, 
a good application (Da C) ; internally the best agent of all in essential neu- 
ralgia ; should be combined with Quinine in intermittent forms and those which 
resist quinine alone. [See formula below.] Belladonna, must be persisted 
with in full doses ; gr. -^ of Atropine internally, or gr. -^ to -^ hypodermically 
in vicinity of nerve, has special utility in tic douloureux and sciatica ; also in 
peri-uterine and dysmenorrhceal neuralgias (B) ; try of solution of gr. j in gij 
of water hypodermically (P) ; for spinal irritation ; intercostal neuralgia ; the 
Liniment or Ointment of Atropine in facial (R) ; gr. ijss of the extract every 
hour till giddiness, then lessen the dose and continue for several days (Tr). 
Veratrum Viride, tincture, said to be very useful (R) ; Veratrine Ointment for 
facial neuralgia and sciatica (R) ; the Oint., gr. viij to £j, frequently of much 
benefit (P). Quinine, large doses, gr. v-xx in sherry, just before the attack in 
periodical neuralgia, whether malarial or not ; useful also, in small, frequently 
repeated doses, in other types, especially of supra-orbital nerve (P) ; has selec- 
tive action upon supra-orbital form (Spender). Arsenic, cures by its influence 
on bodily nutrition ; directly so in neuralgia of malarial origin, though inferior 
to Quinine (B) ; in various neuralgias, also in angina pectoris (R) ; the Bromide 
of Gold and Arsenic rendered good service in an obstinate case of trifacial 
neuralgia diagnosed as due to syphilis, after other treatment besides anti- 
syphilitic had failed (E. A. Wood). 

Nux Vomica, is most useful in visceral neuralgias, as gastralgia, hepatalgia, 
etc., the tincture with carminatives in the former affection ; or Strychnine, gr. 
3^-0 to -^ twice or thrice daily : in all forms of neuralgia this remedy should be 
used in small doses (P). Ignatia, in hysterical and intercostal neuralgia with 
nervous erethism, is valuable (P). Phosphorus, gr. -^ every few hours, has 
made very effective cures (B) ; gr. y^ to y 1 ^ every 3 hours ; very useful in all 
forms, especially when uncomplicated (R) ; always a good remedy, except for 
cases due to cold or inflammation, and those not depending on depraved nutri- 
tion (H). Ammoniated Copper, in neuralgia of the 5th, used with remarkable 
success ; )4 -grain doses pushed (Fereol). Physostigmine, very efficient in neu- 
ralgia of the eyeball, a solution of gr. ij to the J by instillation. Cannabis 
Indica, %-%. gr. doses of extract 2 or 3 times a day; especially for neuralgic 
headache (P); found useful (R). Cod-liver Oil, when low nutrition, faulty 
assimilation (W). Iron, when from anaemia ; tincture of the Chloride rrLxxx-xl 
ter die, also chalybeate waters (B) ; moderate doses only required (R) ; in 
chlorotic subjects, of whom nearly all will have neuralgia (Tr). Iodides, for 



732 NEURALGIA. 

neuralgia of fifth, dependent on syphiloma of the nervous system, pain noc- 
turnal chiefly (B). Bromides, benefit some kinds, especially ovarian (B) ; 
Potassium Bromide occasionally relieves (R). Ammonium Chloride, half- 
drachm doses in facial and other neuralgias, is much used (R) ; a very efficient 
and diffusible stimulant, gr. xx-£j at first, repeated every hour during the 
attack (H). Chloroform, as anaesthetic to relieve pain, is occasionally useful 
locally, also as spray for uterine neuralgia (R) ; rr^v-xv of pure Chloroform by 
deep injection into vicinity of affected nerve, a very efficient method of dealing 
with long-standing cases (B) ; used in one case it caused symptoms so severe as 
to imperil the life of the patient (W). Theine, hypodermically, is promptly anal- 
gesic, and has prolonged influence, but must be aided by remedies to improve 
the nutritive state of the affected nerves, or those which are capable of remov- 
ing the diathesis upon which the neuralgias depend (Mays). [See formula 
below.] Caffeine, hypodermically has been found useful, especially in cervico- 
brachial neuralgia (P). Cocaine, as a hypodermic injection, a 4 or 5 per cent, 
solution is very effective if administered in the vicinity of the aching nerve 
(R) ; also by instillation in neuralgia of the eyeball, and whenever it can be 
applied to the mucous surface in the vicinity of the pain. Croton Chloral, very 
effective, especially in tic douloureux and sciatica, gr. ij-v every hour till gr. 
xv are taken (B) ; in facial, that from carious teeth, that of neck and back of 
the head, tic douloureux, etc. (R) ; gr. j every J^-hour is a very efficient dose 
(Smith) ; rarely of any value, but when used is best given in 20-grain doses 
twice daily (H). Chloral and Camphor, equal parts, triturated together, and 
painted over surface (R) : also with Morphine (B). Amyl Nitrite, inhaled in 
dysmenorrhceal neuralgia (B) ; and when of 5th nerve (R). Nitro-glycerin, 
has often afforded great relief (Wa). 

Sumbul, for certain types, of more value than any other remedy ; facial, 
sciatic, or ovarian neuralgias, in women of nervous constitution, often yield to 
it at once (P). Cimicifuga, in neuralgia of the 5th from cold, and in ovarian 
(B). Gelsemium, successful in neuralgia of 5th (B) ; especially dental branches 
(R) ; of value in trigeminal, ovarian, etc. (W) ; in suitable cases small doses 
answer as well if not better than large ones (Pf) ; rrpij of the tincture every yi 
hour often succeed miraculously with no ill results in neuralgias about the head 
and face (Smith) ; no better remedy in tic douloureux, but must be given in 
large doses, Tr^x-xv of a strong tincture or fluid extract (H). Zinc Valerianate, 
extremely beneficial in neuralgia from reflex irritation of female pelvic organs 
(B). Spigelia Anthelmia, is useful in the facial form (P). Ammonium Valeri- 
anate, or Zinc Valerianate in neuralgia of face or head (R) ; the latter in ner- 
vous cases, and uterine (Wa). Chamomile, in neuralgia of 5th nerve (R). 
Staphisagria, internally and externally often curative in obstinate facial and 
cervical neuralgia (P). Ergot, much employed in visceral forms, especially 
gastralgia (P) ; is said to be useful (R). Digitalis, is strongly recommended in 
sciatica, also locally in earache (P). Valerian, serviceable in facial neuralgia 
of hysterical type (P). Bibiru Bark, in intermittent forms (P). Pyrethrum, 
root, is chewed with benefit in facial neuralgia (P). Capsicum, a strong infu- 
sion, on lint covered with gutta-percha (R). Coccus Cacti, has been very suc- 
cessful in 20-30 minim doses of a 1 to 8 tincture twice daily, the larger doses 
in the paroxysms (W). Peppermint, the Oil, painted over the part in facial 
neuralgia (R) ; especially the Chinese oil, which contains a large excess of 
Menthol, a very useful application in superficial neuralgias (W). Turpentine, 
has cured tic douloureux and sciatica (B) ; often of wonderful service (P). 
Potassium Chlorate, for facial neuralgia (B). Alcohol, with much volatile 
Ether ; care must be taken in prescribing it (R). Piscidia, almost specific in 
many forms, useless in many cases (W). Tonga, is efficient in facial neural- 
gia, tt\,x-xx every two hours (H). Osmic Acid, a one per cent, aqueous solu- 
tion with glycerin to prevent change, of which 5 to 10 drops hypodermically, 
has made striking cures of inveterate neuralgias, with no ill effects resulting 
(Shapiro). Carbonic Acid Gas, injected into vagina for neuralgia of uterus. 
Aquapuncture, strangely relieves pain in a superficial nerve, so much so, that 
some hold the curative effects of morphine injections to be due to the water (B). 



NEURASTHENIA. 



733 



Counter-irritation, Mustard poultices in neuralgic pains (P) ; blisters to a pos- 
terior branch of the spinal nerve-trunk from which the painful nerve issues 
(Anstie). Wet Pack, is of great benefit, especially in sciatica. Intense Cold, 
produced by a spray of Methyl Chloride, or concentrated Carbonic Acid gas, 
directed along the nerve from special apparatus, immediately relieves the pain, 
and usually cures (Jacoby). Compressed Air, by insufflation into the middle 
ear, in cases of persistent and paroxysmal temporo-occipital neuralgia, due to 
chronic follicular pharyngitis and inflammation of middle ear (Legal's Disease) ; 
if these insufflations result in diminution of the pain, treatment should be di- 
rected to the naso-pharynx and Eustachian tubes (Masucci). Galvanism of 
the affected nerve, one of the most important curative measures ; a continuous 
current of 4 to 8 cells down the nerve generally answers best, though some 
cases are helped more by a rapidly interrupted faradic current : Electricity is 
of no value in cases dependent upon organic lesions, and in any individual 
case is purely experimental (W). Diet, animal fats necessary, as cod-liver oil, 
butter, cream, etc., in as large quantity as can be digested. Rest often needed, 
with protection from cold and damp, flannel clothing, bathing and shampoo- 
ing. [Compare Gastralgia, Hemicrania, Hepatalgia, Otalgia, Ovarian 
Neuralgia, Sciatica, Tic Douloureux, etc.] 



Prescriptions. 



For Internal Use. 

K . Phosphori, gr. ss-jss. 

Alcoholis, q. s. ad solv. 

Spt. Menthae Piperitae, . . q. s. 
Glycerini, , . . q. s. ad %\v. 
M. Sig. — A teasp. after each meal. 

(H-) 

R . Cupri Ammonio-sulphat. , . gr. j-iv. 

Syr. Aurantii Flor. , . . . gj. 

Aquae Destil., ^ iij. 

M. Sig. — One-third as a dose, thrice 
daily. (-P ro f- Fereol.) 



3h 

gr. ss. 



M 



Quininse Sulphatis, 

Ferri Pyrophosphatis, 

Strychninae Sulphat, 

Ac. Phosphor. Diluti, . . gij. 

Syr. Zingiberis, Jfij. 

Aquae, q. s. ad g iv. 

Sig. — A tablespoonful twice daily. 



30* 

XX. 



. Aconitinae Crystal., . . . gr. 
Quininae Hydrobrom., . . gr. 
M. ft. massa, et div. in pil. no. xij. 
Sig. — One every 4 or 5 hours. (Potter. 



R ■ Tinct. Aconiti, 

Tinct. Colchici Sem., 

Tinct. Cimicifugae, 

Tinct. Belladonnae, . . aapart. aeq. 
M. Sig. — 6 drops every hour until re- 
lieved. (Metcalf.) 



For Local Use. 



R . Chloroformi, 

Tinct. Aconiti, . . . aa 5ss. 

Linim. Saponis, 3J. 

M. Sig. — Apply on flannel and cover 
with oiled silk. For superficial neuralgia. 



R. Aconitinae (Duquesnel), . gr. iv. 

Veratrinae, gr. xv. 

Glycerini, ^ij. 

Cerati, gvj. 

M. Sig. — To be rubbed over the part, 
avoiding any abraded surface carefully. 

\Da Costa.) 



R 



M, 



Mentholi, gr. xlv. 

Cocainae Hydrochlor. , . . gr. xv. 
Chloralis Hydratis, . . . gr. x. 
Vaselini, 3 v. 

ft. ung. Sig. — For local use. 

(Potter.) 



R 



M 



Veratrinae, .... 

Adipis, vel Unguenti, 

Sig. — Local use. 



. gr. xl. 
(Da Costa.) 



B 



Theinae, 

Sodii Benzoatis, . . . aa ^j. 

Sodii Chloridi, gr. x. 

Aquae Destil., ^j. 

M. Sig. — 3 to 20 drops hypodermically 
at central seat of disturbance. ttlvj — gr. 
ss of Theine. (Mays.) 



Neurasthenia. 

Ammonia, the Aromatic Spirit proves very serviceable ; ^ss-j in water 
thrice daily (Wa). Hypophosphites of Lime or Sodium, or Iron, are actively 
tonic in cases of nervous depression and torpor, with occasional shooting pains 



734 



NEURITIS. 



(Wa) ; the Syrup of the Hypophosphites with Strychnine is of service as a 
general tonic, in connection with other remedies. Arsenic, is often very 
serviceable; Fowler's or Pearson's solution, in doses of ™Jij-v, in water, after 
each meal. Aurum, the Bromide of Gold and Arsenic (Barclay), gave excel- 
lent results in 3 out of 4 cases of marked neurasthenia, in doses of r^v of the 
solution 4 times daily (Love). Strychnine Acetate, a remedy of great promise, 
when combined with a rigid system of diet, mental discipline, etc. (Marshall 
Hall). Zinc Oxide, often excellent as a tonic and sedative, in nervous irrita- 
bility and depression from anxiety, over-study, etc. (Wa). Phosphorus, of 
occasional utility in nervous breakdown from over-study, etc. (Wa). Caffeine, 
gr. j or more in a cup of coffee, to relieve brain weariness and nervous 
exhaustion (Wa). Cocaine, in j^-grain doses proves serviceable in nervous 
exhaustion (R) : danger of cocaine-habit if identity known to the patient. 
Coca, as a stimulant has been used with benefit, but only for a short time, 
and acts deleteriously unless given in small doses (W). Kola-nut is used in 
France, contains Caffeine, and is subject to the same remarks as above. 
Musk, is a valuable remedy in such cases, being stimulant and antispasmodic ; 
it stimulates the nervous centres when exhausted, without producing any very 
pronounced symptoms (W). Orchitic Extract, has been used with benefit. 
Nuclein, is useful in many cases (Vaughn). Cerebrinin, has been used 
with advantage (Paul). Artificial Serum, in cases of lowered arterial tension 
(lessening of first sound, tachycardia embryocardia), an injection hypo- 
dermically of rr\,xv of the solution formulated below, 2 to 4 times a day (La 
France Medicaid). Diet should be chosen from the most readily assimilable 
food, calling for a minimum amount of digestive work. As a rule, neurasthenics 
eat too much and drink too little ; plenty of water, at least a litre and a half 
per day, is the best drink ; it maintains the arterial tension, irrigates the tissues 
and assists the excretion of debris. Milk should be prohibited, also vegetable 
soups, peptones and extracts of meat. The albuminoid element of the food 
should not exceed one- sixth of the total (Vigoreaux). Counterirritation, the 
actual cautery along the spine has rendered excellent service in several cases 
of neurasthenia accompanied by neuralgia of the superficial branches of the 
spinal nerves ; its action is doubtless often a mental one, and it renders the 
carrying out of the rest-cure more thorough than when attempted without some- 
thing to enforce quiet. Rest-cure, with forced alimentation and systematic 
massage to keep up the muscles while holding the nervous system as inactive 
as possible, will do more than medicine in these cases. Many such will recover 
under the discipline and quiet of an hospital or sanitarium alone ; while others 
are greatly benefited by removal from home influences and cares, and from 
association with certain persons who irritate them. [Compare Adynamia, Ex- 
haustion, Gout, Hysteria, Spinal Irritation.] 



Prescriptions. 



R. 



Artificial Serum. 



. 311J. 
. gr. lxxx. 
. gr. xxx. 
. gr. v. 

ad £ iv. 



E 



Sodii Phosphatis Pur. , . 
Sodii Sulphatis Pur., . 
Sodii Chloridi Pur., . . 
Ac. Carbol. Cryst. , . . 
Aq. Destil. Bullient, . . 
Dose, TT^xv hypodermically. 

Strychnine Acetatis, . . . gr. j. 
Ac. Acetici Diluti, .... rtlxx. 

Alcoholis, gij. 

Aquse Destill., 3 v j- 

Sig. — Ten drops thrice daily. [Hall. 



Tonic and Stimulant. 

R. Tinct. Kobe, gjss. 

Ac. Citrici, gr. xx. 

Sodii Arseniat., gr. j. 

Tinct. Cocae, . . q. s. ad ^ iv. 
Dose, ^j at each meal. 

R. Ac. Phosphorici Dil., . . 5j. 
Elixir Calisayse( U.S. Disp.),^ vj. 
Elix. Ammonii Valerian., . .^ij. 

Glycerini, ^iij. 

Vini Xerici, . . . q. s. ad O]. 
M. Sig. — %] thrice daily. 



Neuritis. 

Strychnine, internally, is of value, and may be given in increasing doses (O) ; 
hypodermically, in multiple peripheral neuritis, is of great advantage ; no case 



NIGHTMARE NIPPLES NODES. 735 

remembered in which it failed to cause improvement (Walker). Acetanilid, 
is so effective that it seems to have specific action (B). Antipyrin and Salicy- 
lates, are recommended in the acute cases with fever (O). Arsenic may be 
employed (O) ; the Bromide of Gold and Arsenic cured a case of neuritis with 
partial hemiplegia lasting five years, with inability to walk and considerable 
pain along the spine and in right arm and leg (Barclay). Potassium Iodide 
and Mercury, if there is a history of syphilis (O). Massage is probably the 
most reliable means at our command in the later stages, when the atrophy is 
marked and the pains < have lessened. Contractures may be gradually over- 
come by passive movements and extension. The interrupted current is useful 
when the acute stage is passed (O). [Compare Alcoholism, Neuralgia, 
Spinal Irritation.] 

Nightmare. 

Potassium Bromide, in nightmare of adults ; and children's attacks of night- 
screaming often associated with squinting : the digestive organs may also 
require attention (R). Camphor- water, a teaspoonful or two the most suitable 
medicine (H). Sleep, in abundance, may prevent nightmare (H). Diet, light ; 
avoid late meals and indigestible food. 



Nipples, Sore, Fissured. 

Benzoin, an admirable local application (P) ; the tincture locally for slight 
erosions (Parvin). Silver Nitrate, touched lightly, is effectual (Wa). Sulphur- 
ous Acid, solution neat or diluted, constantly applied, or with equal quantity of 
Glycerin as lotion (R). Collodion, sometimes used (R) ; useful for protection 
(P) ; as coating (B) ; better applications are Arnica cerate, the glycerite of 
Starch, or 2 parts of eau de Cologne to 1 of glycerin (R). Lime-water, is a 
useful application for cracked nipples. Alcohol, Brandy and water as lotion 
before delivery and after each suckling to prevent cracking (R). Borax, satu- 
rated solution, beneficial (Wa). Iron, the Solution of the Subsulphate diluted 
with 3 parts of Glycerin, and applied with a camel's-hair brush, an effective ap- 
plication for fissured nipples (B). Tannin, the Glycerite, one of the best appli- 
cations to fissured nipples (B). Lead Nitrate, in Glycerin, or ointment 3j to ^j, 
in fissured nipples (B). Zinc Shield, constantly worn (R). Balsam of Peru 
or Tolu, valuable as application, with Oil of Almond, gum arabic, and rose- 
water (P). Rhatany, as wash or cerate, has had great success in fissure (Tr) ; 
1 part of extract to 15 of Cacao-butter (Wa). Nipple-shield, to give the nipple 
rest while the child sucks, gives great comfort. [Compare Lactation, Mas- 
titis.] 

Prescriptions. 

R • Balsam. Peruvian., . . . gij. R . Liq. Plumbi. Subacet. Dil., Jss. 

Olei Amygdalae, 5J SS - Ext. Opii, gj. 

Mucil. Acaciae, . . . . 3 Ij. Aquae Rosae, Jiijss. 

Aquae Rosae, q. s. M. Sig. — Lotion, to be used after a 

M. Sig. — Apply to the nipples after bread-and-milk poultice, for inflamed nip- 
each nursing. [Phillips.) pies. (F. Barker.) 



Nodes. 

Mercury, the Oleate of Mercury and Morphine externally, is very valuable 
(R). Potassium Iodide, as ointment in conjunction with internal use, in syph- 
ilitic nodes of children ; also in non-syphilitic periosteal thickenings (R) : in 
syphilitic nodes it holds the first place, especially when pains are worse at night 
and increased by heat of bed (Wa). Stramonium leaves, locally, relieve (Wa). 
[Compare Exostosis, Periostitis.] 



73^ NYMPHOMANIA — OBESITY — ODONTALGIA. 



Nymphomania. 

Potassium Bromide, when from plethora; not useful when relaxation, or 
from cerebral lesion (B) ; large doses required, at least gr. xx ter die (R) ; an 
abundance of evidence testifies to its value (W). Tobacco, to nausea, effect- 
ually cures, but is horribly depressing (B). Camphor, in considerable doses 
said to control inordinate sexual desire (R) ; at present not much relied on 
(Wa). Lupulin, seems worthy of fair trial (Wa). Sulphur, or dilute Sulphuric 
Acid internally, when arising from hemorrhoidal congestion, not an infrequent 
cause (Wa). Orchitic Extract, has given satisfaction. Cerebrinin, has been 
used with benefit (Paul). 

Obesity. 

Iodoform is highly efficient, but causes wasting and anaemia, the latter by 
injuring red blood corpuscles (B). Iodol, in 2-grain doses thrice daily, is 
equally effective (B). Alkalies, as solutions of Oxides or Bicarbonates (R) ; 
alkaline mineral waters, with exercise and dietary (B) ; serviceable (Wa) ; 
Liquor Potassse gss in milk, thrice daily, of established value (Wa) ; generally 
fails (R). Ammonium Bromide, sets up gastric catarrh (B) ; but lessens 
corpulency (Wa). Sulphurous Waters, especially Blue Lick, ^iv before each 
meal (B). Potassium Permanganate, for attendant dyspepsia and flatulence ; 
also useful for the obesity ; gr. %-] ter die, in distilled water (B). Vinegar, 
only successful at expense of serious injury to the body (R). Fucus Vesi- 
culosus, has power to reduce adipose tissue ; an extract is sold under the title 
" Antifat" as a proprietary medicine (W). Phytolacca, has been long known 
as a reducer of adipose tissue ; a resinoid preparation, named Phytoline, is on 
the market as an " anti-fat," the dose of which is rtVx, six times daily, before 
and after each meal. Thyroid Extract, has been employed in several cases 
with uniformly good results (see page 132). 

Banting Dietary is alone sufficient to improve the condition ; its chief feature 
is the exclusion of the two elements, starch and sugar, from the food ; there- 
fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, 
butter, sugar, cream, beer, porter, and champagne, should be avoided. In one 
year, on this diet, Mr. Banting reduced his weight 46 pounds, and his girth 
about 12 inches; at the same time, his numerous corporeal infirmities were 
greatly mitigated or altogether removed ; but it cannot be recommended indis- 
criminately. This was the method of Hippocrates, avoiding all fats, starches, 
and sugars; in fact, all roots or vegetables grown underground (B). Meat 
Diet, very successful in 42 cases, the diet being confined to rump-steak, hot 
water and codfish, for 14 days, absolutely excluding everything else (Smith). 
The Schweninger or CErtel method is similar, using chiefly albuminous food, 
excluding fat and carbohydrates, limiting the fluids drank, especially at meals, 
and enforcing exercise. Peanuts, are an excellent article of food for the cor- 
pulent (Furbringer). [See under Diabetes Mellitus.] Exercise, daily, in the 
open air, is necessary, and if carried on systematically is the most efficient and 
least injurious method of reducing an excess of adipose tissue. 



Odontalgia. 

Aconite, as ointment or liniment for facial neuralgia due to diseased teeth, 
will succeed quickly if at all (R, Wa). Arsenic, gr. ^, as escharotic to destroy 
pulp ; when used for pain may be mixed with Opium ; it sometimes at first 
aggravates pain (R, W). Staphisagria, the alcoholic solution dropped into the 
cavity (P). Alum, a solution in Nitric Ether, 3U to 3vij, is said to be an effect- 
ual application (B) ; Alum and salt powdered and placed in the cavity, excellent 
when nerve exposed. Chloral, rubbed up with an equal weight of Camphor, 
and placed in the cavity (R) ; these two, with Glycerin and Carbolic Acid, equal 
parts of each ingredient, applied on a little cotton after cleaning the cavity, will 



(ESOPHAGEAL AFFECTIONS ONYCHIA. 737 

relieve the pain, and makes an excellent mixture for " toothache drops " (Brod- 
nax). Chloroform or Croton-Chloral, equal parts of the former and Creosote, a 
good application (R). Tannin, a solution in Ether is a good application to a 
carious tooth (B). Creosote, with Tannin or Opium or Chloroform, placed in 
the cavity of a decayed tooth, often gives relief (R). Cocaine, a 5 per cent, 
solution on cotton applied to a cavity will often bring instant relief. Coniine, a 
solution in alcohol placed into a hollow painful tooth (R). Collodion and 
Carbolic Acid, equal parts, as jelly for stopping carious teeth (R). Opium, 
mixed with Tannin or Creosote inserted in cavity of painful tooth (R). Mor- 
phine, hypodermically for severe toothache (R). Oil of Cloves, inserted into 
cavity (P). Camphor, with Morphine and Flaxseed, as a cataplasm to the 
cheek (B). Xanthoxylum, a domestic remedy (B). Capsicum, a strong infu- 
sion on lint (R). Gelsemium, useful in some forms (R). Zinc Chloride, to de- 
stroy exposed painful pulp (R). Ginger, Mezereon, Pyrethrum, are useful 
masticatories in toothache (P). 

Preset iplions. 



R. Linim. Aconiti_(B. P.), 

Chloroformi, . . . . aa ^iij. 

Tinct. Capsici, ^j. 

Tinct. Pyrethri, 
Olei Caryophylli, 
Pulv. Camphorae, . . aa £ss. 
M. Sig. — A few drops to be placed on 
a pellet of cotton and applied to the cavity. 

[Mason. ) 

R . Acidi Tannici, gr. xx. 

Mastiches, gr. x. 

^Etheris, 3 ss. 

M. Sig. — On cotton to cavity. (D.) 



R . Creosoti, 3 ij . 

01. Caryophylli, ziv. 

01. Menth. Piperit, . . . %]. 

Camphorae, ^ij ss - 

Alcoholis, . . . . q. s. adO). 
M. Sig. — Toothache Drops. 



R . Morphinae Sulph. , . . . . gr. iv. 

Atropinae Sulph. , . . . . gr. j. 

Aquae Destill., ^j. 

M. Sig. — A few drops on cotton, placed 
in the cavity. (B.) 



Oesophageal Affections. 

Belladonna, the liniment with frictions to the sternum, often very useful as a 
palliative in stricture of the oesophagus (Wa). Conium, in spasmodic contrac- 
tions, with crampy pains of stomach, flatulence, and globus hystericus, has 
proved very serviceable (Wa). Hyoscyamus, or Conium, in stricture of oesoph- 
agus, if much irritability ; with occasional leeching to relieve exacerbations 
of pain or spasm (D). Silver Nitrate, in stricture of the oesophagus, a weak 
solution on sponge probang (D). Anaesthetics, should be used only to meet 
temporary indications (W). Nutrient Enemata, in stricture of the oesophagus, 
when swallowing impossible (R) ; may, in some cases, even preserve life(Wa). 
[See Enemata.] Dilatation, by bougies, in non-spasmodic (structural) strict- 
ure, the only appropriate treatment (H). [Compare Choking, Dysphagia.] 



Onychia and Paronychia. 

Silver Nitrate, a strong solution in Nitrous Ether, painted over the adjacent 
tissue, will abort if applied early (B) ; frequently causes resolution of the 
inflammation (Wa). Lead Nitrate, dusted over night and morning (R) ; 
relieves pain and hastens healing process (B). Turpentine, applied on a piece 
of lint or other absorbent material, stops the pain at once, and seems to kill the 
felon. Mercury, as ointment, for 10 minutes in every hour ; poultices in interim 
(R). Arsenic, gr. ij ad %] Adipis, as ointment, almost specific in onychia 
maligna (Wa). Tartar Emetic, will shorten course and render it milder (R). 
Iodoform, oint. or powder dusted on (B) ; or 1 part to 9 of Ether applied by a 
dropper, in syphilitic onychia (Fox). Iodine, a strong alcoholic solution locally 
will often subdue the disorder (Wa). Chloral, a solution locally, as antiseptic 

47 



?$8 OPHTHALMIA. 

and to promote healing (B). Sodium Chloride, common salt roasted until 
the chlorine is driven off, equal parts of this, Castile Soap and Venice Turpen- 
tine, as a poultice, is a very efficient application. Carbolic Acid, to benumb 
surface during incision (R) ; which should be carried down to the bone, espe- 
cially in tendinous whitlow (D). Cocaine, hypodermically, will accomplish the 
local anaesthesia more thoroughly, if delivered deeply into the tissue. Mor- 
phine, powdered, as local application to relieve pain. Heat, by poultices, is 
very useful. In Opening a felon avoid the lines of the arteries on the sides of 
the fingers, and that of the flexor tendons, which is the median line on the 
palmar surface ; the incision should be made midway between these lines. If 
the sheath of the tendon be opened the tendon may slough, and the finger be 
rendered useless (Ashhurst). 

Ophthalmia. 

Silver Nitrate, a strong solution, gr. xx to theg, in granular lids ; cautiously 
when corneal ulcers exist (B) ; solid stick diluted with 2 to 4 parts of Potassium 
Nitrate, appled lightly and quickly ; or a solution, gr. ij-x to the 3, painted over 
the everted lids, which should be washed with a solution of common salt, and 
then with water before being replaced (C) ; in solution, gr. v to 3jj aquae destil- 
latae, locally once a day in purulent ophthalmia of the new-born, washed off with 
a weak solution of common salt (Noyes) ; in solution, gr. iij to the %, to abort 
the discharge in catarrhal ophthalmia (Fox). Boroglyceride, in many catarrhal 
affections, especially ophthalmia neonatorum, is a most efficacious application, 
the solutions used being of 10, 25 and 50 per cent, strength (Fox). Alum, gr. 
viij to ^j aquae, applied every )( to }4 hour in purulent ophthalmia of children ; 
success depends on the frequency of the application (R) ; a crayon formed of 
a crystal of alum, a mild and occasionally useful application (C). Mercury, 
Calomel dusted over membrane in phlyctenular ophthalmia ; or after detach- 
ing scales rub in Brown Citrine Ointment every night, for eczema of margin of 
lids (B). Pulsatilla, as a lotion to conjunctiva 8 or 10 times in 24 hours, also 
internally (P) ; much used by homoeopaths (B). Spigelia, useful in rheumatic 
ophthalmia (P). Antimony, as Tartar Emetic, gr. ^ to -£$, three or four times 
a day in strumous ophthalmia, with sharp purgation at commencement (R). 
Belladonna, or Atropine, locally, of great service in strumous ophthalmia to 
relieve pain ; constitutional treatment also required (Wa) ; Atropine, gr. ij of 
neutral sulphate to the ^ of aqua destillata, twice or thrice daily, as soothing 
application (C). Arsenic, invaluable in inveterate cases of strumous ophthal- 
mia, especially when complicated with cutaneous eruptions (Wa). Copper 
Sulphate, gr. j to ^j aquae camphorae as collyrium in purulent ophthalmia of 
infants ; in substance to inner part of lids in granular conjunctivitis (Wa). 
Tannin, powdered or in solution, gr. j-x to the % , produces remarkable results (B). 
Lead Acetate, gr.j. ad ^j aquae destillatae, applied by camel's-hair pencil to sur- 
faces of everted lids, washed away before the lid is replaced ; or the Tannate 
of Lead i}4 to 3 parts fine Oil and 1 of fresh Lard, a very small piece as oint- 
ment to lid (C). Carbonic Acid Gas, said to relieve the pain and photophobia 
of strumous ophthalmia, when locally used (R). Physostigma, to reduce pupil 
and shut out the light (P). Iodine, is employed locally in scrofulous ophthalmia 
for its alterative stimulation (W). Iodoform, in gonorrhceal ophthalmia, and 
purulent conjunctivitis, of very great value locally, but should be pulverized 
very finely (Grossmann) ; does not bear out the claims made for it (Keyser). 
Zinc Chloride, gr. j ad ^j aquae, as collyrium in gonorrhceal ophthalmia is used 
with marked benefit; also a stronger solution, gr. ij-iv to the %, effectually 
arrests the muco-purulent discharge remaining after subsidence of purulent 
ophthalmia, and has succeeded admirably in diphtheritic conjunctivitis and 
pustular ophthalmia (Wa). Zinc Sulphate, as collyrium, gr. j-iv to the %, is 
very serviceable in ophthalmia of infants or adults; Liquor Plumbi added 
improves it (Wa). Staphisagria, especially in tarsal ophthalmia (P). Colchi- 
cum, when gouty diathesis (P). Cod-liver Oil, in strumous subjects, tends to 
remove the manifestations of the disease (R). Cold Wet Compresses, or iced, 



OPIUM HABIT. 739 

are held to be essential in early stage of acute purulent and gonorrhceal 
ophthalmia (C). [Compare Blepharitis, Conjunctivitis, Keratitis.] 

Opium Habit. 

Sodium Bromide, in large and increasing doses, 3j twice daily, increased 
by 20 grains each day, to a maximum of 100 to 120 grains twice in twenty-four 
hours, with simultaneous gradual reduction of the opiate dose, so that from the 
8th to the 10th day it is entirely abandoned; each dose of the salt should be 
given in 6 or 8 fluid ounces of cold water : this drug, with Codeine and Trional, 
form a combination of unrivalled efficacy, if properly used in proper cases, and 
combined with minor aids make a method far in advance of any yet presented, 
to secure the minimum duration of treatment and maximum freedom from pain 
(Mattison) : a combination of Bromides [see formula below], commencing with 
40 grains twice daily, increasing to 100 grains twice daily, at 10 A. M. and 4 p. m., 
freely diluted with water, does not depress vitality, or produce the injurious re- 
sults of the bromides as commonly administered; this, with gj of Warburg's 
Tincture before breakfast each morning, with the use of Spt. Etheris Nitrosi to 
eliminate the bromides rapidly, electricity, a mixture of Iron and Strychnine, 
and an occasional hypodermic of 5 or 10 minims of a 4 per cent, solution of 
Cocaine for nervous restlessness, is the general line of my treatment (Mann) : 
Bromides may do great harm, if recklessly administered, paralyzing the mus- 
cular system and causing prolonged delirium. Cocaine, or the fluid extract of 
Coca, has been used to relieve the depression caused by the withdrawal of the 
drug (B) ; has been, by many careful observers, pronounced of great benefit, 
restoring appetite, inducing sleep, promoting digestion, while soothing the brain 
and inducing a feeling of contentment and calm (R) : should never be entrusted 
to the patient, lest he jump out of the frying-pan into the fire. In the treat- 
ment of the combined morphine and cocaine habit, the latter drug may be 
withdrawn entirely at once without any suffering, and the former may be re- 
duced one-half at the same time. Codeine, in doses of a grain or more, is very 
useful in combating the nervous agitation which succeeds to the final with- 
drawal of the opium. [See under Sodium Bromide above.] Trional, in dose 
of 30 to 40 grains as a hypnotic, is of special value in these cases. Paralde- 
hyde, in dose of 3jss-ij, as a hypnotic, is efficient, but its sleep is of briefer 
duration than that produced by Trional or Sulphonal. Gelsemium, subdues 
the restlessness and motor excitement ; proved of great value in one case where 
30 grains of morphine were used daily ; tt\j of tincture every yi hour (Pennoyer). 
Conium, in 10-drop doses of a good fluid extract, to check motor activity and 
relieve the wandering pains. Sparteine, in doses of gr. ^ to ^ hypodermi- 
cally, at moment of systolic cardiac depression which answers to the period of 
craving, and corresponds to the truncated curve of the sphygmographic trace, 
characteristic of the period when the stimulant effect of morphine has passed 
(Jennings). Nitroglycerin acts in the same manner, but its effect is more rapid 
and ephemeral (Id). Atropine, used with great benefit in one severe case, re- 
moving the copious exudation from the air-passages, bowels and skin, and 
moderating the distressing symptoms due to the withdrawal of the morphine 
(W. Koch). Physostigmine, gr. yi^ acts remarkably well at the crisis as a 
substitute for the drug. Duboisine, injected daily succeeded in destroying the 
craving for morphine in a case of long standing (Birnabee) ; is an excellent 
calmative and hypnotic at the crisis. Hyoscyamine, Merck's amorphous, is 
useful as a hypnotic, and perfectly safe, in patients of good general condition, 
in whom the disuse of opium produces unusual insomnia and motor activity 
(M). Hyoscine, the Hydrobromate, in doses of gr. -j-^j- to -J-q, hypodermically, 
is highly efficient for the same purpose, but must be used sparingly, as it excites 
high delirium in most subjects for a time. Cannabis Indica, may be required 
in full doses, for restlessness after withdrawal of the opiate, 3-doses of Squibb's 
fluid extract, repeated every hour or two, as required (M) ; or increasing doses 
of Hering's solid extract, beginning with one or two grains. Chloral, as a hyp- 



740 



ORCHITIS. 



notic, fails in the first few days of abstinence ; later in full doses, 45 grains at 
once, rather than three 15-grain doses, alone or with a Bromide, it can be re- 
lied on (M). Galvanism, is very efficient for the neuralgic pains in various 
parts ; a strong faradic current sometimes acting better (M). Baths, if hot, 
105° to 112 F., are of great value to relieve disquiet; warm baths are worth- 
less (M). 

Strychnine, is invaluable, especially after the cure is nearly completed (Barr). 
Aurum, the Bromide of Gold and Arsenic, fl^x hypodermically, as a tonic, 
thrice daily, to complete the cure. Capsicum, is serviceable as a stimulant to 
the stomach and a cerebral sedative ; removes the sinking sensation at the epi- 
gastrium, and tones up the intestines. Catechu, the tincture in 3 doses, for the 
diarrhoea. Ergot, in full doses, for the headache. Lupulin, with Phosphoric 
Acid [see formula below], helps to sustain the patient, lessens the force of his 
suffering, and shortens its duration (Fleming). Zinc and Iron as blood tonics, 
given for a month at least [see formula below], are valuable, and are best 
given on alternate days (Fleming). Piscidia Erythrina, has been proposed as 
a substitute, and highly recommended, but is worthless, as are also Avena 
Sativa and many other falsely termed substitutes (M) ; there is no remedy for 
the opium habit (Da C). Zinc Oxide, for the vomiting and diarrhoea, begin- 
ning with gr. j once daily and increasing to tolerance (Da C). Withdrawal of 
the drug suddenly and completely, is the method of Levinstein and other Ger- 
mans, and is preferred when we can have absolute control and surveillance of 
the patient (Da C) ; entails horrible suffering, and is utterly inexcusable (M) : 
a more gradual reduction is the method usually employed, taking off one-third 
the first day, one-fourth the second day, and then gradually reducing the 
amount until the sixth or seventh day, when it is entirely withdrawn. No 
agent is of any value unless strengthened by moral courage and perseverance 
on the part of the patient (Squibb). Useless to try to cure a patient while he 
is pursuing his ordinary avocations ; failure will result unless there is complete 
seclusion and entire giving up to the treatment (Mann). It is very important 
to keep the patient in total ignorance of the rate of reduction. 



Combination of Bromides. 

$ . Ammonii Bromidi, 

Sodii Bromidi, .... a 

Potassii Bromidi, . . . 

Liq. Potass. Arsenit. , . 

Syr. Tolutan., .... 

Aquae Menthae Piper. , . 

Syr. Hypophos. Comp., 

M. Sig. — 3J to £ij in water thrice 

daily. Has of total Bromides, gr. 21^ in 



Prescriptions. 

R . Codeinae, gr. xvj. 

Alcoholis, . . . . q. s. ad solv. 

Cocainae Hydrochlor. , . . gr. xvj. 

Elixir Simplicis, . q. s. ad ^ij. 

M. Sig. — 3J in water, occasionally, 

when great restlessness. Formula never 

to be given to the patient. [Potter.) 



each 3 



R. 



[Mann.) 



Tinct. Capsici, 

Potassii Bromidi, . . . aa 2iv. 

Spt. Ammoniae Aromat., . liij. 

Aquse Camphorae, . q. s. ad 3 vj. 
M. Sig. — A dessertsp. several times 
daily, in the depression of alcoholism and 
opium-habit. Instead of the bromide, 
Fowler's Solution, mj, may be added ; or 
Tinct. Nucis Vomicae ^ij, or Tinct. Aur- 
antii Amari 3 v. [Ringer.) 



& . Tinct. Cannabis Ind., . . TTLxl-lx. 

Spt. ^Etheris, zj. 

Aquae, q. s. ad 3J. 

M. Sig. — One dose, if insomnia is very 
protracted. [Fleming.) 



R. Tinct. Nucis Vomicae, . . ^iij. 

Ac. Phosphor. Diluti, . . 3 v. 

Syr. Pruni Virg. , . . . . % ij . 

Aquae, q. s. ad ^iv. 

M. Sig. — 3 i j twice daily as a nerve 
tonic. [Potter. ) 



Orchitis. 

Pulsatilla, TT\j or less of the tincture every hour, relieves pain rapidly, 
though not the oedema (St). Belladonna, int., and as oint., extract j ad iij 



OTALGIA OTITIS. 74 1 

Adipis, when inflammation has subsided (Wa). Sodium Salicylate, in gonor- 
rhceal orchitis, subdues the pain in a few hours. Iodine, tinct. locally to 
remove swelling after the acute stage has passed (B). Mercury, the Oleate 
locally (B) ; Calomel gr. iij with Ipecac, gr. x, at once, followed by a saline 
next morning, and smaller doses of Calomel and Ipecac every 6 hours, with 
Morphine gr. \ hypodermically into cellular tissue of scrotum (McElroy). 
Ammonium Chloride, makes a good evaporating lotion in solution with alcohol 
and water (R). Silver Nitrate, a strong solution to the scrotum, with gentle 
pressure (Wa). Tartar Emetic, in acute orchitis (R). Digitalis, locally, is 
found most useful (P). Guaiacol, pure, as a local application for the pain. 
Alcohol, with equal quantity of water, as evaporating lotion (B). Ice, bene- 
fits the inflammation and relieves pain (B). [Compare Epididymitis.] 

Prescriptions. 

U. Ammonii Chloridi, . . gr. xl. : R- . Hydrarg. Ammoniat., . . zj. 

Alcoholis, Aquae, . . . aa l|ij. Cerati Simplicis, .... gj. 

M. Sig. — Lotion, to be applied on M. ft. unguent. Sig. — Apply locally, 

cloths to the part. with gentle friction. 



Otalgia. 

Aconite and Opium, equal parts of the tinctures, a few drops well down the 
external meatus, will usually subdue the pain. Blistering Fluid, or Croton Oil 
Liniment behind the ear, often relieves earache (R). Glycerin, for dryness of 
meatus (R) ; or Olive Oil for accumulation of wax in external meatus dropped 
in every night, gentle syringing in the morning with warm water (CI). Opium, 
Morphine in solution, gr. iv to the 3, with gr. j-ij of Atropine, is an excellent 
application (B). Atropine, gr. -^ in £xx of water, a teasp. every three hours 
for a child in the acute otitis media of children from coryza, very successfully 
used to abort the otitis, and relieve the earache (Miot) ; a solution locally is 
especially applicable in the earache of children from whatever cause, gr. j to 
the §, of which gtt. iv dropped into ear to remain for 10 or 15 minutes. Pul- 
satilla, internally and externally, is often used with advantage (P). Cocaine, 
a 4 per cent, solution sprayed over the tympanic membrane through the exter- 
nal meatus, and forced into the Eustachian tubes by inhaling the vapor and 
then expanding the tubes by Valsalva's method ; this repeated every three 
minutes is a very sure method of curing otalgia (R). Olive Oil, often used 
warm as local application, but is of no service and may do harm by under- 
going decomposition and becoming favorable soil for the growth of aspergillus 
or other vegetable fungi. [Compare Otitis.] 

Prescription . 

R . Chloralis Hydratis, Sig. — Pour into the ear (after warming) 

Camphorae, I enough to fill it ; cover with cotton wet 

Acidi Carbolici, . . . aa gr. xx. i with warm water, and a cloth wrung out 

Olei Ricini, ^j. | of hot water. (Brodnax.) 



Otitis. 

Pulsatilla, in inflammation of external auditory canal ; in otitis, as lotion 
warmed and applied by syringe, three or four times a day (P). Aconite, 
quickly relieves the pain (R) ; should be used internally and locally. Carbolic 
Acid, a 20 per cent, solution instilled into ear in moderate otitis, relieves the 
pain at once and checks progress ; a solution in glycerin is best (Rohrer). 
Atropine, in the acute otitis media of children, is very efficient. [See Otalgia, 
above.] Blisters, behind ears, either kept discharging or repeated, are often 
very useful (Wa). Leeches, behind the ear, afterwards a small blister upon 



742 OTORRHCEA OVARIAN NEURALGIA — OVARITIS. 

the same place, when the leech-bites have healed (H). Warm Douche fre- 
quently to the ear, to secure cleanliness, then dry the part thoroughly (Roosa). 
[Compare Otalgia.] 

Otorrhcea. 

Salol and Camphor, equal parts, heated together, have given good results in 
suppuration of the middle ear; the application causes neither pain nor inflam- 
mation (Pegon). Bismuth Subgallate (Dermatol), on cotton tampon, intro- 
duced after thorough syringing with a 3 per cent, solution of Boric Acid, and 
careful drying with absorbent cotton, the best means of combating an acute 
or chronic otorrhcea, outside surgical measures (Chaniavsky). Boric Acid, 
finely pulverized, as astringent and disinfectant application ; may be mixed 
with pulv. Alum, and just enough powdered Lycopodium to keep it dry; this 
packed carefully through speculum, after washing with a weak and tepid alka- 
line solution. Absorbent Cotton, on holder, may be used every few hours by 
patient to keep pus removed from the canal. Syringing with warm salt water, 
once daily, as absolute cleanliness is essential in the treatment. Politzer Bag 
is a useful adjunct in keeping secretions out of tympanum and breaking up ad- 
hesions (Roosa). Mercury, in chronic cases, the Brown Citrine Ointment (B). 
Lead, lotions much employed (B). [See Gonorrhoea, for formula.] Potas- 
sium Permanganate, as injection or spray, gr. j to ^j aq. destil. (B). Silver 
Nitrate, locally, a solution of gr. iv to the ^ (B) ; gr. x to the ^ (Roosa). Cop- 
per Sulphate, gr. j-v to the ^ (Roosa). Tannin, the Glycerite, locally, is suc- 
cessful (B) ; especially in children (Wa). Zinc Sulphate, locally, in solutions 
of gr. ij-viij to the ^ (B); gr. j-v to the 3 (Roosa). Cadmium, gr. ij to ^j 
rose-water (B). Liquor Sodse Chloratae, rr^xv-xxx ad ^j aquae when discharge 
fetid ; is highly useful as injection (Wa). Quinine, with Sulphuric Acid, advis- 
able in otorrhcea after scarlatina (Wa). [Compare Otitis.] 



Ovarian Neuralgia. 

Codeine, has especial value against ovarian pain (Freund), whether of inflam- 
matory or neuralgic origin, in dose of gr. }( at least. Opium, often the cause ; 
if use stopped entirely improvement may ensue (E) ; one of the best remedies 
in ovarian pain of non-inflammatory character (Graily Hewitt). Atropine, 
subcutaneously, the best remedy for pain in the pelvic viscera (Wa). Am- 
monium Chloride, gr. xxx with gtt. ij-v Tinct. Aconiti, repeated in J^-hour if 
necessary, to remove pain (W). Camphor, with Cannabis Indica, of great ser- 
vice in relieving ovarian pain, especially when spasmodic in character (Wa). 
Conium, or, better still, its alkaloid, used as a vaginal pessary, in all cases of 
ovarian pain, whether neuralgic or inflammatory, is quite a specific (Meadows). 
Ether, the compound spirit, in doses of rr^xxx-xl as a palliative (Anstie). 
Gelsemium, deserves a trial ; its power is great but not certain (Wa). Hot 
Water, vaginal injections, night and morning ; sunlight baths, fresh air (E). 
Leeches over the groin, or inside the thigh, where ovarian pain persistent, or 
tenderness and aching (Wa). Surgical, Battey's operation as a last resort (E). 
[Compare Dysmenorrhea, Ovaritis.] 



Ovaritis. 

Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- 
acute ovaritis; at same time a pill of Opium, Hemp and Camphor (Hewitt). 
[See formula below.] Opium, in suppository or enema, more effectual than 
internally (Tilt). Mercurial Ointment, combined with Camphor and Bella- 
donna, over the seat of the disease by friction (West). Blisters, in subacute 
ovaritis are often of great service, placed over the region or to the cervix uteri 



OXALURIA — OZ^NA. 743 

(Wa). Enemas, of warm water, simple or medicated, in subacute ovaritis, 
are warmly recommended ; they should be retained as long as possible (Wa). 
Salix Nigra, the " pussy willow," in doses of n\xxx of the fluid extract thrice 
daily, of decided benefit in ovarian hyperaesthesia, etc., of highly nervous 
women. Ergot, is valuable in chronic ovaritis, with rest and Potassium Bro- 
mide (Tait). Aurum salts, have been found beneficial in dropsy of the ovaries 
(Martini). Ovarian Extract, has been used in ovarian disease (see page 139). 
Parotid Extract, used as an internal remedy in six cases of enlarged and tender 
ovary with menorrhagia, etc., with signal success (Bell). Turpentine, hot tur- 
pentine epithems applied over the seat of the disease (Wa). Ice, in bag, over 
seat of pain, when intolerable, and patient too much reduced to bear leeches ; 
is often of benefit (Wa). Poultices of Linseed meal, as light as possible, often 
produce great benefit in ovarian inflammation. 

Prescriptions. 

R. Ext. Opii gr. iij. R . Ung. Hydrargyri, . . . . %vj. 

Ext. Cannabis Ind. , Camphors gr. xl. 

Camphors, aa gr. vj. Ext. Belladonna, . . . . gij. 

M. ft. pil. no. vj. Sig. — One pill twice M. ft. unguent. Sig. — To be rubbed in 

daily. (Grailv Hewitt.') twice daily. (West.) 



Oxaluria. 

Mineral Acids, when eructations of sulphuretted hydrogen (R). Nitro- 
muriatic Acid, renders important service (B) ; especially in the condition show- 
ing general malaise, weakness, and depression of spirits, with oxalate crystals 
in the urine (W) ; also in sciatica and other forms of neuralgic rheumatism 
accompanied with oxaluria, full doses, rr^vj-x, of this acid, with an occasional 
brisk purgative, and cold douche, followed by friction (Wa). Zinc Sulphate, 
often very serviceable in irritability of the nervous system, associated with dys- 
pepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B). [Com- 
pare Dyspepsia.] 



Ozsena. 

Aurum Salts, are very serviceable in syphilitic ozsena (B). Mercury, 
the Ointment of the Nitrate in syphilitic form ; the White or Red Precipitate 
with 58 times its weight of sugar, snuffed after clearing the nose, in non-syphi- 
litic forms (R). Potassium Permanganate, 3j to Oj solution as an injection or 
spray (B). Hydrastis, the fluid extract locally (B) ; gj to -fviij solution as 
lotion with l\v of the tincture internally thrice daily (P). Bromine, as inhala- 
tion [see formula below] ; or Iodine with Carbolic Acid, or the latter in one 
per cent, solution, as inhalations (B). Carbolic Acid, a 1 per cent, solution in- 
haled (B). Silver Nitrate, applied behind veil of palate; gr. v-xx ad 5J (B). 
Alum, solution, Z] to Oj, for irrigation (R). Glycerite of Tannin, by irrigation 
(R). Salicylic Acid, in very weak solution, 1 to 500, as cleansing, astringent, 
and disinfectant wash, used by retro-pharyngeal syringe, and followed by ap- 
plications of Calomel, in powder, to the ulcerated portions of the mucous 
membrane (Massei). Hydrogen Dioxide, the solution as spray, is a most excel- 
lent application. Salol, has done good service, as insufflation. Strontium 
Iodide, has been used in scrofulous ozaena, with varied results. Cubeb, the 
Oleo-resin, gtt. xv-xx on sugar after each meal, to restrain the secretion and 
perhaps modify its character (Cohen). Calcium Chloride, gr. xxx-lx with ^j 
Decocti Kramerise; of which 5ij-iij, diluted with an equal quantity of water, 
should be injected twice daily after cleansing with salt and water (Cohen). 
[Compare Catarrh, chronic nasal.] 



744 



PAIN. 



Prescriptions. 



R. Tinct. Iodi, 5pv. 

Acidi Carbolici, .... gj-ij. 
M. Sig. — Use on sponge in a wide- 
mouthed bottle as inhalation. To be va- 
porized by heat of hand. (Potter.) 



R. Bromi, gss. 

Alcoholis, ^ss. 

M. Sig. — Use by inhalation when va- 
porized by heat of the hand. 



R . Sodii Carbonatis, 

Sodii Boratis, aa^ij. 

Liq. Sodse Chloratse, . . j^ss-gij. 

Glycerini, ^j. 

Aquae, q.s. ad ^\). 

M. Sig. — Apply by means of a hand- 
spray apparatus. (Thornton.) 



R 



. Acidi Carbolici, \r\xx. 

Aquse Calcis, Oj. 

M. Sig. — Use as wash or spray. 



Pain. 

Opiunj, is the most efficient of all analgesics and is universally used to relieve 
pain (see page 367) ; the Liniment applied with friction relieves pleurodynia, 
superficial neuralgia, etc., and poultices containing the Tincture are useful ap- 
plications in the pain of inflammation. Opiates soon lose their power in any 
particular dose, and require increasing dosage to sustain their analgesic influ- 
ence, hence in chronic cases all other means should be exhausted before re- 
sorting to them (R). Morphine, is the most analgesic alkaloid of opium ; 
hypodermically in the vicinity of the nerve is curative when not so by the 
stomach (B) ; the Sulphate, gr. ye to ]/ 2 with Atropine Sulphate gr. y^ to y^, 
is very efficient, but the morphine-habit must be kept in mind ; a single injec- 
tion thereof is sometimes curative in sciatica and other neuralgias ; the con- 
joined administration of Morphine and Antipyrin is much more efficient in 
pain than the use of either agent alone. Codeine, has a special influence 
over abdominal pain and that of the ovaries, and is not liable to give rise to a 
drug habit. Antipyrin, is a most efficient analgesic in doses of 10 to 15 grains, 
being especially adapted to neuralgia, migraine and the pains of gouty and 
rheumatic origin, but is of no value in pain due to a local inflammation ; it may 
be used hypodermically. [See under Morphine, above ; also page 145.] Ace- 
tanilid, is highly efficient in doses of 4 to 7 grains for the pains of locomotor 
ataxia and those of rheumatic origin ; also locally as a dry dressing for painful 
wounds, ulcers, etc. ; it is the active ingredient in a host of recent proprietary 
remedies against pain (see page 67). Phenacetin, is efficient in 10 to 15 grain 
doses, for neuralgia, hemicrania, etc. Phenocoll Hydrochloride, in dose of 12 
to 15 grains, is a good analgesic in the neuralgic pains of influenza, and in 
gouty and rheumatic pain. Belladonna, is the best remedy for every kind of 
pain in the pelvic viscera (Anstie). Atropine, hypodermically in local pain, 
neuralgia, sciatica, glaucoma, etc. ; when it succeeds, has more lasting effect 
than morphine (R) ; for sciatica, tic douloureux, etc. (B). Iodides, are magical 
in syphilitic nocturnal pains of head (B) ; the Ammonium Iodide, gr. iij ad %j 
01. Olivae, with friction ; causes the disappearance of nocturnal syphilitic pains 
(W). Cimicifuga, relieves many kinds of pain, as neuralgia of 5th, rheumatic 
headache, ovarian neuralgia, dysmenorrhea ; inferior to Ergot in labor-pains 
or after-pains ; 5j doses (B). Conium, in cancer, rheumatism, neuralgia, 
ovarian pain, etc. (R) ; also for the fulgurant pains of locomotor ataxia, chronic 
alcoholism, sciatica, phthisis, etc., doses of tr\,x of a fluid extr. of the unripe 
fruit every yi hour, well watched (Madigan). Iron, with Belladonna, for the 
wandering pains of anaemia, in which morphine is dangerous and bromides 
are useless (Waugh). Aconitine, locally over seat of pain ; one of the most 
certain and powerful palliatives in neuralgic, rheumatic, and gouty affections 
(Wa) ; especially serviceable in neuralgia of 5th nerve (B). Carbolic Acid, as 
local anaesthetic (R). Cocaine, as a local anaesthetic to mucous surfaces, or 
hypodermically for minor operations involving a small area, as circumcision, 
eye operations, etc., has no equal ; a 4 percent, solution is generally employed 
(R) ; has many applications, as in odontalgia, otalgia, neuralgia of superficial 



PARALYSIS AND PARESIS. 745 

nerves, etc. Eucaine, is fully as efficient as Cocaine in causing anaesthesia of 
the mucous membranes, and is much less poisonous (Schleich) ; is absolutely 
harmless in medicinal doses, and does not affect the heart (Reichert). Theine, 
of very great value for neuralgic pain ; affects the nerve outwardly along its 
course from the site of the injection (Mays). Chloroform, locally, inferior to 
other local anaesthetics, two or three drops on cotton into the ear for faceache 
or toothache ; the vapor on raw surface of cancers, for neuralgia of uterus, 
photophobic eye, etc. ; by inhalation in renal and biliary colic, and to produce 
general anaesthesia [which see] (R). Ether, spray for local anaesthesia ; in- 
haled for general anaesthesia (R). Guaiacol, locally or by hypodermic injec- 
tion, i part in 10 of olive oil, or mixed with equal parts of glycerin for painting 
on the surface, is an efficient local anaesthetic, and is used successfully in or- 
chitis, in neuralgic pains of tuberculous subjects, also in sciatica and rheuma- 
tism (Moissy). Chloral, has no direct pain-relieving power, except in dangerous 
doses ; to relieve pain and promote sleep, the best agent is a combination of 
Chloral and Morphine; cautiously, if heart trouble, or to old drunkards ; gr. 
xv-xxx with gr. X (B) : sometimes relieves neuralgia, also pain of chronic 
rheumatism, gall-stones, colic, gastralgia, and even of cancer (R). Iodoform, 
as suppository in painful diseases of the rectum or bladder (R). Stramonium, 
is used as ointment (R). Duboisine, used instead of Atropine (B). Rhatany, 
relieves the pain of ulcerative disease of mucous membranes, pain of burns, 
ulcers, and especially of blisters (Tr). Cannabis Indica, formerly used (B). 
Aquapuncture (B). [See under Neuralgia.] Galvanism, of an affected 
nerve gives certain relief; the positive pole on point of emergence, negative 
over superior ganglion of cervical sympathetic (B). Heat, if pain is without 
fever or inflammation (B) ; warm injections soothe the pain of cystitis, prosta- 
titis and abdominal pains generally (B). Hot Water, as bath, relieves pain 
most wonderfully : Napoleon, at St. Helena, suffering from cancer of the 
stomach, appreciated highly the pain-relieving power of the hot bath ; often 
staying half and even whole days therein. Cold, when pain is inflamma- 
tory (B). [Compare the Lists of Anaesthetics, Analgesics and Narcotics, on 
pages 33, 34, 35, ante; also in this part the articles entitled After-pains, 
Anesthesia, Boils, Chest-pains, Colic, Gastralgia, Headache, Hepa- 
talgia, Inflammation, Lumbago, Myalgia, Neuralgia, Neuritis, Odon- 
talgia, Otalgia, Ovarian Neuralgia, Rheumatism, etc.] 

Prescriptions. 

R . Antipyrini, gr. xv. | R- . Liquoris Magendie, . . . 5jj. 

Cocainae Hydrochlor. , . . gr. ss. Aquae, q. s. ad ^ij. 

Aquae Destil., V\xv. M. Sig. — A teasp. to a dessertsp. every 

M. Sig. — One-half as hypodermic in- '< six or eight hours, for pain. Each drachm 

jection, or the whole when rapid action de- contains y$ grain of Morphine Sulphate, 

sired. (See.) (Potter.) 



Paralysis and Paresis. 

Nux Vomica, in hysterical paralysis and in that from lead-poisoning ; only 
in chronic cases (P) ; in paraplegia due to sofcening and wasting of the cord 
(Brown-Sequard). Ignatia, in paralysis of the lower extremities (P). Strych- 
nine, hypodermically into the affected muscles, for hemiplegia, paraplegia, 
local, mercurial, paludal, rheumatismal, facial, infantile and diphtheritic 
paralyses ; in that of the spinal muscles, of the bladder and all local forms (B) ; 
in hysterical paralyses (P) ; in all forms except cerebral and spinal paralyses 
(Barwell) ; internally in doses of gr. -g^ to -^ (R). Phosphorus, with Cod-liver 
Oil in the paralysis of white softening of the brain (B) ; in hysterical paralysis 
(R) ; in myelitic paraplegia from excessive venery ; the only drug which really 
affects the nerve-centres (W). Belladonna, when depending on chronic in- 
flammation of the cord (R) ; externally as ointment along spine, with Ergot 
internally (Brown-Sequard). Physostigma, into the eye in ocular paralyses 



746 PARALYSIS AGITANS. 

(B) ; in general paralysis of the insane, also in progressive muscular atrophy- 
without much mental disorder, long-standing hemiplegia, paraplegia, locomotor 
ataxia (R). Ergot, in paralysis of bladder from over-distention (B) ; paralytic 
dysuria, sensation of but partial emptying of bladder (P) ; said to be useful in 
paraplegia (R) ; in paraplegia complicated with menstrual irregularity and 
forms of paralysis arising from spinal congestion (Wa) ; has cured cases of 
constipation of the paralytic when all the most powerful cathartics failed (Cur- 
ran). Cocculus Indicus, valuable in hemiplegia, paraplegia, and paralytic 
stiffness (P) ; Picrotoxin has greatly benefited several forms, especially paraly- 
sis of the sphincters, hemiplegia from cold, and glosso-labio-laryngeal paralysis. 
Cannabis Indica, for retention of urine in spinal paralysis (R). Rhus Toxico- 
dendron, is certainly efficacious in paralysis depending on rheumatism (P). 
Ammonium Iodide and Carbonate, to aid in absorption of thrombi, thus pro- 
moting cerebral nutrition in cases of incipient hemiplegia, due to endarteritis 
deformans reducing the lumen of the vessels in the brain (B). [See formula 
below.] Arnica, in paralysis of the bladder, and many forms (P). Orchitic 
Extract, has been thought to be beneficial in general paralysis (see page 135). 
Capsicum, in ^ to 2-grain doses every 4 hours as general stimulant (P). 
Colocynth, in cerebral paralyses, sometimes seems to act favorably upon prin- 
ciples of revulsion or counter-irritation (P). Mustard, as an emetic to stimulate 
failing heart in certain forms of paralysis (P). Senega, in rheumatic paralysis, 
is a powerful help (P). Nutmeg, the Oil as external stimulant (P). Oil of Bay, 
has been given ; is obsolete (P). Cajuput Oil, efficacious in palsy (P). Coun- 
ter-irritation, by blistering fluid in peripheral paralysis of the 7th nerve (R). 
Cod-liver Oil, when low nutrition and faulty assimilation (Anstie). Galvanism, 
in hemiplegia and many forms (B). Electricity, faradization of the muscles 
affected ; localized electricity probably of more importance in confirmed spinal 
paralysis than medicinal treatment. Massage, in infantile paralysis, given 
with Calcium Lactophosphate and Cod-liver Oil, and Strychnine injected into 
the muscles (B). [Compare Hemiplegia, Locomotor Ataxia, Tongue, 
Paralysis Agitans.] 

Prescriptions. 

R. Strychninse Sulph., . . . gr. iij. R. Ammonii Iodidi, . . . . ^j. 
Aquse Destillatas (fervid.), . 7,x. Ammonii Carbonatis, . . gij. 

M. Sig. — For hypodermic administra- Liq. Ammonii Acetatis, . 3VJ. 

tion : nix=gr. ^V °f Strychnine Sulphate. M. Sig. — A tablesp. thrice daily. (B.) 



Paralysis Agitans. 

Hyoscyamus, full doses of the tincture will palliate the trembling; or Hyos- 
cyamine, gr. -^ gradually increased to gr. ^ (B). Hyoscine, gr. T ^ 15 or less, 
efficiently out temporarily controls the tremor of paralysis agitans (Weatherly). 
Duboisine, acts well in most cases. Conium, has benefited some cases 
(Harley). Gelsemium, in full doses, to quiet the nervous irritation (Lavers) ; 
a combination of Conium, Hyoscyamus and Gelsemium (see under Tremor). 
Potassium Iodide, to promote absorption (Lavers). Cocaine, influences paraly- 
sis agitans more favorably than any other remedy, large doses and frequent 
administration are unnecessary (B). Cannabis Indica, in large doses, lowers 
reflex activity. Picrotoxin, has greatly benefited some cases. Opium, Arsenic 
and Hyoscyamine may be tried, but the disease is incurable, and nothing can 
be done except to attend to the physical comfort of the patient ; there is no 
treatment which can be recommended as satisfactory in any respect (O). 
Sodium Borate, gr. xv-xlv daily, in 3 or 4 doses, produced most striking 
improvement in a case of paralysis agitans which developed after a fall upon 
the shoulder (Sacaze). Phosphorus, in small doses, with Cod-liver Oil, is very 
useful (R). Hypophosphites, the Syrup ought to be of service, if taken 
steadily for a long time. Cod-liver Oil, long continued, is more constantly 
useful than any other medicine (Anstie). Orchitic Extract, has been used 



PAROTITIS PEDICULI PEMPHIGUS. 747 

with benefit (see page 136). Sulphur Baths, are certainly of great value in 
this disease (Lavers). Electricity, the constant current, anode over the spine, 
cathode drawn along the course of the nerves as they leave the vertebral 
column to the periphery (Id). [Compare Chorea, Tremor.] 

Parotitis. 

Aconite, in febrile conditions (R). Mercury, ]A, grain of Gray Powder, 3 or 
4 times a day, is very useful, relieving pain and swelling (R). Poultice of 
Flaxseed meal, is a good local application for the gland. Leeching, often 
gives speedy relief, when pain is great and resists hot fomentations (Wa). 
Care to avoid chilling, important. Incision, when suppuration occurs. Stimu- 
lants and Tonics internally are very necessary in symptomatic parotitis, occur- 
ring as a complication or sequel of other diseases, with adynamic symptoms. 

Pediculi. 

Mercury, as Citrine Ointment or a wash of Corrosive Sublimate solution, for 
lice on all parts of the body ; the Oleate destroys lice immediately, and also 
kills the ova (R) ; for crab-lice the ordinary Blue Oint. is very disagreeable, and 
often toxic in its effect on the patient ; a better preparation is Calomel in 5 per 
cent, oint., or the Bichloride, a 1 per cent, solution in alcohol, of which a teasp. 
to a pint of water, as a bath to parts twice daily. Cocculus Indicus, destroys 
pediculi (P) ; the tincture undiluted as a wash. Staphisagria, as Oil or an oint- 
ment of the powdered drug (R) ; " lice-bane " (P) ; the tincture a very efficient 
application, and much more cleanly than an oil or an ointment. Acetum, 
Vinegar will kill the nits, as it softens the adhesive chitin by which the ova are 
glued to the hairs. Benzol, is a very efficient, convenient and cleanly applica- 
tion for destroying pediculi capitis or pubis, if fire or light be carefully avoided : 
a single application is usually sufficient. Ether, washed over the parts, effectu- 
ally destroys crab-lice. Tobacco, a decoction of the leaf is an efficient appli- 
cation, but requires care, especially if the surface is abraded (Wa). Essential 
Oils, will kill pediculi, as Rosemary, Anise (P) ; or powdered Pyrethrum (R). 
Cleanliness, cannot be dispensed with, and in many cases may alone be suffi- 
cient. Boil the underclothing. Isolation of person, and of brushes, towels, 
etc., to prevent infection. In Vienna the following prescriptions are used : — 

Prescriptions. 



R- . Bals. Peruvian., 

Petrolei, aa part. xv. 

Olei Pichuri, ..... . part. j. 

To be applied and washed off after 3 
hours. 



R. Acidi Salicylici, . . . .part, ij-iij. 

Aceti, part. xxv. 

Alcoholis (80 per cent.), . part. lxxv. 
To be rubbed on with a bit of flannel. 
One application is often enough. 



Pemphigus. 

Antipyrin, internally, for the itching, is efficient. Arsenic, is curative, espe- 
cially when chronic (B) ; largest dose, rr\,v of Liquor Arsenicalis 3 times a day, 
on full stomach (R) ; exercises a powerful influence (Wa). Mercury, as Citrine 
Ointment is largely used (Wa). Potassium Iodide, improves the condition in 
pemphigus (Wa) ; with good, simple diet ; Quinine, Cod-liver Oil, etc. Silver 
Nitrate, gr. ij ad 5J aquas in pemphigus, after the bullae have burst, and ex- 
coriations remain (Wa). Water Dressings, on lint, covered with oiled silk, ap- 
plied constantly, in pemphigus and rupia (Wa). Cod-liver Oil, with nutritious 
diet, is a powerful auxiliary to treatment (Wa). Puncturing the blebs and 
evacuation of their contents is necessary as soon as formed ; then dusting- 
powders of Zinc Oxide, Starch, or Buckwheat flour, or lotions of Liquor 
Plumbi Subacetatis Dilutus. 



74$ PERICARDITIS PERIOSTITIS PERITONITIS. 



Pericarditis. 

Aconite, when violent throbbing and extreme pain (R) ; of great value, if 
given early (P) ; proves in the highest degree serviceable, when object is to 
diminish vascular excitement or irritability (Wa). Spigelia Anthelmia, useful 
in rheumatic pericarditis (P). Digitalis, when rapid and feeble heart, cyanosis 
and dropsy (P, N) ; in second stage when heart flags, a tablespoonful of the 
infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in second 
stage, that of exudation ; fully equals any remedy in pericarditis (P). Opium, 
regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial (Wa). 
Veratrum Viride, extract made by inspissating the juice of the root, of which 
gr. ij with gr. j of Calomel every 2 hours, valuable (Waring-Curran). Quinine, 
gr. xv-xx may suppress an acute attack, if given at critical moment (B) ; may 
be used as an antipyretic. Counter-irritation, has been much abused ; useful 
at commencement, but not in acute inflammatory stage (B) ; by Iodine painted 
over the cardiac region, or flying blisters in the second stage. Iron, the tinc- 
ture in full doses may be required in the second stage. Poultices, large, hot, 
often renewed (R). Ice may be used instead of poultices in the early stage. 
Paracentesis, by aspiration, may be required in the second stage. [Compare 
Endocarditis.] 

Periostitis. 

Mezereon, in the rheumatic and scrofulous form (P). Mercury and Mor- 
phine, the Oleate externally (R). Potassium Iodide, in syphilitic children, also 
in non-syphilitic periosteal thickening (R) ; holds the first place for syphilitic 
affections of the bones (Wa). Ammonium Iodide, cures periostitis most readily 
when syphilitic (Wa). Staphisagria, when the long bones are affected (P). 
Iodine, the tincture, or blisters locally, of great service in chronic form (R) ; 
under the external use of Iodine periostitis often rapidly improves (Wa). 
Poultices, after an early and free incision, when suppuration takes places (C). 
Incisions, carried deeply, should be made without waiting for fluctuation, when 
great tension exists and there is a tendency to suppuration ; the sides of the 
abscess should then be brought together with compresses and a bandage 
(Gross). Tonics and Stimulants, as milk-punch, Quinine, Iron, and Opium, in 
full and sustained doses, are imperatively demanded in many cases (Gross). 
[Compare Nodes, Onychia.] 

Peritonitis. 

Phenacetin, as an antipyretic ; is efficient and safe. Aconite, of great utility 
when sthenic reaction ; [see Opium belowj ; should be given early in all 
inflammations of serous membranes (P). Bryonia, exceedingly valuable in 
second stage, when exudation (P). Mercury, when tendency to fibrinous 
exudations, is employed with good effect (W). Opium, to quiet intestinal 
movements (R) ; by far the best agent (P); Morphine, gr. ]/ z hypodermically, 
will often abort, if given early ; Aconite and Opium, the tinctures, gtt. ij of the 
former with gtt. vj of the latter, in water every hour or two ; a larger dose of 
opium if pain is severe (B); large doses of opium are easily borne in this affec- 
tion (Wa). Cocculus Indicus, for tympanites; a few doses will often remove 
the pain and relieve distention (P). Quinine, strongly urged by Trousseau; is 
naturally indicated in most inflammations (P). Turpentine, for tympanites 
(P) ; turpentine stupes, v-xv drops of Turpentine on flannel wrung out of hot 
water during acute stage, then blisters for a short time (B). Leeches, to abdo- 
men, if patient plethoric, and of sthenic reaction, relieve pain (B). Purga- 
tives, are inadmissible when from perityphlitis or inflammation of appendix 
vermiformis (B). Poultices, large, hot, and frequently renewed ; should be 
thin, and covered with cotton-wool (R). Ice, to abdomen (B) ; cold relieves 
(W). Hot Water, as fomentations to relieve pain, sometimes cold compress 
better. Ice, sucked or swallowed, to assuage the vomiting ; sips of cold water. 



PERITONITIS PERSPIRATION. 749 

Diet, after acuteness of the attack has passed; should be mild and unstimulat- 
ing. [Compare Puerperal Peritonitis.] 



Peritonitis, Tubercular. 

Quinine, in the acute form to reduce fever, as in acute tuberculosis, together 
with rest, poultices or warm fomentations, liquid diet, Opium, etc. (Whitla). 
Cod-liver Oil, by inunction with friction, also its continuous administration by 
the binder and mackintosh, is of great value in the chronic form of this disease 
(Id). Arsenic, children affected with tuberculosis involving the intestines and 
peritoneum have steadily and slowly improved and finally recovered under the 
Arsenic treatment (R). Laparotomy, has been done with uniform success and 
with complete cure of the disease in 80 per cent, of all cases of tubercular 
peritonitis in which the abdomen was opened, cleaned and drained (Tait) : in 
131 cases so treated 84 were cured and 23 greatly improved; only in 3 per 
cent, could death be ascribed to the operation (Konig). 



Perspiration. 

Belladonna, as liniment locally, also the tincture internally, especially in 
weakly children who sweat profusely (R). Atropine, gr. ^-^ to y^ hypoder- 
mically, or in exceptional cases even gr. -^ in pill, in sweating of phthisis and 
exhausting diseases (R); gr. -g 1 ^ at bedtime for sweats of phthisis (B). Duboi- 
sine, may be used instead of atropine. Pilocarpine, gr. ^ thrice daily, checks 
profuse perspiration (R, Pf ). Naphtol, in a 5 per cent, ointment or alcoholic 
solution, is a very efficient application for local sweating (Kaposi). Potentilla 
Sarmentosa, the Cinquefoil, an infusion of the vine, leaves, and root, may be 
drunk ad libitum, and is a very efficient remedy for night-sweats, having 
stopped them when Atropine failed to relieve (Pope). Salvia, the ordinary 
Sage-tea is very efficient, used internally and locally by sponging the body ; 
the infusion for night-sweats of phthisis (Da C). Quinine, in that of exhaust- 
ing diseases ; in many cases a night-draught of Quinine, Zinc Sulphate and 
Sulphuric Acid is useful (R). Opium, as Dover's powder, may succeed in 
profuse colliquative sweating (R) ; a fact, though hard to account for it 
(Wa). Agaricine, is used successfully (see formula below). Agaricic Acid, 
in dose of gr. -^ to \, not hypodermically, one of the most efficient agents 
against sweating from various causes, especially that after influenza; in over 
two years' use, it only failed me in one case (Richards). Camphoric Acid, gr. 
x-xxx, dry on the tongue, not over 2 hours before the expected sweating, is 
remarkably efficient against sweating from various causes, especially that of 
phthisis even when very profuse (Jas. Wood). Aromatic Sulphuric Acid, 
to check sweats of phthisis ; bad for digestion (B). Muscarine, has been used 
with great success in the sweats of phthisis and of other morbid states (R). 
Zinc Oleate, rapidly controls excessive and offensive sweating on slight 
exertion in the axillae and groins, also the night-sweats of phthisis (Murrell). 
Zinc Oxide, gr. iij, with gr. ss of Ext. Belladonnas, in a pill at bedtime for the 
sweats of phthisis (R). Gallic Acid, is very useful for the same condition, and 
may be combined with extract of Belladonna (B). Tannic Acid, may also be 
used with benefit. Aluminum, the Oleate, checks hyperidrosis and antiseptizes 
the sweat, thus forming a useful application to the axillae and groins of children 
(Wa). Potassium Permanganate, gr. j in 3J of water, for fetid perspirations 
of axillae, feet, etc. (B). Salicin. profuse sweats of hectic fever (Wa). Salicylic 
Acid, in solution with Borax, the most agreeable and efficient deodorant for 
fetid perspirations (B). Carbolic Acid, 2 parts, to 3 of glycerin and water, twice 
daily for fetid sweat (Wa). Oils, rubbed into the whole skin to prevent sweat- 
ing accompanying exhausting diseases, as phthisis ; but sponging with a weak 
acid wash better (R). Ergot, said to arrest sweating (R). Sponging, with 
acidulated water, or very hot sponging in phthisis (R). [Compare Feet.] 



75o 



PERTUSSIS. 



Prescriptions. 



gr- 



R . Acidi Gallici, .... 

Ext. Belladonna, .... gr. ij. 
Ft. pil. x. Sig. — Two at bedtime. 



R . Acidi Tannici, gr. xxx. 

Pulv. Digitalis, gr. xv. 

Ext. Cinchonae, . . . . . q. s. 
Ft. pil. xx. Sig. — One at bedtime. 



J-& . Agaricinae (Merck), . . . gr. x. 

Atrophias Sulphatis, . . . gr. j. 

Acidi Sulph. Aromat., . . tt\, 1200. 
Solve et filtra. Dose, y\ x in syrup or 
simple elixir, 5 or 6 hours before retiring, 
as the action of Agaricine is slow. 



Pertussis. 

Antipyrin, is successfully employed. Phenacetin, is highly praised. Aconite, 
in all acute congestions (P) ; as a preventive or abortive remedy very efficient, 
when associated with Ipecac and Cherry-laurel water (Dervieux). Amyl 
Nitrite, with Carbolic Acid, in steam atomizer, has proved a very efficient in- 
halation (Bayliss). Ipecacuanha, useful in many cases (R) ; tt\J for 5 years of 
age, every hour or two, gives the greatest relief (P) ; when bronchitic or pneu- 
monic complications, combined with Ammonium Bromide (Wa). Bromides, 
relieve spasmodic element (B); that of Ammonium will readily cure many 
cases ; gr. ij or iij ter die for infants (Wa). Lobelia, in spasmodic stages ; well 
tolerated by children ; rr^x of tinct. every hour for child 2 years old ; also ad- 
ditional dose when cough is imminent (R, P). Alum, when acute stage is over 
and no complication exists, gr. ij-vj every three hours, or less every hour in 
glycerin or honey (R). Bromoform, in daily dosage of 5 to 20 minims, in gly- 
cerin and alcohol, very efficient in relief of paroxysms, and to reduce their num- 
ber, but has little other influence on the course of the disease ; must be pure, 
hence colorless ; and increasing doses should not be pushed very far, for fear 
of toxic symptoms (Bedford) ; is almost a specific, acting as a local anaesthetic 
on the mucous membrane of the pharynx and larynx, given in doses of 1 to 5 
drops 3 or 4 times daily (Carpenter) ; [see formulas below] ; it may be used by 
inhalation instead of chloroform or ether, to lessen severity of the paroxysms. 
Hydrogen Dioxide, the solution, in drachm doses diluted with 2 or 3 of water, 
internally, cuts short the paroxysms and lessens the duration of the disease. 
Benzol, is a reliable pulmonary antiseptic, and has been used for many years 
in this affection with unvarying success (Robertson) ; the vapor maybe diffused 
throughout the room, carefully avoiding a light or fire. Ouabain, in doses of gr. 
ToW every three hours, is highly efficient in all stages of the disease (Gemmell). 
Resorcin in solution, applied to the perilaryngeal mucous membrane, has 
aborted an attack at the outset in 24 hours, has cured well-marked cases in from 
9 to 14 days, and is a perfect method of prophylaxis for children living with 
those suffering from the affection (Moncorvo). Naphtalin, burned in the patient's 
room, is of high value, both as a palliative and a curative agent (Chavernac). 
Belladonna, obviously of value in febrile stage, is of special use when dentition 
is in progress ; relieves the congestion of air-passages and also the determination 
of blood to the head (P) ; good when profuse bronchial secretion ; best in spas- 
modic stage ; children bear this drug well ; rr\,x of tinct. may be given hourly 
to a child 2 or 3 years old (R). [See formula below.] Sodium Benzoate is 
highly efficient. Conium, or the Hydrobromate of Coniine, in doses of gr. -^ 
to gr. \ according to age, a very efficient remedy (W). Drosera, small doses are 
very effective (Murrell). Chamomile Oil, a very useful remedy (P). Coccus 
Cacti (Cochineal), in doses of gr. l / z thrice daily for infants, has been highly 
recommended (W) ; proves very effective in most cases. Hydrocyanic Acid, 
very serviceable in cough from habit after cessation of whooping-cough proper, 
or in the nervous sympathetic cough of the mother (P). Myrtol, may be ex- 
pected to afford a large measure of relief (B). Formalin, as spray, is quite effi- 
cient. Opium, in the convulsive stage, to produce and maintain slight heaviness 
(R). Cocaine, a 5 per cent, solution, painted on tonsils, fauces, back of tongue, 
and if possible on larynx, is very efficient (Labrie). Chloral, gr. v-x in spas- 



PHARYNGITIS. 



751 



modic stage, relieves quickly (B) ; gr. iij-viij every 4 hours (Porter). Carbolic 
Acid, as vapor, with steam atomizer ; found to be very beneficial (J. L. Smith). 
Castanea, a decoction of chestnut leaves has been used with much success ; 
dose ad libitum (B) ; the fluid extract, in g-doses, exercises a remarkable in- 
fluence over the cough (W). Valerian, said to control the paroxysms (R). 
Nitric Acid, well diluted in sweetened water, after the subsidence of the catarrhal 
stage (B). Gelsemium, in spasmodic stage (B). Camphor Monobromide, gr. 
v in mucilage and Syrup of Tolu 3 or 4 times a day, has been serviceable (B). 
Zinc Sulphate, gr. %-] with Ext. Belladon., gr.-J^-J^, has varying degree of 
success (B). [See formula below.] Lactucarium, the syrup as vehicle for 
cough mixtures (B). Quinine, in solution, locally to fauces (Dawson) ; the Tan- 
nate with Sodii Bicarb, of each 5, and Pulv. Acaciae 100 parts, used with an 
insufflator (Pollack). Petroleum, on rags around head of the bed, is recom- 
mended highly by Hildebrandt. Silver Nitrate, when acute stage passed (Tr) ; 
probably inferior to Alum (Wa). [Compare Cough.] 

Prescriptions. 



R. Chloralis Hydratis, . . . £j. 
Potassii Bromidi, . . . . 3 i j . 
Syr. Pruni Virgin. , 

Aquse, aa ,lJ- 

M. Sig. — A teasp. thrice daily for in- 



fants in the convulsive staee. 



{Dessau. 



R 



. Olei Morrhuae, 

Mellis Despumat., 

Succi Limonis, . . . . aa partes seq. 

M. Sig. — A teasp. or two as required. 

{Sir Wm. Gull.) 



3-ss. 
n\x. 



R . Amyli Nitritis, . . . 

Acidi Carbolici, . . 

Glycerini, 

Alcoholis, aa ^ ss. 

M. Sig. — Use by inhalation with steam 
atomizer. (Bayliss.) 



R. Bromoformi, W\,xyj. 

Glycerini, ,?j ss - 

Tinct. Cardamom. Co. , 

Alcoholis, aa^ij. 

M. Sig. — A teaspoonful at commence- 
ment of the paroxysm. [Bedford.) 



R . Bromoformi, TT^xlviij. 

Alcoholis, 3* v - 

Tinct. Cardamom. Co., . giij. 
M. Sig. — A teaspoonful in water three 

or four times daily. {Carpenter.) 



\l 



Zinci Sulphatis, gr. iv. 

Tinct. Belladonnas, . . . TT^xlviij. 
Aq. Anisi, . . . . q. s. ad^'x). 
M. Sig. — 20 to 60 drops, according to 
ge of child, every three hours. 



Pharyngitis. 

Aconite and Belladonna, for acute attacks (B) ; when high temperature (R). 
Belladonna, is very useful, relaxes the pharyngeal muscles (W). Capsicum, 
Z] of the tincture to 0}4 of water, as gargle in the very early stage only (R). 
Alum, gargles, in chronic throat inflammations (R). Silver Nitrate, gr. v-xx 
to the ^, on sponge probang, successful if systematically applied (B) ; in early 
stage of inflammation ; also on brush, or as spray in the chronic form (R) : the 
solid stick to each diseased follicle, after scraping (A). Ammonium Chloride, 
gr. ij with rr\,xv of Tinctura Cubebae, every half hour, often controls acute 
pharyngitis ; when a gouty diathesis exists add tr^x of the Ammoniated Tinct- 
ure of Guaiac, and give every hour (Smith). Xanthoxylum, a decoction of the 
bark locally to throat, and n^x-xxx of the fluid extract thrice daily, a very 
successful remedy for chronic pharyngitis (B). Tannin, by insufflation to 
affected surface (B). Cubeb, powdered, locally, useful (B). Glycerin, pure, 
locally, with Tannic Acid, very serviceable (B) ; in chronic inflammation of 
the throat (R). Glycozone, frequently applied, is of benefit in follicular pha- 
ryngitis (Edson). Hydrastis, the fluid extract locally, also Tr^v-x internally 
(B). Alcohol, diluted, as gargle in relaxed throat (R). Cimicifuga, when 
pharynx dry and spotted over with inspissated mucus (R). Ipecacuanha, the 
wine as spray in non-inflammatory sore throat, with hoarseness from con- 



752 PHIMOSIS PHLEBITIS PHLEGMASIA. 

gestion of vocal cords (R). Pomegranate Bark, as gargle (P). Resorcin, in 
strong solution, a very efficient application (Tymowski). Potassium Chlorate, 
as lozenge to stimulate the follicular secretions to a healthy condition (A). 
Iron, Quinine, and Strychnine, as tonics, are mainly indicated (A). Zinc Sul- 
phate, as gargle, occasionally employed in relaxed throat (R). Inhalation of 
vapors, or of pulverized fluids, by the atomizer, found very beneficial (VVa). 
Food, of piquant kind, spices, pepper, mustard, etc., should be strictly pro- 
hibited ; all fluids should be used at a moderate temperature (A). Water, by 
throat compress, relieves ; also in daytime, in obstinate cases. Rest to voice 
and cultivation of beard, are useful aids. [Compare Throat, sore, Tonsil- 
litis, and Formulae for Gargles on page 538.] 

Prescriptions. 

R. Tinct. Aconiti, I R- . Aluminis, 3 ss ~ij- 

Tinct. Belladonna, . . aa ^ss. Sodii Boratis, oJ ss - 

Tinct. Guaiaci Ammon. , . 3 v. Glycerini, gij. 

Syr. Limonis, Jss. Tinct. Myrrhse, 2ij. 

Aquas Cinnamomi, q. s. ad ,51V. Aquae, . . . . q. s. ad 5W. 

M. Sig. — A teasp. every 3 hours for M. Sig. — Use as an astringent gargle, 

acute pharyngitis. 4 or 5 times a day. 



R. Tinct. Aconiti, sjss. 

Ac. Hydrocyan. Dil., . . TTVxl. 



R . Acidi Tannici, gr. 1: 



Liquor AmmoniiAcetat. , ad §iv. Alcoholis, TT^xxx. 

M. Sig. — Teasp. every 2 or 3 hours Aquae Camphorae, . q. s. ad % iv. 

according to the severity of the case. In [ M. Sig. — An astringent gargle, to be 

acute and subacute pharyngitis. ; used several times a day. 



Phimosis. 

Belladonna, as ointment, the extract 7 to 20 parts of Lard, has proven effect- 
ual (Wa). Lupulin, 5 to 15 grain doses, of advantage after operation, to keep 
penis at rest (Wa). Surgical, division of the prepuce by a bistoury and 
director; circumcision (D). Cocaine, a 4 per cent, solution injected at several 
points around the edge of prepuce, as local anaesthetic during the operation of 
circumcision. Chloroform, or Ether, as an anaesthetic in paraphimosis, before 
attempting reduction (Wa). 

Phlebitis. 

Hamamelis, has as decided an influence on the venous system as Aconite on 
the arterial (Pf ). Mercury, in frequent and liberal doses, to early and decisive 
constitutional impression ; the best form being Calomel, or Calomel and Blue 
Mass (Gross). Rest, fomentations, poultices, early incision of abscesses, aperi- 
ents, Opium to relieve pain and insure quiet of mind and body (D). Blister, 
over the course of an inflamed superficial vein (R). Diet, nutritious, also wine, 
especially if great loss of blood (D). Stimulants, as Quinine and Iron, espe- 
cially the tincture of the Chloride, also milk-punch, are needed to combat the 
depression which is sure to arise : the disease is always dangerous and often 
fatal (Gross). Incisions, must be freely made if abscesses form, and the inter- 
nal organs watched for multiple abscess. Ulceration, if it occur, must be 
watched for hemorrhage, which should be arrested by compression and styptics 
(Gross). [Compare Phlegmasia, Varicosis.] 

Phlegmasia Alba Dolens. 

Belladonna, and Mercury, equal parts, as ointment, often of much benefit 
(Wa). Hamamelis, has specific action on venous system (P) ; extolled by Dr. 
Preston (R). Blisters, in early stage ; are extremely useful if judiciously em- 



PHLEGMON PHOTOPHOBIA PHTHISIS. 753 

ployed (L). Ammonium Carbonate, often valuable where great prostration ; 
full doses (Wa). Hydrochloric Acid, Z] of dilute acid in Oij of Barley-water, 
with 3jss of Potassium Chlorate, to be taken daily (Mackenzie). Opium, large 
doses internally, with leeches and anodyne ointments (Wa) ; Laudanum, 
sprinkled on hot fomentations, if pain severe (L). Leeches, of great service 
during the acute inflammatory stage (Wa). Bandaging, when the more acute 
symptoms subside ; at first with flannel, afterwards with ordinary roller band- 
age (L). Regimen, should be tonic (L). Water, by compresses in active 
stage ; douches, hot and cold in chronic form. 



Phlegmon. 

Aconite, or Belladonna are certainly efficacious ; Aconite best (R). Sulph- 
ides, to abort, or when inevitable, to promote ; gr. ss-j every hour or two of 
Potassa Sulphurata (B). Silver Nitrate, a strong solution may check if ap- 
plied early in the vicinity (B). Carbolic Acid, injections ; a 2 per cent, solution 
(B) ; used with great success (W). Iodine Injections, after evacuation (B). 
[Compare Erysipelas.] 

Photophobia. 

Atropine, a neutral solution of the Sulphate, gr. j to the ^, for adult, dropped 
into the eye every 4 hours (C) ; if much lachrymation, so as to dilute the solu- 
tion, it may be applied more frequently ; in some cases Belladonna irritates 
and has to be abandoned (Wa). Conium, in scrofulous photophobia, gr. ss of 
Coniine in Z] of 01. Amygdalae, locally twice or thrice daily ; or the vapor of 
Coniine (Wa). Mercury, Calomel by insufflation (C). Canthoplasty, for the 
spasm of the orbicularis in severe photophobia (C). Glasses, of cobalt blue, 
the best (R). Arsenic, in the condition described by old writers as strumous 
ophthalmia, with its attendant photophobia, is very valuable as an internal 
remedy (C). Chloroform, the eye exposed to the vapor of a few drops, in severe 
photophobia will be speedily relieved ( Jones). Croton-Chloral, gr. v-x, in young 
people and those suffering from syphilitic corneo-iritis (Bader). Potassium 
Chlorate, internally, is most useful in some cases (Vernon). Cocaine, in 2 to 4 
per cent, solution, a few drops upon the conjunctiva, will be found promptly 
efficient in most cases. 

Phthisis. 

Creosotum, gives excellent results (Bouchard) ; is directly curative, at least in 
the initial stage of the disease (Frantzel) ; promotes the sclerotic change by 
means of which recovery is found to occur (Jaccoud) ; Morson's beechwood 
Creosote should be used, in doses of try in whiskey and glycerin, every 3 or 4 
hours ; should be largely diluted to prevent irritation, and continued for many 
months (see page 258) ; relieves cough, diminishes expectoration, stops night- 
sweats, increases weight, decreases fever, promotes appetite, and in many cases 
improves the local condition, as shown by the physical signs (Robinson) : 
Creosote, Tar, or Carbolic Acid, to check expectoration (R, P) ; Creosote is 
often curative, gr. iij in a pill with Bals. Tolu., three or four times daily, the 
dose being increased until urine is darkened ; or it may be inhaled with Iodine 
from hot water (B). Guaiacol, the principal ingredient of Creosote, and equally 
efficient : may be given in the same doses ; the Carbonate, in doses of 6 to 8 
grains, up to 3jss daily, is better borne, and a useful substitute (see page 259). 
Benzosol, contains 54 per cent, of Guaiacol, which it yields up in the intestines : 
in doses of 4 grains, gradually increased to 12 grains, thrice daily, it has given 
results in phthisis, equal if not superior to those from Creosote (Walzer). 
Iodine, should be more used than it is; the compound solution, gtt. j-iij thrice 
daily, or when anaemia and not much fever use Ferrous Iodide, gr. xv of the 
Syrup pushed to Z] ter die (Da C) ; as inhalation in chronic phthisis ; to lessen 
48 



754 PHTHISIS. 

expectoration and cough ; also as liniment painted under clavicles, to allay 
harassing cough, and to check secretion (R) ; extremely useful ; also as intra- 
pulmonary injection, a solution of the compound tincture of Iodine, i to 4 of 
distilled water, of which ttl,x-xx injected once every 4 or 5 days, through the 
1 st, 2d, or 3d intercostal spaces, anteriorly, or in the axillary region, avoiding 
the pericardium and great vessels (Robinson) : Iodine or Iodoform, with 
Creosote, Carbolic Acid, Eucalyptus, Chloroform and Alcohol or Ether, as a 
combination for an antiseptic inhalation (Br). Iodoform, internally, has proved 
extremely effective in all forms, as witnessed by numerous observers in various 
countries (S. Smith) ; though not one of the most active germicides, it is 
very destructive to the bacillus tuberculosis (B). Iodol, may be advanta- 
geously substituted for Iodoform (B). Ichthyol, is far superior to Creosote 
or Cod-liver oil, and is very useful in pulmonary tuberculosis (Cohn) ; a 
mixture of equal parts of Ichthyol and water, of which 4 drops are taken 
thrice daily, the dose being increased by one drop daily until the maxi- 
mum of 40 drops three times daily is reached (Id). Cod-liver Oil, holds first 
rank as a remedy and food in the chronic forms ; a teasp. after meals ter die is 
enough ; when not well borne may be combined with Aqua Calcis, Comp. 
Tinct. of Gentian ; or, when not digested, with Ether (B, R) ; is of great utility 
by improving nutrition, and by affecting the tubercle ; give ^ss thrice daily one 
hour after meals, with rr\,v-xv of Ether, or an equal quantity of malt or whis- 
key ; do not give it in hot weather (Da C). Alcohol, an important remedy ; 
may be given with Cod-liver Oil ; or Spt. Frumenti, 3J-^ij with some bitter, im- 
mediately after meals ; if it disagrees, it harms : curiously, it induces an 
intractable form of phthisis (B). Sulphurous Acid, by inhalation, spray or 
fumigation, in chronic phthisis (R). 

Aconite, in small doses for the irritative fever, is a remedy of much value (Da 
C). Antipyrin in a 2^ -grain dose hourly for 3 doses daily, for the hectic fever. 
Phenacetin is better borne and is efficiently antipyretic ; extensively employed 
in the hectic of phthisis. Cinchona, for the hectic and sweats, Quinine, gr. xv- 
xx (B) ; if small doses fail, a dose of 6 or 8 grains at once, or in portions re- 
peated hourly (R). Ipecacuanha, the wine as spray to throat when bronchial 
asthma and emphysema combined with fibroid phthisis (R). Opium, or Mor- 
phine, in a viscid vehicle for cough, or as lozenges when cough due to inflamed 
throat (R) ; must in time be given for the cough, which is an irritative one. 
Codeine, gr. ^ to ^ in simple elixir, is useful and does not constipate (Da C). 
Apomorphine, with Morphine, makes a good combination for many symptoms, 
especially for dyspnoea, continual cough and thick, tenacious mucus (Br). 
Cannabis Indica, an aqueous solution (see page 209) relieves the cough and 
aids the patient in many ways (Lees). Hydrogen Dioxide, the solution inter- 
nally, in doses of Z) to iij diluted with 3 to 4 of water, renders good service 
by promoting digestion, palliating cough, and increasing the activity of chaly- 
beate remedies. Terebene, with Thymol and Carbolic Acid, equal parts of 
each, of which 3ss to a pint of hot water as an inhalation : is extremely useful 
for the dyspnoea (Camman). Verbascum, the Mullein-plant, has long been a 
popular remedy in phthisis ; it facilitates expectoration, improves the general 
condition, and palliates the cough. Calcium Phosphate, in diarrhoea, and in 
chronic forms of phthisis with little or no fever (R). Cimicifuga, useless in 
tuberculosis, but in phthisis it relieves cough, improves appetite, lessens inter- 
current bronchitis, and so improves the patient's general condition (Wa). 
Aurum, the Bromide of Gold and Arsenic internally, with inhalations of 
Papoid as glycerole by the atomizer, gave astonishing improvement in two 
cases of fibroid phthisis with cavities, due to neglected pneumonitis ; also in a 
case of grinders' consumption (E. A. Wood) ; the Chloride has rendered ex- 
cellent service in the hands of Gibbes and Shurley. [See infra, under Chlor- 
ine.] Arsenic, valuable in chronic forms as no other remedy ; but not in 
caseous or where much hectic ; may be given by stomach or fumigation (B) ; 
as cigarettes, useful in the diarrhoea, probably diminishes temperature, 
caution required ! (R) ; of great value in early stage, in later stages it is of 



phthisis. 755 

no avail ; Arsenous Acid, gr. ^> or ^"j °f Fowler's solution, thrice daily (Da 
C). Cocaine, locally for the throat symptoms, to be applied just before meals 
are eaten (Da C). Sanguinaria, helps expectoration, and revives the enfeebled 
stomach (P). Camphorated Naphtol, undiluted, or TT\jj in olive oil hypoder- 
mically, used with very good results in 15 out of 32 cases so treated (Reboul). 
Chloroform, with glycerin or honey, for the cough in fibroid phthisis (R) ; by 
inhalation in small quantities for the cough and dyspnoea, gave extraordinary 
relief to a noble patient of mine during the last 8 months of his life (Spencer 
Wells) ; by continuous inhalation, kept short of full anaesthesia, maybe effective 
as a germicide in phthisis (Potter, in Pacific Med. Jour., Oct., 1890). Chlorine 
gas, by inhalation, also the hypodermic use of Iodine and Chloride of Gold and 
Sodium, extensively employed in pulmonary consumption with good results 
(Gibbes and Shurly in Therapeutic Gazette, April, 1891, and April, 1892). Fer- 
rum, often prescribed; has no especial influence on deposit (B) ; is prescribed 
in tuberculosis (Tr) ; the Liquor Ferri Perchloridi, 3j ad 3J aquae, the most ser- 
viceable local application in laryngeal phthisis, diminishing irritability of the 
mucous membrane, and quieting cough (Mackenzie). Mercury, gr. y^- of 
Corrosive Sublimate every two or three hours, for the diarrhoea (R). Benzoin, 
as inhalation, to lessen cough and expectoration (R). Mineral Acids, for the 
indigestion ; especially the dilute Hydrochloric (B). Prunus Virginiana, has a 
domestic reputation, probably due to its influence over cough ; the syrup is 
much used as a vehicle for cough-mixtures (B). Hypophosphites, are very use- 
ful in chronic cases (B) ; have no special effect (Da C). Digitalis, as an anti- 
pyretic; deranges intestinal canal, therefore injurious in phthisis (B). Copper 
Phosphate, in nascent form soluble in an alkaline body, is held to be specific 
by Prof. Luton of Rheims ; his formula contains Neutral Acetate of Copper 0.15, 
Cry st. Phosphate of Sodium 0.75, Glycerin and Pulv. Liquorice, aa q. s. for one 
pill. Copper Sulphate, gr. T x ^ or Silver Nitrate, gr. % , or Bismuth, gr. xx, for 
the diarrhoea (Da C). Camphor, in oil, as subcutaneous injections during the 
period of softening (see page 206). Amick Chemical Cure consists in the use 
of Calomel, Iodoform, Guaiacol, etc., as described by Dr. N. B. Shade in various 
journals (Waugh). [See under Patent Medicines in Appendix.] Aseptolin, 
lately put on the market by Dr. C. Edson, is described on page 78. Tuberculin, 
(Koch's lymph) described on page 473 ; a deceptive bubble which for a short 
time commanded the attention and admiration of the whole world, but which 
has been ruthlessly pricked by the critical scalpel in the hands of the father of 
modern pathology (Senn). Tuberculocidin, a derivative of Tuberculin (Klebs) ; 
is described on page 476. Antiphthisin, is Dr. Klebs' latest remedy, and is fully 
described on page 476. Antitoxin, advocated by Maragliano and Paquin, is 
described fully on page 153. Nuclein, has been employed with encouraging 
results by Vaughn (see page 134). Baths, sea-bathing, if chronic, little or no 
fever, without active deposition of tubercle, or scrofulous pneumonia ; Turkish 
baths for the cough (R). Grape-cure, is serviceable (B). Aliment, should be 
nutritious and digestible, malt liquors better than wine or spirits : Extract of 
Malt, Cod-liver Oil, plenty of meat, and alcohol in moderation (Da C) ; warm 
clothing, bathing and friction of skin, moderate exercise, and a suitable climate. 
Forced Alimentation, when anorexia appears, and superalimentation at all 
times, necessary to successful treatment ; washing out the stomach daily by 
syphon-tube, with warm water alkalinized with Borax, and then feeding through 
the tube (Robinson). Climate, the best by far is that of Egypt, or Algeria ; 
next coming New Mexico, Southern California, especially in the desert along 
the Colorado River, South Carolina and portions of Georgia and Florida; the 
latter being especially suitable for cases having a co-existing bronchitis ; for 
some cases Colorado is very good, and the Adirondack region for early cases 
in which there is no tendency to hemorrhage (Da C). [Compare Cough, 
Hemoptysis, Hectic Fever, Perspiration, Laryngitis, tubercular, 
Meningitis, tubercular, Peritonitis, tubercular, Tuberculosis, acute, 
Tuberculous Affections.] 



756 



PITYRIASIS. 



R . Quininae Sulphatis, 
Pulv. Digitalis, . . 
Pulv. Opii, . . . 
M. ft. pil. no. xij. Sig. 



Presa 
. gr. xviij. 

• g r - v j- 

• gr. iij- 
-One pill thrice 



daily, for the irritative fever. [Niemeyer. 



B 



M 



Pepsini (Jensen), . . . . gr. xl. 
Acidi Hydrochlor. Dil., . gijss. 

Glycerini, 3 v. 

Succi Limonis, £iv. 

Aq. Aurantii Flor. , q. s. ad 3 iv. 
Sig. — Dessertspoonful with meals 



iptions. 

R . Tinct. Belladonnae, . 

Syr. Sciltae, .... 

Morphinae Sulph., . . 

Syr. Tolutani, . . q. s. ad 3 iv. 
M. Sig. — Tablespoonful at bedtime, for 
cough and restlessness ; to be repeated if 
necessary. 



for the dyspeptic symptoms. 



R. Iodoformi, gr. xxiv. 

Creosoti, TTUv. 

01. Eucalypti, n\viij. 

Chloroformi, Tr^xlviij. 

Alcoholis, 

Athens, . , . aa q. s. ad ^ ss. 
M. Sig. — 10 to 20 drops on the sponge 
of a perforated zinc inhaler, to be worn 20 
minutes thrice daily. [Brnnton.) 



R . Iodoformi, 
Greosoti, 
Pulv. Benzoini, 

Bals. Tolu., .... aagr. j. 
In pill, of such 2 to 4 daily. [Huchard.) 



R. Petrolei Massae, %]. 

Pulv. Cubebae, 

Pulv. Doveri, . . . . aa^ss. 
Cinchonidinae Sulph. , . . gij. 
M. ft. massa., et div. in pil. no. cclxx. 
Sig. — One pill every 3 or 4 hours. 

{Griffith.) 



gr-j- 



R. Codeinae, gr. xv-xx. 

Alcoholis, . . . . q. s. adsolw. 

Potassii Cyanidi, . . . . gr. xij. 

Syr. Pruni Virgin., . . £ iv. 

Aquae, q. s. ad ^yj. 

M. Sig. — A teasp. 4 to 6 times daily, 
for the cough. [Potter.) 



R . Olei Morrhuae, z ss. 

Mucil. Acaciae, 31J. 

Sacchari, gij. 

Tinct. Lavandulae Co., . . n\xx. 

Aquae, ^ss. 

M. Sig. — Teaspoonful for children. An 
agreeable mixture. [Farqitharson.) 



R. Creosoti (beech- wood), . TT^vj. 

Glycerini, J|j. 

Spt. Frumenti, Sij. 

M . Sig. — For one day's use , as directed, 
in ^ ss doses. [Robinson.) 



R . Arseni Iodidi, 

Strychninae Sulph., 

Hydrarg. Chlor. Corr., . aa gr. j. 

Quininae Sulph. , 

Iodoformi, aa ^ij. 

M. ft. pil. no. xl. Sig. — One thrice daily 
as a tonic in tubercular cases. [Mann.) 



[For a Cod-liver Oil Emulsion see formula on page 534.] 



Pityriasis. 

Alkaline and Tonic Remedies generally control mild cases, together with 
baths and emollients ; the more severe ones requiring constant envelopment 
in linseed or cod-liver oil (Bulkley). Mercury, in obstinate cases, Donovan's 
solution, is highly successful (Wa) ; the yellow Iodide, gr. x to %j of lard, or a 
5 per cent, solution of the Oleate of Mercury in Oleic Acid with one-eighth part 
of Ether, applied by a camel's-hair brush (B) ; Citrine ointment, especially 
when the hairy parts of the face are affected (R) ; an ointment of Ammoniated 
Mercury and Calomel is very useful in ordinary cases of dandruff or pityriasis 
simplex (Bronson). Sulphur, 3j to ^j of vaselin applied every morning to the 
scalp, with sweet Almond Oil anointing at night (Jackson). Soap, the liniment 
of soft soap as shampoo every morning for cleanliness, or Borax and water, or 
the yolks of three eggs beaten up in a pint of Limewater with gss of Alcohol, 
all of which make good shampooing mixtures (Jackson). Borax, to cleanse 
the scalp, a saturated solution ; or the Glycerite of Borax (R). Lead, the Liq- 
uor Plumbi, with glycerin, equal parts of each, and two of water, as lotion for 



PLETHORA PLEURITIS. 



757 



cases where there is high inflammation and abundant weeping (R). Carbolic 
Acid, 2 parts to 3 of glycerin and water, twice daily, with the daily use of a 
carbolized soap, is often effectual (Wa). Sulphides, ^ss of Potassa Sulphurata 
to Oj of Lime-water, as a lotion, or the Bareges Pomade (see below for for- 
mula). Thyroid Extract, as a stimulant of the cutaneous circulation, has been 
used with satisfactory results (see page 132). Myrtol, is curative (B). Baths, 
frequently, and hard rubbing after shampooing the scalp; avoid stimulating- 
food in bad cases, as well as the use of a fine-toothed comb on children's 
heads. [Compare Seborrhcea, and for Pityriasis versicolor see Tinea 
versicolor.] 

Prescriptions. 



R . Sodae Sulphurate, 

Sodii Carbonatis, . . aazij. 

Axungice, 3 ijss. 

M. Sig. — Pomade de Bareges. 



R. Hydrarg. Aramoniat. , . . gr. xx. 
Hydrarg. Chlor. Mitis, . gr. x. 

Petrolati, f j. 

M. ft. unguent. Sig. — Local use. 



Plethora. 

Aconite, is useful for affections of plethoric subjects ; and is decidedly the 
best remedy for apoplexy in the plethoric (P). Arsenic, is used with advantage 
when there is determination of blood to the head (Wa). Sulphur, as a mild 
purgative for plethora from cessation of the menses (Wa). [Compare Abdo- 
minal Plethora.] 



Pleuritis. 

Aconite, no remedy more effective prior to the stage of effusion (R) ; [See 
under Inflammation] ; the tincture in doses of l / 2 drop every 3 hours to a child 
3 years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride, gtt. viij of tinc- 
ture every 3 hours, with a drop added to each dose until the pulse is reduced or 
nausea occurs (Wa) ; opinions differ as to whether it should be used in sthenic 
or asthenic forms (R). Bryonia, exceedingly valuable in second stage ; should 
follow Aconite (P). Tartar Emetic, in early stages and young plethoric sub- 
jects, when much febrile action, small doses, gr. -^ to % , may be useful (Wa) : 
[See under Inflammation.] Digitalis, as antipyretic (R) ; deranges intestinal 
canal (B) ; Aconite preferred (P) ; the tincture in doses of one drop every 3 
hours to a child of 2 years old (J. Lewis Smith). Quinine, has abortive power, 
increased by combination with Morphine, gr. xv -f- gr. ss ; also as restorative 
tonic in low-type cases (B). Opium, cannot be too highly extolled (P) ; is 
especially beneficial ; gr. ss of Morphine hypodermically at beginning will 
often cut short an attack ; during the disease its effects are very beneficial ; a 
slight physiological effect should be maintained (B) ; Morphine for severe pain 
(R). Antipyrin, is found effective in promoting the absorption of pleuritic effu- 
sions (see page 146). Diuretin, has caused a large pleuritic effusion to dis- 
appear (see page 199). Guaiacol, locally to promote absorption of effusion (see 
page 259). Potassium Iodide, to promote absorption of effusions, steadily for 
a long time (R) ; also chest painted with tincture of Iodine, one day on each 
wall alternately ; may be washed off with Potassium Iodide, Alcohol or Ether 
(B) ; as a diuretic to remove effusion (Clark). Iodine, also as injections, with 
great benefit and without risk, in empyema and hydrothorax (R). Burgundy 
Pitch, the plaster externally as a mechanical support (P). Asclepias, the popu- 
lar pleurisy-root, is a favorite remedy in the south (W). Pilocarpus, in sub- 
acute cases to remove fluids (Caro) ; or Pilocarpine Nitrate, gr. \ bis die, for 
children (Vigier) ; is too depressing and therefore unsafe (Smith). Sodium 
Chloride, gss in H;j of water, flavored with Liquorice, in tablesp. doses every 3 
hours, often very useful in causing absorption of pleuritic serous exudations ; 
but is contraindicated when exudation is purulent (Br). Bloodletting, by cups 
or leeches, useful by reason of counter-irritation produced, and to relieve pain, 
only in robust sthenic cases (B). Blisters, often greatly abused; are harmful 



75 8 PLEURODYNIA — PNEUMONIA. 

during inflammatory stage (B). Poultices, large, hot, and frequently renewed 
(R). Water, cold wet-pack to chest probably better than a hot one, pinned 
tightly to limit movement of chest-walls (B). Thoracentesis, by aspiration, if 
the quantity of fluid seriously embarrasses respiration. [For Chronic 
Pleurisy see Empyema, also compare Hydrothorax, Pleuropneumonia.] 

Prescriptions. 



R. Potassii Acetat. , . . . . j^j. 
Infusi Digitalis, . q. s. ad £ iv. 
M. Sig. — Teasp. every 3 hours to a 
child of 4 or 6 years, in the second stage. 



H. Morph. Sulphat., . . . . gr. j. 

Tinct. Aconiti, TTLxxiv. 

Liq. Potassii Citratis, . . ^ij. 
M. Sig. — A teasp. every 3 hours. 



Pleurodynia. 

Cimicifuga, curative when rheumatic and valuable in sympathetic cases from 
irritability of uterus (P) ; or uterine derangements (R, Wa). Croton Oil, in 
obstinate pleurodynia especially when blackened feces (R). Belladonna, the 
plaster or liniment ; the latter generally best (R). Chloral, made liquid with an 
equal weight of Camphor, rubbed in gently, often affords instant relief in severe 
pleurisy (R). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in most 
cases (Hughes). Ether, as spray, sometimes immediately and permanently 
removes the pain (R). Opium, as liniment rubbed in after warm fomentations 
(Wa) ; or a hypodermic injection of Morphine (R). Iodine, as liniment painted 
on the chest, often relieves where mustard fails (R). Blistering, often success- 
ful when other means fail ; sometimes strong vesication necessary (R). Rest, 
is important and may be obtained by strapping the affected side with strips of 
adhesive plaster. Poultices, very hot, followed by application of lint and oil- 
skin ; Belladonna Liniment generally better (R). Mustard, as a poultice, is 
generally efficient, and can be renewed when the pain returns (R). [Compare 
Neuralgia, Myalgia.] 

Pleuro-pneumonia. 

Bryonia, is often of great service ; limits effusion and assists absorption (P). 
Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice 
a day, has had remarkable success (B). Sanguinaria, as a contra-stimulant 
(P). Turpentine, as a fomentation (P). Arnica, the tincture in doses of rr\,x 
every 3 or 4 hours, very useful in controlling the heart's action (Wa). Pilo- 
carpine, gr. ss, or 3ij of the tincture of Jaborandi, benefits cases of pleuro- 
pneumonia (Wa). [Compare Pneumonia.] 

Pneumonia. 

Aconite, gives good results in catarrhal and fibrinous forms (B) ; has marked 
effect (R) ; very valuable in first stages (P) ; in several cases it apparently cut 
short the attack (Wa) ; to reduce circulation either Aconite or Veratrum Viride, 
until the pulse is impressed (Da C). Veratrum Viride, valuable (P) ; in the very 
incipiency (B) ; opinions differ as to whether it should be used in sthenic or 
asthenic cases (R). Quinine or Salicylic Acid, to reduce temperature (R) ; 
Quinine as a tonic in cases which are asthenic from the first (P) ; in conjunc- 
tion with Aconite and Veratrum, gr. viij-xij daily at start, is beneficial (Da C). 
Antipyrin, to reduce pyrexia ; is decidedly more serviceable in pneumonia than 
Quinine (Wa) ; gr. xv several times a day, or 3 hourly doses each of gr. xxx, 
then stopping until temperature rises again (R) ; such doses are too high and 
are dangerous (see page 143) ; with Camphor internally, successful in all of 22 
cases of croupous pneumonia so treated at the Lorn Hospital, in 1894, Anti- 
pyrin gr. viij, Camphor gr. ij, Morphine Hydrochlorate gr. ^g, in powder every 
one or two hours (Ivanoff ). Camphor in olive oil, in doses of from gr. j to gr. 
ij three or four times a day, hypodermically, in adynamic cases, used simul- 



PNEUMONIA. 



759 



taneously with the above antipyrin and camphor powder (Id) ; in fibrinous 
pneumonia these injections lower the temperature about a degree and amelior- 
ate the general condition. Ammonium Carbonate, at crisis for depression ; give 
in infusion of Senega (B) [see formula below] ; is useful as expectorant late in 
disease when lung tissue breaks down (Da C). Ammonia, the Aromatic Spirit 
as a substitute for the Carbonate, in doses of 3ss in simple elixir (Da C). 
Turpentine, as stimulant at crisis (B). Serpentaria, with Ammonium Carbon- 
ate in low types, as a stimulant about the crisis. Digitalis, of doubtful value ; 
may be useful for high temperature, ischasmia, and low tension of vessels (B) ; 
as case goes on and circulation is to be further controlled, Digitalis is indicated 
(Da C) ; the best agent to slow the heart in infantile pneumonia, with Belladonna 
as an adjuvant (Brown). Bryonia, when pleural complications (P). Phos- 
phorus, especially when typhoid symptoms ; approved by Fleischmann (R). 
Belladonna is useful in the first stage (P) ; Harley esteemed it highly in pneu- 
monia (Wa) ; as an adjuvant to Digitalis in infantile pneumonia, to soothe the 
irritable nervous system and curtail superabundant secretion (Brown). Tartar 
Emetic, formerly given in large doses ; now abandoned ; small doses may be 
useful, but should be used with care, lest depression ensue (B) ; at commence- 
ment with alcoholic stimulants, if patient weak (R) ; may benefit young, robust 
subjects (Wa). [See under Pleuritis.] Sanguinaria, as a contra-stimulant, 
when fever has abated, and graver symptoms have amended (P). Iodides, no 
remedy more efficient ; Ammonium Iodide with Arsenic, to prevent caseation 
of inflammatory products (R) ; Ethyl Iodide, gtt. v-xx ter die by inhalation, 
very valuable in catarrhal form (B) ; Sodium Iodide is useful in catarrhal pneu- 
monia (Da C). Ipecacuanha, the wine in infantile pneumonia, should never 
be dispensed with, as it promotes expectoration, controls hemorrhage and 
regulates secretion (Brown). Senega, in advanced stages as expectorant, when 
cough is dry, irritating and painful, tightness and oppression of chest (P). 
Opium, or Morphine by injection, sometimes needed for severe pain (R) ; 
Opium is very desirable in many cases, relieves the symptoms and arrests 
delirium (Wa). Copper Acetate, Kissel regards it curative ; under it the mor- 
tality was only 4^ per cent. Stimulants, in asthenic cases, those of malignant 
type, and those occurring in aged people (Wa). Blisters, useful at very begin- 
ning only, or at crisis of disease, harmful in inflammatory stage (B) ; to lessen 
the pain, but should be used in moderation (R). Wet-pack, hot, tightly pinned 
to limit motion of chest-walls (B). Poultices, encircling the whole chest in 
children (R). Diet, farinaceous, mucilaginous drinks, and rest in warm room 
(R). [Compare Pleuropneumonia.] 



Prescriptions. 



R . Tinct. Veratri Viridis, . . rr\xl. 
Spt. ./Etheris Nitrosi, . . £vj. 
Liq. Potassii Citratis, . . 3 ivss. 
Syr. Zingiberis, . . q. s. ad 3YJ. 
M. Sig. — A tablesp. every 3 hours, 



the early stage. 



[Da Costa.) 



R. 



TTLxxiv. 

3U- 



Tinct. Aconiti, .... 
Tinct. Opii Camphorat, 
Liq. Ammonii Acetatis, 
Syr. Zingiberis, . . aa ^ ss. 
Aquae, .... q. s. ad ^vj. 
M. Sig. — A tablesp. every 2 hours, after 
free catharsis by calomel. [Ripley.) 



R . Ammonii Carbonat. , . . gr. xl. 
Infusi Serpentariae, . . . H5 iv. 
M. Sig. — A teasp. every 3 hours, as a 
stimulant about the crisis. (B. ) 



R. Potassii Iodidi, Sjj. 

Ammonii Chloridi, . . . ^jss. 

Mist. Glycyrrh. Comp., . £vj. 
M. Sig. — A tablesp. 4 times daily, to 
promote absorption, together with blisters 
to the chest. ( Univ. Penna. Hosp. ) 



R. Sodii Iodidi, ^iij. 

Morphinae Sulph., . . . . gr. j. 
Elixir Simplicis, . . . . ^ iv. 
M. Sig. — A teasp. ter die, also blisters 
over the apex. In catarrhal pneumonia. 

{Da C.) 

R . Ammonii Iodidi, . . . . gr. xl. 
Spt. Ammonii Aromat., . zij. 
Elix. Simp, et Aquae, . ad J viij. 
M. Sig. — Two tablesp. thrice daily. In 
syphilitic lobar pneumonia. [Da C.) 



760 POLYPUS POULTICES PREGNANCY. 

Polypus. 

Sanguinaria, has been employed as snuff for nasal polypi (P) ; with doubtful 
benefit (W). Tannin, finely powdered, as snuff blown daily into nostrils 
through a quill, is especially adapted to the soft and gelatinous varieties ; while 
it has apparently no effect on the healthy mucous membrane it causes the 
complete withering of the polypus (Wa). Zinc Chloride, has been injected 
interstitially with success in a case of naso-pharyngeal polypus (Barthelemy). 
Iron, a solution of the Chloride is advised as an interstitial application (Auger). 
Acetic Acid, glacial, injection into the body of the tumor, will cause it to shrink 
up and to drop off in a few days. Alum, in powder, applied to point of origin 
to prevent recurrence (D). Surgical, — a nasal polypus should be seized with 
polypus forceps and twisted off at the neck ; it may be removed through the 
mouth or the nostril ; in a few cases the nostril must be dilated with a specu- 
lum, or the ala slit to give access to the root of the tumor (D). 



Poultices. 

Poultices and Fomentations are simply local baths utilizing warmth and 
moisture, relaxing the tissues and relieving pain. If applied early they will 
check inflammation, or assist the evacuation of pus when suppuration has set 
in. Poultices should be applied thick (thin in peritonitis), as hot as possible, 
covered with cotton-wool, and frequently changed ; large at onset, very small 
after maturation. Belladonna and Glycerin, partes sequales, smeared over tis- 
sues under a poultice, aid the latter greatly, also Tinctura Opii, especially where 
the skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in 
the order mentioned; add the meal to boiling water, stir and spread quickly on 
warm linen. Charcoal under the poultice, when foul sores are being treated. 

An excellent method of preparing poultices is to make a lot of bags of 
various sizes, of either of the fabrics known as Swiss and Cheese-cloth, filling 
each bag half full with the linseed meal or other agent used, then sewing up 
the open end. When wanted for use one of these bags is submerged in boiling 
water for a few minutes, and on taking it out the meal is found to have swelled 
so as to fill the bag, which should then be squeezed to rid it of the superfluous 
water, laid on the part and covered with oiled silk and a bandage. If too hot 
the poultice will scald the skin. 

Fomentations, — Flannel may be wrung very dry out of boiling water, ap- 
plied and covered with oiled silk. Spongio-piline, a fabric composed of sponge 
and wool, coated with india-rubber, is an excellent vehicle for the application 
of warmth and moisture. The inner surface is moistened with hot water ; and 
its utility may be increased by sprinkling the moistened surface with charcoal 
or yeast ; or by saturating it with any desired lotion or liniment. 



Pregnancy, Disorders of. 

Mercury, a few grains of blue pill to correct clay-colored stools (L). Iodine, 
the tincture internally for cardialgia (Wa). Aloes, have cured piles in preg- 
nancy, by removing constipation ; cautiously ! (P). Alum, Tannin or Catechu, 
in medicated pessaries for vaginal leucorrhcea (L). Castor Oil, an excellent 
laxative (P) ; to clear out the bowels in diarrhoea (L). Cocculus Indicus, 
when intestines much distended with flatus, and frequent desire to urinate from 
flatulent pressure on bladder (P). Bismuth, Calumba and Antispasmodics, 
with minute doses of Opium, for gastrodyniaand pyrosis (L). Potassium Bro- 
mide, with Chloroform, as an antispasmodic in dyspnoea (L). Sumbul, is invalu- 
able in the restlessness ; n\, xxx-xl of the tincture with a little Chloric Ether, 
giVing quiet nights for a long time (P). Galla, Unguentum Gallae cum Opio, 
the best local application to hemorrhoids, also fomentations with sponges 
wrung out in very hot water, to relieve pain (L). Digitalis, in infusion,very 



PROLAPSUS PROSTATE — PROSTATITIS. ?6 I 

beneficial in the albuminuria (L). Potassium Acetate, with Basham's mixture 
(Liq. Ferri et Ammonii Acetatis), when albuminuria with anaemia. Calcium 
Phosphate, believed to exert an influence on the foetus if administered during 
pregnancy, so that mothers who have borne only rachitic or scrofulous children 
will bear healthy ones (W). Berberine, found very useful in the periodical 
neuralgias of pregnancy, even in cases in which Quinine had previously failed 
(Maclagan). Camphor Liniment, for lumbar pains (Wa). Senna, the confec- 
tion proves a mild and efficient purgative in the constipation of pregnancy 
(Wa). Milk-diet, the best remedy for albuminuria of pregnancy, if strictly 
carried out (Parvin). Injections, must be used carefully, even tepid water often 
induces uterine contractions (L). [Compare Albuminuria, Nephritis, Ner- 
vousness, Ptyalism, Vomiting of Pregnancy.] 

Prolapsus Ani. 

Nux Vomica, or Strychnine, especially when in children, with constipation ; 
in the latter event add Nux Vomica to a purgative, as tincture of Rhubarb 
(R, P) ;. Strychnine hypodermicaliy, gr. T \ for an adult every 48 hours, }( inch 
from anus and parallel to rectum, into the cellular tissue ; generally requires 
4 to 8 injections (Weber). Piper, the Confectio Piperis in doses of gr. lx to 
cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa). Sulphur, 
has a beneficial effect in addition to its laxative value (R). Alum, in solution, 
gr. vj to the % (R). Ice, locally, when parts inflamed (R). Ergot, the fluid 
extract injected into the perineum, is followed by immediate relief (Vidal). 
Ferrous Sulphate, 3j to ^viij aquae, of which one-third by enema twice daily. 
Podophyllin, in small doses for rectal prolapse in children (P). Tannin, by 
injection to restrain the prolapsus (R). Hydrastis, by enema, or as a lotion (P). 

Prolapsus Uteri. 

Cimicifuga, to prevent miscarriage in prolapsus uteri (R) ; has a remarkable 
effect upon the uterus (P). Astringents, as Decoctum Quercus, Decoctum 
Gallae (Wa) ; or Pomegranate bark (P). Tannin, as Catechu, Kino, Rhatany. 
Alum, a solution, gr. vj to the ^ (R) ; lb. j ad Cj aquae, as hip-bath ; should also 
be passed well up vagina (Wa). Ice, locally when parts inflamed (R) ; ap- 
plied to the spine (Wa). Pessaries, in any form, are of but temporary benefit, 
and in the end positively detrimental (E) ; but many cases cannot be treated 
without mechanical support of some kind. 

Prostate, Hypertrophied. 

Alkalies, for the cystic irritation with acid urine ; great benefit from Liquor 
Potassse, or the Citrate and Acetate of Potassium (B). Triticum Repens, bene- 
fit follows its use in the prostatic enlargement of old men (Sir H. Thompson). 
Ammonium Benzoate, for the cystitis, urine alkaline (B). Ammonium Chloride, 
is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa). Iodine Injections, 
through rectal walls (B) ; a weak ointment applied by rectum (Wa). Iodine, 
has been tried in all forms, but is of no value (Thompson). Iodoform, as sup- 
pository in the rectum, has proven of great value (B). Colchicum, in persons 
of a gouty diathesis (Wa). Medicine is not likely to have any control over this 
condition, which is a simple hypertrophy ; castration was suggested by J. Wm. 
White, and has been performed with successful results in three cases by 
Haynes, also by other operators. [Compare Cystitis.] 

Prostatitis. 

Cantharides, a drop of the tincture (5 may be required) 3 or 4 times a day 
(R). Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino- 



762 PROSTATORRHCEA — PRURIGO PRURITUS. 

Genitals, especially Turpentine, Cubeb, Juniper, Cantharis (B) ; Cubeb, in doses 
of gr. xx daily, is found of much benefit (Wa) ; Buchu relieves (P). Silver 
Nitrate, a solution, gr. v-x to the ^. applied to the prostatic urethra in chronic 
prostatitis, may be useful (Wa). Blisters, in chronic prostatitis, a small blister 
on each side of the raphe of the perineum, kept open 4 to 6 weeks, has given 
the best results (Wa). Tonic medicines and regimen should be prescribed 
(Wa). Hot Injections, to relieve pain (R). [Compare Prostatorrhcea.] 



Prostatorrhoea. 

Iron, the Tincture of the Chloride, when there is much debility (B) ; chaly- 
beate tonics with Quinine and Strychnine (Gross). Atropine, indicated in all 
cases with Potassium Bromide (Gross). Potassium Bromide, when irritability 
and excitement (B) ; indicated in all cases (Gross). Lead, injections of Gou- 
lard's Extract, 3j to ^x of water, night and morning, for 10 minutes at a time 
(Gross). Ergot, when relaxation exists (B). Bougie, methodically intro- 
duced, is one of the best local measures (Gross). Hydrastis, locally applied, 
a useful medicine (B). [Compare Prostatitis.] 

Prurigo. 

Antipyrin, as a symptomatic remedy, is efficient in true prurigo. Alkaline 
Baths, followed by a carbolized ointment, and Carbolic Acid internally, are of 
value in the papular eruption known as prurigo (Bulkley). Sulphides, Potassa 
Sulphurata, with Tar and Benzoinated Lard, as ointment in genuine prurigo 
(R). Arsenic, in doses of tt\,v of Liquor Arsenicalis thrice daily and gradually 
increased, has exercised a more or less powerful influence (Wa) ; has only a 
moderate effect (Bulkley). Belladonna, controls cases which have resisted 
ordinary treatment (B). Carbolic Acid, locally and internally, is especially 
serviceable in prurigo senilis (B). Mercury, the Bichloride gr. xx, with Ammo- 
nium Chloride, gr. xxx, in Oj of pure water, as lotion in prurigo contagiosa, the 
so-called army-itch ; nothing equal to it (White). Borax, a saturated solution 
in rose-water locally (R) ; gr. v-x to ^j of hot water for pruriginous eruptions on 
mucous membrane of vulva and vagina (R). Galvanism, when prurigo is 
referable to alterations in the cutaneous nerves (B). Tonics, are required, 
nerve-tonics as well as general ones, Cod-liver Oil, Quinine, Strychnine and 
Phosphorus (E. Wilson). Quinine, in large doses, gr. v-x, will control violent 
exacerbations (Wilson). Baths, the Turkish, frequently repeated, with inunc- 
tion of the skin, may be regarded as curative in most cases (Wilson). [Com- 
pare Pruritus.] 

Pruritus. 

Cocaine, in 5 per cent, solution or oleate, is by far the most efficient of all 
antipruritics ; relieves the itching of scrotal eczema, pruritus ani et pudendi, 
and especially in lesions of the epidermis where the oleate or solution can 
penetrate at once to the true skin. Resorcin, in solution locally, gives marked 
relief, lasting for several hours, in the majority of cases. Carbolic Acid, is the 
opium of the skin (Unna), and the most useful antipruritic agent ; in combina- 
tion with glycerin, as lotion to the itching surface, gives great relief (Bulkley) ; 
internally and locally in pruritus senilis (B) ; a one per cent, solution as lotion 
in pruritus ani (R). Chloral, with Carbolic Acid, locally (see page 224). 
Camphor, and Chloral, rubbed together, make a liquid which, added to vaselin, 
makes an ointment which is powerfully antipruritic (Bulkley) ; added to dust- 
ing powders, allays heat and itching of eczema and intertrigo (R). Tumenol, 
as tincture, is used locally with almost universal success (Neisser). Menthol, 
seems to be of marked value in almost ail cases of pruritus, from whatever 
cause (Squibb). Antipyrin, internally as a symptomatic remedy against itching, 
is promptly efficient in nervous pruritus, true prurigo, urticaria, erythema, pern- 



PRURITUS. 



763 



phigus vulgaris and lichen ruber. Alkaline Baths, locally, followed by the 
application of carbolized ointment, give great comfort in all forms of pruritus 
(Bulkley) ; Sodium or Potassium Carbonate preferred (Tr) ; in solution locally, 
giij ad ^iv (B). Brucine, in 20 per cent, solution, has been employed with 
satisfaction in chronic pruritus, as a local application (Mays). Mercury, strong 
solutions of the Bichloride, Black or Yellow Wash or Mercurial Ointment, in 
the itching of skin affections (R) ; Yellow Wash is one of the most efficient 
applications for pruritus ani : solutions of the Bichloride are very useful 
applications in pruritus vulvae et ani (Tr) ; for pruritus vulvae a lotion of the 
Bichloride 1 to 2500 parts of water, with Alum and Starch, is recommended 
(B) : Calomel gj to ^j of Lard, as ointment, is the best application, except in 
the pruritus of urticaria ; very useful in pruritus ani, less so in pruritus pudendi 
(R) : the Oleate, a 5 per cent, solution in Oleic Acid with one-eighth part of 
Ether, applied by a camel's-hair brush, in pruritus ani et pudendi (Marshall). 
Alum, a strong solution is very useful for pruritus vulvae (Tr). Hydrocyanic 
Acid, diluted as lotion, often very serviceable ; may be prescribed in solution 
with Borax (B) ; or Laurel-water as lotion, especially in pruritus senilis (P). 
Potassium Cyanide, 5j to Oj of water, as lotion for pruritus of various kinds 
when the skin is unbroken (R) ; as ointment or solution, if strong enough, 
relieves greatly, but must be used with caution (B) ; or rr^xxx of the dilute Hey 
Acid of the Br. Ph. in 3J of water or glycerin, may be used instead (R). Silver 
Nitrate, a solution, gr. xx to the ( ^, painted over the affected parts in pruritus 
vulvae, is very effective (B). Tobacco, is an effective but dangerous applica- 
tion (B). Iodoform, as ointment, Z) ad ^j Adipis (R). Iodine, for itching of 
the nose or inner canthus, sneezing, etc., its inhalation has a marked effect (R). 
Arsenic, for itching of the nose accompanying asthmatic symptoms (R). 
Benzoin, the compound tincture painted on the skin, for the itching of 
eczema, urticaria, etc. (R). Boracic Acid makes an excellent lotion in pruritus 
pudendi, a teasp. to the pint of hot water (R). Borax, gr. v-x to the ^ of hot 
water (R). [See Prurigo.] Balsam of Peru, is a very good application in 
pruritus ani, scabies, and many other forms of itching (Auerbach). Zinc 
Sulphate and Alum, equal parts of each, are almost a specific in pruritus ani 
(Agnew). Chloroform, as ointment to allay itching of skin diseases. Gelsemium, 
n\,xv of the tincture every half hour, up to £>j m all. f° r itching which is out of 
proportion to the cutaneous lesion (Pelcher). Lead Lotions, to ease the itching 
of urticaria, pruritus pudendi, etc., especially when the mucous membrane is 
red and excoriated (R). Piperazin, gives immediate relief in the pruritus of 
the uric acid diathesis. Salicylic Acid, as ointment, in pruritus ani et vulvas 
(R). Sodium Salicylate, in 15-grain doses by mouth every four hours, will 
greatly relieve pruritus vulvae, when due to diabetes (G). Tar, as ointment, is 
strongly recommended (Tr) ; for general pruritus, if no cause can be found, 
the two best remedies are Tar and Sulphur, as lotion or bath (Sparks) ; 
ointments containing Tar give relief in many instances (Bulkley). Sulphur, 
may be employed as a bath, Potassa Sulphurata, ^ij ad C xv of hot water 
(Sparks) ; or the alkaline sulphites locally (Wa) ; the Iodide of Sulphur extern- 
ally and internally, in pruritus senilis (Wa). Chlorine, the Liquor Sodae 
Chloratae, diluted, a useful application in pruritus ani (Wa). [Compare Ec- 
zema, Erythema, Lice, Pediculi, Prurigo, Scabies, Urticaria.] 



R 



B 



Prescriptions. 



Hydrarg. Chlor. Corr., . . gr. j. 

Pulv. Aluminis, gr. xx. 

Amyli, 3J SS - 

Aquae, 5 v j- 

M. Sig. — Apply locally. {Goodell. 



. Acidi Hydrocyanici Dil. 
Infusi Althea?, . . . . 
M. Sisf. — Lotion. 



gv-viij. 
[Fox. 



R. Acidi Hydrocyan. Dil., .'Sfij- 

Sodii Boratis, £j. 

Aquas Rosa?, ^ vn j- 

M. Sig. — Lotion. {Fox. 



Potassii Cyanidi, . . , 
Pulv. Cocci, .... 
Ung. Aquae Rosae, . . 
M. Sig. — Ointment. {Anderson.) 



gr- 

5J< 



7^4 PSORIASIS PTERYGIUM PTOSIS. 



R . Potassii Cyanidi, . . . . gr. xv. 
Aquas Laurocerasi, . . . ^5 viij. 
M. Sig. — Lotion. {Anderson. \ 



R. Acidi Benzoici, gr. ex. 

Olei Caryophylli, .... gtt. xl. 

Alcoholis, 3lJ ss - 

Solve et adde — 

Cerati Simplicis, . . . . ^ viij. 
Balsami Peruviani, . . . 5J. 
M. ft. vmguentum. Especially good for 
scabies, but may be used for any pruritus. 



R . Gummi Camphorae, 

Chloralis Hydratis, . . aa^j-ij. 
Rub together until liquefied, 
then add slowly, with friction, — 

Unguenti Aquae Rosae, . . ^j. 
Sig. — Ointment for itching. 

{Bulkley.) 

R. Acidi Carbolici, .... 2fij. 

Glycerini, Jj. 

Aquae Rosae, . . . q. s. ad 3 viij. 
M. Sig. — Lotion for pruritus. 



Psoriasis. 

Chrysarobin, has the most decided effect on psoriasis, 3ss-ij ad ^j of ung. 
aquas rosae ; often irritates, and should be employed at first with caution 
(Bulkley); gr. x-xxx to the 3 of Petrolatum, applied to each spot twice daily, 
invariably successful (Hughes). Thyroid Extract, several cases of psoriasis 
treated with this remedy alone recovered completely in the course of a few 
weeks (Bramwell). [See page 132.] Aurum, is useful in the squamous skin 
diseases. Ichthyol, is a very efficient application. Thiol, is probably a better 
remedy than Ichthyol ; the dry form, used as a dusting powder, is remarkably 
efficient (Squibb). Aristol, is an excellent application. Arsenic, at first appar- 
ently aggravates, but soon heals the disease (R) ; must be persistently used 
for a long time (B) ; exercises a powerful influence (Wa) ; maximum dose tr^v 
Liquor Arsenicalis ter die, never on empty stomach (R). Mercury, in patches 
of obstinate psoriasis, especially of hands, even when not syphilitic ; Calomel 
and Mercuric Nitrate ointment may be mixed and Tar ointment added (R). 
Lappa Major, a tincture of the seeds in whiskey, used by tablespoonful doses, 
cured several cases of long-standing (Reiter). Carbolic Acid, 1 to 4 of lard, as 
ointment (Wa). Mezereon, a useful adjunct (Wa). Sulphur, internally (R) ; 
a solution of Potassa Sulphurata in water, is excellent in chronic psoriasis (B) ; 
not in acute (R). Sulphur Iodide, externally and internally, in doses of gr.j-vj 
used with great advantage (Wa). Silver Nitrate, occasionally in psoriasis of 
tongue and buccal mucous membrane ; if syphilitic, mercurials best (R). 
Nitric and Nitro-Hydrochloric Acids, when symptomatic of imperfect digestion 
and assimilation (B). Phosphorus, as substitute for Arsenic (B). Coptis, has 
reputation in New England (B). Copper Sulphate, applied solid to spots (R). 
Lead, the ointment of the Iodide (B). Tar, painted on, in obstinate cases (R). 
Oils, Cod-liver Oil internally and locally, is the sheet-anchor, especially when 
of strumous origin (B) ; oils and fats to lubricate skin, with warm baths (R). 
Diet and Hygiene, nourishing diet, frequent small quantities of raw vegetables, 
Cod-liver Oil for growing persons, especially when stale fish the cause. Rest 
and change for overworked subjects. Daily baths and cold sponging. Free, 
open-air exercise is also most useful. Warm or tepid soft-water baths at night, 
with use of pure soap. 

Pterygium. 

Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- 
tivitis (Wa). Treatment is unavailing, and benefit is seldom derived from any 
operation (C). Arlt's Operation, the most satisfactory; cut away as little tissue 
as possible, dissect cleanly, close with suture (Green). 



Ptosis. 

Veratrine, gr. x in £ij of Sulphuric Ether and gj of Alcohol, brushed over 
the eyelids, brows and temples every morning, till a slight burning sensation 



PTYALISM PUERPERAL CONVULSIONS. 765 

is produced; conjoined with the use of electricity (W). Ergot, aqueous 
infusion as collyrium (Wa). Electricity, the constant current may often relieve 
recent cases (C). Operation for shortening the lid, by removing an elliptical 
piece of skin and subjacent muscle (C) ; is not advisable unless the ptosis is 
nearly or quite complete, and of great inconvenience. 

Ptyalism. 

Acids, as astringents, small medicinal doses (R). Sulphuric Acid, internally 
and with Decoctum Cinchonas as a gargle, of great benefit in mercurial ptyalism 
(Wa). Potassium Chlorate, in simple or mercurial ptyalism (R) ; in the latter 
form Z) ad §vj aquae as mouth-wash, and internally in teasp. doses, 4 or 5 
times daily (St). Belladonna, very effective in mercurial ptyalism, and that of 
pregnancy ; gtt. v-x, or Atropine gr. T ^ to T ^ every 4 to 6 hours (B) : is good 
treatment when ptyalism is the result of some reflex action, but not so when it 
is an effort of nature to eliminate some drug-poison, as mercury, iodine, etc., from 
the system (Whitla). Pellitory, to stimulate the salivary flow in the latter case, 
unless the gums are swollen and ulcerated (Id). Hyoscine or Opium, may 
be used instead of Atropine (Id). Astringents, [in ptyalism from excessive 
mercurialism when the gums are swollen and ulcerated ; Alum 1 in 40, Zinc 
Chloride 2 grains to the 5, Tannic Acid 1 in 40, or other vegetable astringents 
(Id). Tannic Acid, in mercurial ptyalism is an excellent gargle, Z] of Tannin 
to ^ij of Mel Rosas, and ^vj of water (B). Alcohol, diluted, as a gargle (R). 
Potassium Iodide, is sometimes beneficial in mercurial ptyalism, but often 
aggravates it (R). Iodine, the tincture 3>ij in 3viij of water, as a gargle (R) ; 
is worthy of trial (Wa). Borax, the glycerite is an efficient local application, 
but must be used almost continuously (W T hitla). Potassium Bromide, has 
proved useful in the salivation of pregnancy ; it may be combined with small 
doses of Belladonna or Hyoscyamus (Id). Chlorinated Lime or Soda, in weak 
solution, for the fetor (Id). Stimulants, may be needed in severe cases. Diet, 
liquid food when swallowing is difficult. [Compare the Lists of Sialogogues and 
Antisialics on page 43.] 

Prescriptions. 

ft. Acidi Sulphurici, . . . . £ss. ft. Sodii Boratis, . . . . . gij. 

Tinct. Myrrhae, . . . . Z). Pulv. Myrrhae, Zj. 

Aquae, q. s. adgv]. Aquae, gvj. 

M. Sig. — Mouth- wash. M. Sig. — Mouth-wash or gargle. 



Puerperal Convulsions. 

Chloroform, by inhalation to narcosis (R) ; its utility unquestionable when 
convulsions are not due to cerebral hemorrhage (B) ; the combined chloroform 
and chloral treatment results in a death-rate of only 7.6 per cent. (Winckel). 
Chloral, after the chloroform, given with Bromides by the rectum to keep up the 
effect ; full doses, 20 to 30 grains every 2 hours (B) ; a remedy of the greatest 
value, in full dose before proceeding to one of the bromides (Playfair, Barnes). 
Bromides, in large doses by enema, are distinctly indicated (P) ; Potassium 
Bromide, 3j-ij by the rectum, after venesection if convulsions return (Whitla). 
Veratrum Viride, in £ss doses of fluid extract every 15 minutes, to nausea, 
invaluable (R) ; the fl. ext., in doses of rrvviij-x hypodermically, may be re- 
peated in half-hour with Morphine, or TTLx by enema, promptly efficient in the 
worst cases (Elmer) ; a very bad case cured by 20-minim doses every hour for 
5 days (Dunn) ; the worst case seen in my 30 years' experience, after 14 seiz- 
ures was promptly cured by a hypodermic injection of n\jv of Norwood's 
tincture in a little water (Etheridge). Pilocarpine Nitrate, gr. £ hypodermically 
every 2 hours, very successfully used in several cases (Finniss) ; is dangerous, 
being liable to cause oedema of the lungs (P). Aconite, one of the best agents 
(P) ; gtt. j-ij of tinct. every 10 or 15 minutes for the first hour, then at longer 



766 PUERPERAL DISORDERS FEVER. 

intervals (B). Belladonna, the tincture internally with Atropine hypoder., of 
verified utility (P). Potassium Bitartrate, administered for a month prior to 
confinement, in quantity sufficient to bring about free action of kidneys and 
bowels, will certainly prevent puerperal convulsions (Anderson). Opium is 
apt to induce eclampsia, unless its use be preceded by free purgation or vene- 
section (Idem) ; as Morphine hypodermically, the most important agent for 
cure of uraemic convulsions (B) ; with the lancet, sometimes required (P) ; 
Morphine is combined with the chloral treatment by many authorities. Amyl 
Nitrite, by inhalation (B) ; may cause alarming hemorrhage (W). Ice, to 
the head (R) ; and mustard poultices at same time to the feet (Wa). Vene- 
section, by far the most efficient measure (Wallace) ; when great cerebral 
congestion and vascular tension, shown by a livid face, a full and bounding 
pulse, and strong pulsation in the carotids (Playfair) : remove 15-20 ounces of 
blood, and follow by enemata of Potassium Bromide, 3j-ij, if convulsions 
return ; Chloroform should be very cautiously used, if at all, after blood-letting 
(Whitla). Compression of the Carotids, Trousseau's method, often stops or 
materially modifies the attack, and may be used in most cases to gain time 
until chloroform narcosis is established (Id). Saline Purgatives, the best 
being Magnesium Sulphate, or the compound Jalap powder, with free use of 
the wet pack to act upon the skin, for the rapid elimination of the retained 
excrementitious products, urea, leucin, tyrosin, etc. (Id). 



Puerperal Disorders. 

Cimicifuga, in puerperal hypochondriasis, and depression (Wa, P). Opium, 
either alone or with alteratives, highly serviceable in puerperal intestinal irrita- 
tion ; a few drops of the tincture effectually arrests the diarrhoea (Wa) ; when 
shock and marked exhaustion, a moderate dose is of benefit (L). Castor Oil, 
undoubtedly the best laxative (L) ; purgatives generally are not required, 
castor oil the very worst (Fordyce Barker) ; action uncertain (Parry). Rhu- 
barb, or enemas, best means of stimulating bowels after fourth day (L) ; gr. 
xx-xxx in some aromatic water a good aperient (Wa). Aliment, in puerperal 
state should be easy of digestion and sustaining (L). Catheter, necessary often 
for several days when bladder paralyzed, if warm water lavements fail (L). 
Water, tepid sponging of external parts, vaginal washings daily with warm 
water, with ^j part Carbolic Acid (L). [See After-pains, Hemorrhage, 
Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba-Dolens, etc.] 



Puerperal Fever. 

Aconite, drop doses every one or two hours steadily, with an occasional dose 
of Castor Oil, and repeated hot poultices or Laudanum fomentations, the most 
successful treatment, even in the worst cases, but useless if not promptly effi- 
cient (P). Veratrum Viride, is used with great benefit in most cases (Barker). 
Opium, for wakefulness and delirium (B) ; a very valuable remedy, tending to 
allay pain, and reduce excitement of the nervous and vascular systems (Wa). 
Alkaline Sulphites, especially valuable in early stages, internally and locally ; 
gr. xv-xxx of Magnesium or Calcium Sulphite every 2 or 3 hours, with injec- 
tions every day (Wa). Stramonium, when cerebral excitement (P). Potassium 
Permanganate, gr. X~j ter die, has been given with benefit (B). Alcohol, 
freely used, until all evidence of sepsis subsided, caused recovery in one of the 
most desperate cases of puerperal septicaemia, of three weeks' standing, with 
temp, falling to 95 and rising to 107 (Hills). Calumba, preferable to Cinchona 
(P). Quinine, only large doses are useful : gr. v-xx every 4 hours (B) ; reduces 
the temperature (P). Warburg's Tincture, is more efficient than the largest 
doses of Quinine in cases of puerperal malarial fever, ^ss every four hours 
until fever abates, then in diminishing doses to o\j-ij, until convalescence is 
established (Fordyce Barker). Turpentine, when depression of vaso-motor 



PUERPERAL MANIA PULSE — PURPURA. j6j 

nervous system, cardiac weakness and tympanitic distention of abdomen (P). 
Resorcin, is much used in Vienna by Braun ; gr. xl repeated p. r. n. Strepto- 
coccus Antitoxin, has been used with success by several authorities (see page 
154). Rest and quiet but attentive nursing, frequent liquid food. Water, hot 
fomentations frequently to the parts, valuable as preventive. Antiseptic Injec- 
tions into the uterus are used, but are strenuously opposed by many of the 
most prominent and experienced clinicians. [Compare Puerperal Peri- 
tonitis.] 

Puerperal Mania and Melancholia. 

Stramonium, will allay cerebral excitement, and soothe the nervous system ; 
when delirium mild and furious, but intermittent ; tendency to suicide or to 
destroy the child ; rr\,x-xx of tinct. every 3-4 hours (P). Hyoscyamus, in 
the milder cases ; when nervous system is greatly excited (P). Duboisine, as 
calmative and hypnotic, acts efficiently for a time in puerperal mania. Aconite, 
in puerperal mania with high fever, restlessness ; speedy and marked success 
if given soon after the chill (P). Cimicifuga, has cured (B) ; its effects are 
truly remarkable in the mania and hypochondriasis of the puerperal state (P). 
Chloral, often alleviates symptoms (B) ; to produce sleep (Wa). Potassium 
Bromide, in sthenic cases (R) ; its effects are very variable (Wa). Anaesthetics, 
Chloroform or Ether inhaled in violent paroxysms of mania (B). Tartar 
Emetic, in frequently repeated doses (Wa). Quinine, when much weakness ; 
skin cold and sweating (B). Chalybeates, Tinct. Ferri Chloridi, rr\,v-xx, in the 
anaemic form (B). Opium, cautiously (B) ; gives the best results in such doses 
as may be necessary to allay irritation and procure sleep (Wa). Poultices, 
hot fomentations, enemas, or gentle laxatives ; nutritious and stimulating diet. 
Lochia, should be watched (P). Weaning, imperative in melancholia ; not so 
in acute mania. 

Puerperal Peritonitis. 

Aconite, has cured cases of the usual type (P). [See under Puerperal 
Fever.] Cimicifuga, especially in rheumatic form, has remarkable effects (P). 
Opium, its curative power in this, one of the best established facts in therapeu- 
tics (B) ; is good, but Aconite often better (P) ; especially valuable in adynamic 
cases (Wa) : the drug of all others to be relied on (Godson). Turpentine, as 
stimulant, rr\,x frequently repeated, better than Alcohol (B) ; by enema, also 
hot turpentine epithems may be used with advantage (Wa). Quinine, in con- 
siderable doses, with or without Opium (B) ; gr. x-xx twice daily as an antipy- 
retic (Wa). Antimony, as Tartar Emetic, gr. -^ to ^ every hour to shorten 
attack and render it more mild (R). Cathartics, advised by many, prohibited 
by as many ; evidence is in favor of mild aperients combined with Dover's 
powder or Hyoscyamus (Wa). Poultices, hot, of very great value (B). Water, 
Ice in mouth or swallowed, hot fomentations to abdomen ; in some cases cold 
compresses best. [Compare Puerperal Fever.] 

Pulse. 

Aconite, for a quick, resisting pulse (P) ; a moderate dose, while it makes the 
pulse less frequent, renders it fuller, stronger and less compressible (R). 
Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P). 
Veratrine, pulse at first quick and strong, then slowed ; afterward quick, weak 
and irregular (R). Digitalis, for weak, quick pulse. [Compare Heart Dis- 
eases, Fever, etc., also the Lists of Vascular Stimulants, Tonics and Seda- 
tives on page 42.] 

Purpura. 

Sulphuric Acid, often acts happily (B). Ergot, has been strongly urged 
(R) ; is most useful in removing purpura (P) ; many cases are recorded as 



768 PYEMIA PYROSIS RACHITIS. 

cured by hypodermic injections of Ergotin (Wa). Turpentine, has been used 
(R) ; with invariable benefit (Wa). [See Hematemesis.] Nux Vomica, no 
prescription more generally useful than the Syrup of Iron, Quinine, and Strych- 
nine (B). Iron, when due to anaemia ; the Tincture of the Chloride (B) ; is 
preeminently the curative remedy for purpura hemorrhagica, arresting the 
hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an 
excellent application by sponging over the body (E. Wilson). Quinine, or Hux- 
ham's Tincture of Bark, are much used (H). Potassium Nitrate, gr. x thrice 
daily in purpura simplex, used successfully (Wa). Styptics, as the Ammonio- 
ferric Alum, tincture of Ferric Chloride (Tr) ; Tannic and Gallic Acids, used 
in some cases (H). Alum, and brandy or whiskey and water at such tem- 
perature as is not chilling, applied by sponging the body, is the best local 
measure (H). Wines are generally indicated (B). [Compare Hemorrhage, 
Scurvy.] 

Pyaemia and Septicaemia. 

Quinine, only large doses, gr. xv-xx, are useful (B) ; supposed to diminish 
the temperature (R) ; to cinchonism, in childhood the best remedy (Wa) ; is 
probably the most useful medicine, given in full and frequently repeated doses 
(Haward). Salicin, to reduce the temperature in septicaemia and to relieve the 
cerebral symptoms (R). Salicylic Acid, has decided value (B). Potassium Per- 
manganate, is given with advantage, gr. }{-gr. j thrice daily in distilled water 
(B). Boracic Acid, a saturated solution to wounds, ulcers, etc. ; also Chlorine 
as disinfectant (B). Oleum Caryophylli, locally, also Oleum Gaultheriae, Thymi, 
etc. (B) ; as antiseptics. Water, cold, as dressing ; hot better, 95°-ioo° F., 
Hamilton's immersion plan for wounds (B) ; stumps to be immersed in a 
warm bath, to avert pyaemia (R). Sulphites, may do some good in chronic 
cases, but the use of Sulphurous Acid has not given the results in man which 
Polli obtained from its use on animals (Haward). Streptococcus Antitoxin, 
has been used successfully (see page 154). Turpentine, is a better stimulant 
than Alcohol (B). Ice, dissolved in the mouth (Wa). Aliment, plentiful 
nourishment, with wine and good ventilation, are not to be neglected (Wa) ; 
malt liquors are justly esteemed (B). Stimulants necessary, brandy the best 
(Wa). Abscesses, must be opened early, especially when in joints. 

Pyrosis and Cardialgia. 

Capsicum, in atonic dyspepsia, with heartburn and diarrhoea (P). Nux 
Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- 
cough, regurgitation, etc. ; an excellent combination is tt\,v-x of the tincture 
with tt^xv of dilute Nitric Acid for one dose (P). Pulsatilla, a good medicine in 
the heartburn of dyspepsia in phlegmatic subjects (P). Podophyllin, gr. -^ 
night and morningin obstinate heartburn, with liver derangement (P). Almonds, 
six or eight blanched, said to relieve heartburn (P). Rhubarb, and other pur- 
gatives, are often useful; also Magnesia, Bismuth, and Ginger (Beale). Opium 
in small doses has been advocated for water-brash (Id). Catechu and Kino, 
also other astringents, sometimes do good, and bitter infusions, especially that 
of Calumba, have been given with advantage in water-brash (Id). Diet, lemon- 
juice, aerated bread, plain biscuit, etc. ; but avoid new bread, much vegetable 
food, and pastry. [Compare Acidity, Dyspepsia.] 

Rachitis. 

Lime, as Lime-water, or the Carbonate, or the Syrupus Calcii Lacto-phos- 
phatis (B) ; in small doses (R) ; the Phosphate may be advantageously com- 
bined with Cod-liver Oil (Wa). Iron, the Syrup of the Iodide preferred ; 
Calcium and Ferric Phosphates excellent in combination (B) ; must be con- 
tinued a long time (R). Nitro-hydrochloric Acid, as baths, gives excellent 



RECTUM. 769 

results (Wa). Quinine, often very valuable (P). Thymus Extract, is suggested 
as probably useful (see page 133). Aliment, food rich in Calcium Phosphate 
and other phosphatic salts ; oatmeal, Graham bread, etc. (B) : Cod-liver Oil, 
the best constructive agent (B) ; a full animal diet (Wa) : cold sponging (R). 



Rectum, Diseases of. 

Podophyllum, in doses of gr. ^ to -^ night and morning, for a child, may 
relieve prolapsus of the rectum (P). Belladonna, the extract locally in fissure 
(R) ; and irritable ulcers (P) ; internally and locally to remove ulcers, also ex- 
cellent for burning pain following defecation ; or with mercurial ointment, equal 
parts of each, for fissures and ulcers (P). Acetanilid, in fine powder, is an 
excellent application to ulcers of the rectum. Phosphorus, in chronic inflam- 
mation of the rectum, has been highly recommended (R). Cocaine, gr. xl to 
5jj of glycerite of starch, applied by Seeley's Pile-pipe, very efficient in control- 
ling spasm of the rectum. Potassium Bromide, in 5 parts of glycerin, locally, 
for fissures and painful growths (R). Iodoform, as suppository in painful 
diseases, relieves greatly (R). Pepper, the confection, as gentle stimulant in 
fistula, ulcers, hemorrhoids (P). Castor Oil, in fissure and hemorrhoids, is 
commonly used as purgative (R, P). Sulphur, with Confectio Sennae, in irrit- 
able rectum, is very soothing (Wa). Stramonium, an ointment of the fresh 
leaves to alleviate pain (P). Conium, the extract in doses of gr. x to allay 
pain and irritability in rectal cancer (Wa). Purgatives, are best for proctalgia 
(D). Surgical, an incision through mucous membrane, and in severe cases to 
divide part of the sphincter, in ulcer or fissure ; a flake of cotton should be laid 
in the wound, so that it may heal by granulation (D). [Compare Anus, Diar- 
rhoea, Dysentery, Rectum ulceration of, Hemorrhage intestinal, 
Hemorrhoids, Prolapsus.] 



Rectum, Ulceration of. 

Mercury, the Red Oxide, 3j to the %} of Unguentum, as ointment in flat 
ulcers of rectum existing just within the anus (Coulson). Belladonna, the 
extract locally for rectal ulcers, is very efficient (P). Carbonic Acid, per anum, 
is strongly advised (Wa). Chloroform, as ointment, in irritable ulcer of rectum 
(Curling). Iodoform, in suppository, extremely useful in painful ulceration 
(R) ; used in many cases with very satisfactory results, but in some instances 
poisoning occurs ; hence it should be used with caution (Wa). Phosphorus, 
as an internal remedy, is highly recommended in chronic inflammation of the 
rectum (R). Copper Sulphate, with Opium, may often be used internally with 
advantage, and a weak solution of the same, or of Silver Nitrate, locally (Curl- 
ing) ; the writer had a case resisting treatment for three years, in which a cure 
was effected by the persevering use of a pill of Cuprum Sulphate, Extract of 
Opium, and Quinine Sulphate (see below). Silver Nitrate, gr. %-] combined 
in pill with Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B). 
Glycozone, ^j in ^xij of lukewarm water, mixed immediately before using, 
and given by enema once daily, in ulceration and chronic inflammation of the 
rectum and lower gut (Edson). 



R. Cupri Sulphat., 

Morphinae Sulphat., . . aa gr. ij. 

Quininse Sulphat., . . . gr. xxiv. 
M. ft. pil. no. xxiv. Sig. — One pill 
thrice daily. [Potter.) 

49 



Prescriptions. 

R. Chloroformi, 3^ j — ij . 

Zinci Oxidi, sjss. 

Olei Olivae, gj. 

Cerati Cetacei, 3 iv. 

M. ft. unguentum. (Curling 



770 RELAPSING FEVER RETINA RHEUMATISM. 

Relapsing Fever. 

Cathartic, a mild one at beginning (H) ; if jaundice or other hepatic derange- 
ment, a Calomel purgative, cautiously, lest irritation (Wa). Potassium Citrate, 
as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least 
until the relapse, which will not be prevented by any amount of Quinine (Wa). 
Leeches or Cupping, best for headache (A). Alcohol, required by some pa- 
tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should 
be watched carefully (A). [Compare Typhus Fever.] 



Remittent Fever. 

Antipyrin or Phenacetin, in full dose during pyrexia, to lower the temp., is 
very efficient treatment, especially if conjoined with Quinine during the remis- 
sion ; the latter drug being too slow of action to be of immediate service in the 
pyrexia. Aconite, in the hot stage, if any febrifuge is required, frequently re- 
peated doses (B); is next in value to Quinine for high fever and headache, gtt. 
j of a good tincture every hour (Da C). Quinine, 20 to 30 grains in single dose 
once or twice daily until the temperature is reduced, with other appropriate 
remedies (B) ; 1 5 to 20 grains at most (Maclean) ; 30 to 50 or 60 grains in severe 
cases of pernicious remittents several times a day without regard to exacerba- 
tion (P, B). Warburg's Tincture, has achieved a very high reputation, but 
must be used in less dosage than directed, and supporting treatment given when 
its sudorific action commences (Wa). Gelsemium, exercises a really beneficial 
influence ; depresses the temperature (B) ; valuable in bilious remittents of 
the South (Pf). Morphine, gr. % hypodermically to abort pernicious remittent 
fever (B). Purgation, by Calomel with Jalap or salines afterwards, is very 
necessary during the course of the disease (Da C). Quassia, an excellent 
tonic in the convalescence, combined with mineral acids (Wa). Packing, 
by the wet sheet, is resorted to with advantage, except when hepatic or splenic 
congestion exists (Wa). 

Retina, Affections of. 

Mercury, in syphilitic retinitis, is of great value; Calomel gr.j-ij with Opium 
gr. )i-Yz every 4 or 6 hours; also mercurial inunction till the gums are affected 
or the disease yields (Wa). Potassium Iodide and Bromide, in combination, 
in retinal hemorrhage, to promote absorption of the effused blood and to benefit 
the congestion (C). Physostigmine, locally, to contract the pupil, and diminish 
the amount of light admitted to the eye (Wa). Iron, in full doses, generally the 
tincture of the Chloride, in pigmentary retinitis ; seems to have a tendency to 
arrest the malady (C). Leeches, to the temple better than general bloodletting 
(Wa) ; when much local congestion present, depletion by artificial leech is 
almost always indicated (C). Pilocarpus, in detached retina and optic neuritis ; 
has been found a very useful remedy in retinal affections generally. [Com- 
pare Amaurosis.] 

Rheumatism, Acute. 

Plans of Treatment, may be resolved into three, viz., — (1) that by Salicylic 
Acid, (2) that by Alkalies, (3) that by Iron. Salicylic Acid or the Salicylates, in 
20-grain doses, to not less than 3ij in 24 hours, in solution with excess of 
alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will 
bear it, in whom it often effects a cure in 3 or 4 days. Salicin, gr. x-xxx every 
2, 3, or 4 hours ; gr. xv every 3 hours in powder mixed with water (Maclagan), 
or same dose of Salicylic Acid, is of great benefit ; good effect generally ex- 
perienced within 48 hours (R) ; the Acid is better than the Salicylates, but 
must be abandoned if not effective after 3 or 4 days (Da C). Oil of Gaultheria, 
as a substitute for Salicylic Acid, used very successfully in form of emulsion 



RHEUMATISM, ACUTE. 77 I 

(B). Alkalies, for flabby, fat subjects ; alkaline carbonates, as Potassium Car- 
bonate, ^jss, every 24 hours, alone or with a vegetable acid, until the urine 
becomes neutral or alkaline, when it may be reduced one-half, and so main- 
tained for some days, when Quinine or Iron may be used ; if successful, this 
treatment brings about a cure in two weeks : the alkaline treatment is now 
seriously questioned ; an injurious dyscrasia results from their use (B) ; Potas- 
sium Bicarbonate, gr. xxx every 4 hours, in a dilute solution, until joint-symp- 
toms and fever disappear (Wa) : cardiac complications require Ammonium 
Carbonate, in 5-grain doses frequently, also Infusion of Digitalis with hypo- 
dermics of Morphine, and a blister over the prsecordium, followed by Iron 
and Quinine after the acute symptoms have subsided (B). Tincture of the 
Chloride of Iron, for feeble, anaemic, and nervous subjects, n^xxx every 4 
hours, with an occasional saline laxative, blisters around joints, and Atropine, 
as an anodyne rather than Opium, used hypodermically in the vicinity of the 
affected joint (B) ; very serviceable in pale, delicate subjects, n^xx-xxx every 4 
hours; also as prophylactic where tendency (Anstie) ; harmful to the plethoric 
and overfed (B). Iron and Salicylic Acid in combination, should be most 
valuable, but as heretofore prescribed has always made an insoluble pre- 
cipitate ; this is overcome by Dr. Peabody in the formula given below, which 
makes a ruby-red mixture, and has advantage of preventing the anaemia which 
results from the Acid given alone. 

Aconite, very serviceable when much heat and dry skin (B) ; subdues pain 
in inflamed joints and perhaps shortens the fever (R); in small doses fre- 
quently repeated of the greatest value, and if used from the start prevents 
organic cardiac disease (P) ; not reliable as a curative agent, but is a valuable 
adjunct to other remedies (Wa). Veratrum Viride, said to be useful (R) ; small 
doses, as antipyretic, may be combined with Opium (P). Salipyrin, has been 
employed with excellent results, in 1 5-grain doses every ]/ z hour or hour, until 
about S»ij have been taken, continuing with smaller doses for a long time after 
convalescence, to prevent relapses. Salol, the great remedy, none superior 
(B) ; given in doses of 15 to 30 grains, up to 3ij in 24 hours, and continued for 
some time after acute symptoms have subsided ; may prove toxic in large doses, 
with symptoms of carbolic acid poisoning. Salophen, is said to be equally 
efficient and non-toxic, 3j-<5jss daily. Antipyrin, has held a high place for 
several years (see page 145). Phenacetin, is an efficient and safe antipyretic. 
Phenocoll, for the pyrexia, is used with marked success. Rhus Toxicodendron, 
positively invaluable in after-stage, also in subacute forms, muscular or ten- 
dinous, worse at night (P, Pf). Hydriodic Acid, the Syrup, in dessertsp. doses 
every 2 or 3 hours, the best remedy for acute and subacute rheumatism, reliev- 
ing pain and swelling in 18 to 24 hours (Craig). Cimicifuga, has excellent re- 
ports (B) ; much used, and is said to quell the pain speedily (R) ; found very 
serviceable (P). Dulcamara, recommended especially for persons who are 
subject to catarrhal affections in cold and damp weather (P). Ammonium 
Bromide, a very excellent treatment, followed by Quinine ; gives a very low 
proportion of cardiac complications; gr. xv-xx every 4 hours (Da C) ; dis- 
agreeable but strongly recommended (B). Arnica, lowers pulse and tempera- 
ture, relieves articular pain and swelling, diminishes urea (P). Trimethyl- 
amine, iTLiv-viij in Peppermint-water, often has remarkable power in acute 
rheumatism and gout (B). Bryonia, after the swollen joints have been reduced 
by other means, is extremely efficient for the pain and stiffness (P). Spigelia 
Anthelmia, for rheumatic pericarditis and endocarditis ; rheumatic fever with 
pain shifting from joint to joint (P) ; seems to fix the disease in certain joints, 
and prevent its shifting around (P). Sulphurous Acid, by fumigation, the 
patient covered with blankets and exposed to strong fumes, produces perspira- 
tion, sleep and relief (R). Colchicum, alleviates the symptoms, and shortens 
their duration (Wa). Laville's Mixture, is said to be a tincture of Quinine and 
Colocynthine, but it is more than probable that Colchicine is the active agent 
therein. Quinine, as antipyretic ; not so useful as wet pack or cold bath ; gr. 
ij-v after the more acute symptoms have subsided (B) ; is best for the head 
symptoms (Da C). Opium, strongly recommended as anti-rheumatic ; gr. j 



772 



RHEUMATISM, CHRONIC. 



every 2 or 3 hours, increased to gr. xij in 24 hours ; tolerance remarkable in 
this disease ; in rheumatic carditis it is indispensable (Wa) ; a very good remedy 
in moderate doses (Da C). Lithium Bromide, equally good in all forms, 
especially for insomnia, delirium, etc. (B). Digitalis, in powder, gr. ij every 4 
hours, usually effective after 2 to 7 days ; especially useful in cardiac complica- 
tions with cyanosis and oedema. Lime-juice, ^viij daily, Lemon-juice inferior 
(R). Blisters, are a very effective method ; a number of small blisters applied 
to vesication around a joint (B) ; large flying blisters around a joint (R). 
Water, cold baths for the hyperpyrexia (Da C) ; the wet pack very efficacious 
in rheumatism, also a vinegar vapor bath (B) ; the wet pack, 20 or 30 minutes, 
and tepid (70 ) shallow bath 1 or 2 minutes. Cold applications only when skin 
hot and dry, and temperature high. Warm baths, or hot compresses very use- 
ful. Spongiopiline an excellent substance for applications. Diet, low during 
the fever, water, barley-water, milk-and-water, gruel, etc. ; all through use 
liquid food, avoid malt liquors, port wine and sugar. Lemon-juice may be used 
freely. Blankets, instead of sheets to sleep in, and flannel underclothing, are 
useful adjuncts. Pack the joints with cotton covered with rubber cloth or oiled 
silk. 

Prescriptions. 

R. 



R 



Olei Gaultherise, . 
Acidi Salicylici, . . 
Sodii Boratis, . . . 
Syr. Picis Liquidse, 
Aquae Anisi, 



3J- 



M. Sig. — A dessertsp. every two hours. 



R. 



M 



R. 

M 
hour: 



Potassii Iodidi, , . . . . 3 ij. 
Vini Colchici Sem., 
Syr. Simplicis, . . . . aaziv. 
Aquoe Menthae Pip. , . . - 3 V. 
Sig. — Tablesp. every 4 hours. 

(New Orleans Charity Uosp.) 



Propylaminse Chlorid., . . gr. xxiv. 
Aquae Menthae Pip., . . . ^vj. 

Sig. — A tablesp. every two or three 
;. [Tyson .) 



M 



M 
hours 



M 



Acidi Salicylici, 3;ij. 

Ferri Pyrophosphat. , . . gj. 
Sodii Phosphatis, .... gr. xij. 

Aquae, ^vj. 

Sig. — A tablesp. every two hours. 
(Peabody. ) 

Ammonii Phosphatis, . . £jss. 
Tinct. Colchici Seminis, . ^j. 

Tinct. Aconiti, gij. 

Syr. Simplicis, 3j iij. 

Sig. — A teasp. every three or four 
(Corson.) 

Sodii Salicylates, . . . . ^ss. 
Tinct. Lavand. Co., . . . 5 iij. 

Glycerini, 3 v j- 

Aquae, . ,. . . . q. s. ad£v]. 
Sig. — A tablesp. every three hours, 



well diluted. 



Rheumatism, Chronic. 

Arsenic, is very good in most cases, given in small doses steadily (Da C) ; is 
more efficient than Sulphur and should be used instead thereof in the Chelsea 
Pensioner (see page 530), an old remedy for chronic rheumatism (Fothergill). 
Sulphur waters are undoubtedly efficient (Da C) ; Sulphur locally, also the Sul- 
phides as baths (R) ; is certainly of benefit (B). Guaiac is another ingredient 
of the Chelsea Pensioner ; is used with varying success (B) ; the ammoniated 
tincture in milk often gives excellent results (Da C) ; is vile to the taste. 
Potassium Iodide, especially when pains are worse at night, or of syphilitic 
origin (R) ; should always be fairly tried in chronic rheumatism (Da C) ; was 
Sir Astley Cooper's remedy ; Iodides often prove very satisfactory, especially in 
strumous or syphilitic subjects (B). Rhus Toxicodendron, a very powerful 
agent in subacute muscular or tendinous rheumatism worse at night (Pf ) ; the 
tendons, ligaments, and fasciae are most benefited ; externally, as lotion on 
compresses ; also internally, small doses every two hours (P). Aconite, the 
extract as plaster to joints is unquestionably very useful (P) ; is more useful in 
chronic than acute rheumatism (Wa) ; the liniment of the B. P. locally over the 
sciatic nerve when affected (Fothergill). Ichthyol, is invaluable given inter- 
nally in pill, gr. x-xxx thrice daily ; also as ointment with Lanolin 50 per cent. 



RHEUMATISM, CHRONIC. 773 

(Illinsky) ; or as a liniment with Turpentine or an equal weight of a mixture of 
Lanolin and Olive Oil, with 30 per cent, of Chloroform. Cimicifuga, some- 
times has wonderful success, yet often fails ; no indications (B) ; in rheumatic 
neuralgias and headaches, and rheumatism of uterus (P) ; signally beneficial 
in many forms (R). Lithium Bromide, gives excellent results, when smaller 
joints are swollen and tender (B). Lithium Salicylate, in 15- to 20-grain doses 
every four hours, gives good results in lingering, subacute cases after acute 
attacks (Da C). Colchicum, is of decided advantage in the neuralgia of 
chronic rheumatism (B). Colchicine Salicylate, is used with satisfaction (see 
page 250). Bryonia, is a useful remedy, especially for painful and stiff joints 
(P). Mercury, the oleate of Mercury and Morphine locally, for joint affections 
(R). Mezereon is strongly recommended (P). Phytolacca, has proved useful 
(B). Dulcamara, has been used with benefit (P). Iodine, locally, for pain 
around joints (R). Quinine, in rheumatism with debility, shown by night 
sweats or sweats during sleep and only then (Wa). Arnica, the tincture and 
infusion are useful (P). Cajeput Oil, internally and externally in muscular 
rheumatism (P). Turpentine, benefits and relieves the pains; internally and 
externally as liniment (P). Aletris, is extensively advertised as an efficient 
remedy. Nuclein, has been used with decided advantage (Vaughn). Eucalyp- 
tus, the leaves wrapped around the affected part, renewing them daily for a 
week or more, often very efficient as a local stimulant, but will produce vesica- 
tion if too long continued (Gibbons). Xanthoxylum, has long had deserved 
reputation, TTLxv-^ij of fluid extract (B). Thuja Occidentalis, is useful for 
rheumatic pains (P). Manganese Sulphate, is one of the remedies (B). Bel- 
ladonna, the extract locally very valuable for pains (P). Cod-liver Oil, inter- 
nally and externally, exercises some influence (B). Chimaphila, may prove 
useful, especially when lithiasis (P). Lupulin, as an anodyne (P). Burgundy 
Pitch, as plaster locally (P). Aliment, avoid spirits and malt liquors, coffee, 
also starchy, animal and saccharine food; the farinaceous vegetables and acid 
fruits suitable (B) : Alkaline mineral waters have deserved reputation (B). 
Turkish Baths, in chronic muscular rheumatism (B) ; steam bath daily of great 
benefit, may be obtained at home by pouring water on hot bricks in a tub, the 
patient sitting on a board or chair above, enveloped in a blanket (Brick). Car- 
bonic Acid Baths are sometimes beneficial (see page 82). Red Flannel next 
skin, very popular, but white better, as the red often gives rise to eruptions (Da 
C). [Compare Arthritis, Lumbago, Myalgia, Pleurodynia, Sciatica.] 

Prescriptions, 

R. Pulv. Resin. Guaiaci, j R. Linim. Aconiti (B. P.), 

Potassii Iodidi, . . . aa r 7 j ). Linim. Belladon., . . aa 55 ij. 

Tinct. Colchici Seminis, . giij. Glycerini, ....... ^ij. 

Aquae Cinnamomi, M. Sig. — Apply locally over the seat of 

Syrupi, . . . . aa q. %.ad ^ vj. pain. {Fothergill.) 

M. Sig. — A dessertsp. to a tablesp. 

thrice daily. {Pepper.) R. Olei Sinapis, 3 ss. 

Olei Terebinth., . . . . giij. 

R. Tinct. Guaiaci ^Ether. , . . ^j. Camphoree, 3 lv - 

Tinct. Colchici JEther., . ^vj. Liq. Ammon. Fort., . . . giij. 

Tinct. Cann. Ind. ^Ether. , gij. Tinct. Capsici, £iv. 

M. Sig. — 25 to 30 drops on sugar, every Alcoholis, . . . q. s. ad gv]. 

4 hours, for rheumatic and neuralgic symp- M. Sig. — Russian Spirit, a liniment for 

toms. {Atlee.) rheumatism. 

R. Acidi Arsenosi, gr. iij- R. Potassii Iodidi, . ... £J. 

Pulv. Guaiaci, ^iij. Potassii Nitratis, . . . . ^ss. 

Pulv. Capsici, gss. Ext. Cimicif. FL, 

Pil. Aloes et Myrrhse, . . 3 iij. Glycerini, ' aa ,^ss. 

Ft. pil. no. cxx. Sig. — One thrice daily. Vini Colchici Sem., q. s. ad !|ij. 

The modified Chelsea Pensioner. M. Sig. — A teasp. after each meal. 

{Fothergill.) {Potter.) 



774 RHEUMATISM ROSEOLA SARCIN^ SCABIES. 

Rheumatism, Gonorrhceal. 

Opium, as Dover's powder, full doses in the acute stage (Wa). Potassium 
Iodide, with tonics and stimulants, after the acute stage has passed, followed by 
friction, shampooing, and passive movements of the joints (Wa). Ammonium 
Chloride, in free doses, especially when the muscles are affected (Fuller). 
Potassium Chlorate, internally, and as urethral injection, until urethral dis- 
charge is entirely stopped, then tt^xx of Tinct. Ferri. Chlor. 4 times daily, with 
gr. x of Quinine daily, and good food (Da C). Aspirate, when pus is discov- 
ered around the joints, as the case will be one of pyasmic rheumatism, and 
may involve more joints than one (Da C). 

Rheumatism, Muscular. 

Diaphoretics, as Dover's powder, with Potassium Nitrate, or Ammonium 
salts, with dry heat to the part involved and rest in bed (Da C). Morphine 
and Atropine, gr. \ and gr. fa, together hypodermically, are of great service 
in most forms (R). Lithium Bromide, is almost specific (B) ; Lithium and its 
salts where there is a uric acid diathesis. Colchicine, a fa solution in 5-minim 
doses hypodermically thrice daily into the affected muscles, very effective in 
cases resisting other treatment. Colchicine Salicylate, is used with benefit (see 
page 250). Aurum, the Bromide of Gold and Arsenic is employed successfully 
(Barclay). Jaborandi, or Pilocarpine hypodermically, to get the skin acting 
freely, a great desideratum (Da C). Potassium Iodide and Colchicum, or Qui- 
nine, gr. xij-xvj in 24 hours, if the case lingers over a week (Da C). Capsicum, 
powdered, with Lard, £ij to the ^, rubbed over the part, night and morning, 
with a gloved hand, is very efficient (Macdonald). Cimicifuga, is often very 
efficient in lumbago, myalgia, pleurodynia, and similar conditions (Wa). Xan- 
thoxylum, gives relief in some cases of muscular rheumatism (B). Lini- 
ments are of little use except to amuse the patient, but Chloral ^j in %vj of 
Linim. Saponis, makes a good one (Da C). Electricity, the constant current 
daily renders good service. [Compare Lumbago, Myalgia, Neuritis, Pleuro- 
dynia, Rheumatism chronic, Torticollis.] 



Roseola. 

Scarcely any treatment called for ; no local application needed, as the rash 
is but slightly irritating. Aconite or Belladonna, according to the symptoms, 
or Ammonium Carbonate, answers all the indications. [Compare Measles.] 

Sarcinse. 

Sulphites and Hyposulphites, have been employed to destroy sarcinae and 
torulae in the stomach (R) ; or Sulphurous Acid, diluted, before each meal 
(Wa). The treatment of these microscopic fungi is that of the primary gastric 
affection. [Compare Dyspepsia, Cancer, Gastric Dilatation.] 



Scabies. 

Sulphur, a solution of Potassa Sulphurata £ss-^j, as local application ; an 
extemporaneous Sulphide may be made by boiling one part of quicklime and 
two of Sulphur in ten of water (B) ; Sulphurous Acid, as gaseous bath, the 
quickest method ; Hebra's mixture of Sulphur, Chalk, Tar, Soap and Lard, less 
irritating, and equally sure (R). Calcium Sulphide, as a bath (W). Sulphuric 
Acid, internally, has cured when other remedies failed (Wa). Storax, 
equally serviceable and not irritating as is Sulphur, one part to two of Olive 
Oil, with a warm bath (R). Mercury, the Bichloride is very efficient, if used 



SCARLET FEVER. 775 

strong enough, but caution is required in its employment (B). [See formula 
below.] Staphisagria, a certain remedy ; 3 parts to 5 of Lard, boiled at 212 
F. for 24 hours, when cooled, after straining add a little essence; friction with 
this 4 times daily (Wa). Balsam of Peru, the best of all applications, killing the 
acarus, relieving the itching and dermatitis, and disinfecting the parts; rub in 
3] over the body after a warm bath (Bruce) ; is fatal to the itch-mite (Oldberg). 
Manganese, the Oxide, 3ij to 3J Adipis as ointment (B). Copper Sulphate, as 
lotion, 3J to Oj, has been used with great success, after crusts are thoroughly 
removed with soap-and-water (B). Alkalies, as soaps or ointments to remove 
cuticle and break up burrows (R). Carbolic Acid, locally (B). [See Tinea 
for formula.] Cocculus Indicus, as ointment, useful (P). Tar Ointment, re- 
lieves itching quickly and cures disease in 10 to 12 days (P). Anise or Ka- 
mala, as ointments, efficient (P). Benzoic Acid, gr. x-xx ad 0}£ aquae, as 
lotion, effectual for the pruritus (R). [See formula under Pruritus.] Beta- 
Naphtol, in 3 to 5 per cent, alcoholic solution or as a 10 per cent, ointment, is 
by far the best application (Shoemaker) ; a 2 per cent, ointment applied by 
friction has caused acute nephritis in two brothers aged 6 and 8 years, one of 
whom died therefrom (Baatz). Linen, should be immersed in boiling water, 
other garments should be baked in an oven or well fumigated with Sulphur 
vapor, to destroy the acari and their ova (R). 



Prescriptions. 



rjt . Styracis Liquidis, . . . . gij. 

Ung. Sulphuris, 3 iv. 

Ung. Petrolei, . . q. s. ad$). 

M. Sig. — Apply after washing. 



R. Sulph. Sublimat., . . . . gj. 
Balsam. Peruv , . . . . . ^ss. 

Adipis, § j. 

M. Sig. — For children. (Duhring. 



r£ . Hydrarg. Chlor. Corr., . . gr. iv. R . Sulph. Sublimat., 

Alcoholis 3 v j- . Olei Cadini, aa^ij. 

Ammonii Chloridi, . . . J?ss. Cretae Preparatae, .... £ijss. 

Aquae Rosae, . . q. s. ad ^vj. Saponis Viridis, 

M. Sig. — Lotion for scabies, phthiriasis, ' Adipis, ^ a ,lJ« 

and tinea versicolor. [Fox.) M. ft. unguentum. (Bulkley.) 



Scarlet Fever. 

Aconite, of the highest value for all marked increase of temperature (R) ; 
helps development of the eruption when due (P) ; in the early stage, when 
patient is not decidedly adynamic, is very useful (W). Belladonna, during the 
eruptive stage, when depression exists, and rash is imperfectly evolved (B) ; as 
prophylactic has been recommended (R) ; is often efficacious as prophylactic 
(P) ; the preponderance of evidence is certainly in favor of such use of the drug 
(Pf ) ; this virtue is claimed by imposing authorities ; when so given its dose is 
gr. \ several times a day (Tr). Mercury, gr. \ of Gray Powder every hour has 
marked effect on inflamed tonsils (R). Ammonium Carbonate, feeble circula- 
tion, cyanosis, delirium (B) ; in all forms, especially if given early (R) ; one of 
the most reliable remedies; gr. iij-vij, according to age, in milk or Cinnamon- 
water, every hour or two (Wa). Potassium Iodide, in full doses, a very satis- 
factory remedy (Mitchell). Mineral Acids, Muriatic internally and as gargle; 
Nitric, locally to sloughs in the throat (R). Salicylic Acid, given in 125 malig- 
nant cases, with mortality of only 3^ per cent. (Shakowaki). Salol, in doses 
of 7 to 30 grains daily, according to age, internally, with gargles of a solution 
of Carbolic Acid, used in several cases with recovery in all and without albu- 
minuria or other complications (Ouioc). Carbolic Acid, internally and as gargle, 
successfully used [see Measles, for formula] ; seems to exercise some influence 
as prophylactic (Wa) ; is good for the vomiting and for its general effect on the 
disease ; n\ss, every 2 or 3 hours (Da C). Sodium Sulpho-carbolate, as a 
means of introducing Carbolic Acid into the system ; has been successfully 



776 



SCIATICA. 



employed (Wa). Chloral with Paregoric, is highly efficient for calming the 
patient (see page 224). Potassium Chlorate, in grain-doses every y 2 hour, will 
not injure the kidneys, and will give results equal to those of larger doses on 
the throat inflammation (Smith). Asclepias, to promote the eruption (W). 
Zinc Sulphate, gr. Jg- every 3 hours, believed to have specific influence on the 
disease (Hoyt). Sodium Benzoate, is highly efficient, having slower but more 
permanent effects on the fever than Quinine or the Salicylates (Klebs). Boric 
Acid, makes an excellent gargle (Da C). Juniper, as diuretic when dropsy 
(R). Magnesium Sulphate, as purgative, to prevent sore throat and other 
sequelae (R). Veratrum Viride, in convulsions (R). Rhus Toxicodendron, of 
great service, if typhoid or rheumatic symptoms (P). Digitalis, very useful ; 
lowers temperature and maintains kidney action (B) ; the best antipyretic and 
diuretic, the infusion with dry cups for the renal dropsy in its inception ; later 
on, milk diet and Basham's Mixture (Da C). Potassium Permanganate, lo- 
cally to throat, and internally, gr. %-) ter die, has undoubted benefit (B). 
Sulphurous Acid, by inhalation, spray, or fumigation, in malignant sore throat 
(R). Chlorine Water, in sloughing of throat (R) ; seemingly prophylactic 
(Wa), Quinine, small doses in adynamic states, large in hyperpyrexia (B) ; 
very successful when used systematically from the start (Wa). Ferric Chloride, 
the tincture in doses of rr\,x-xv, according to age, in advanced stage ; when 
with albuminuria and hematuria, is very valuable (Wa). Mustard Bath, on 
recession of rash, to bring it back (R). Oil Inunctions, very grateful, espe- 
cially useful in desquamative stage ; Cacao-butter the most elegant (B). Ice, 
sucked, for the sore throat (R). Water, cold baths with oil are all that are 
needed in mild cases ; when temperature above 104 , urine scanty and rash 
retroceding, the cold-wet pack renders signal service (R) ; cold wet compress 
to neck, through the whole course, renewed every 3 hours (R). Diet, fruit, if 
ripe, in season, toast, gruel, etc., in simple cases ; in malignant, extract of beef, 
stimulants as per pulse. Milk the most suitable aliment, both as nutrient and 
as diuretic ; a strict milk diet was enforced during the illness in all the cases men- 
tioned above under Salol (Ouioc). [Compare Albuminuria, Bright's Dis- 
ease, Uraemia.] 



Pi'escriptions. 



R . Acidi Borici, 3 ss. 

Potassii Chloratis, . . . . ^ij. 
Tinct. Ferri Chloridi, . . 5fij. 

Syrupi, |ij. 

Aquae, §ij. 

M. Sig. — Tablesp. every 2 hours, to a 



child of five years. 



[Smith.) 



H. 



Acidi Carbolici, 5 ss_ j- 

Vaselini, 3 iv. 

M. Sig. — By inunction to the entire 
surface. 



R 



Acidi Salicylici, 
Tinct. Aconiti, . . 
Infusi Digitalis, . . 
Spt. Ammon. Aromat 
Syr. Aurantii Cort., 
Aquae 



M. Sig. — Teasp. 
child of five years. 



3»J- 

gtt. * 

3Jss. 
:f ss. 



every 3 hours, for a 
{Brown. ) 



R . Acidi Borici, ^iij. 

Glycerini, £iv. 

M. Sig. — For a pint of water as a 
gargle. (Da Cos/a.) 



Sciatica. 

Opium, internally and externally (Wa). Morphine, hypodermically, is espe- 
cially curative in sciatica (B) ; 3 or 4 injections of gr. l /e each may almost be re- 
garded as a specific (Wa) ; a single injection sometimes cures long standing 
cases permanently ; if not it may be repeated every second day or so (R) ; 
should be injected deeply into the adjacent muscular structure (Pepper). Apo- 
morphine, gr. ^hypodermically, given by accident instead of morphine, caused 
immediate disappearance of the pain in a very severe and intractable case, 
not returning again for 12 months, and then only a slight attack which pro- 



SCIATICA. 



777 



gressed favorably under Potassium Iodide and Gelsemium (Owen). Antipyrin 
or Acetanilid, efficiently analgesic. Salipyrin, has been employed with excel- 
lent results in rheumatic sciatica. Salicylic Acid, as paste locally, Z] with Zw 
of Lanolin and 01. Olivae, q. s., also Rhus Tox., gtt. j of a I per cent, solution 
of the fluid extract internally every 4 hours, cured one very obstinate case 
(Aulde). Salol, gr. vij in evening and gr. xv more at midnight, completely 
cured me after 3 weeks suffering in bed, unrelieved by other remedies (Aschen- 
berg). Ether, as spray, is generally of temporary value (R). Guaiacol, 
painted over the nerve as a local anaesthetic. Aurum, the Bromide of Gold 
and Arsenic has rendered good service in chronic cases. Chloroform, applied 
on flannel along the course of the nerve, and covered with oiled silk (Wa) ; 
tt\,xv of the official spirit, or ff\,v-xv of pure chloroform, by deep hypodermic 
injection into the vicinity of the affected nerve, gives the best results in old 
cases (B). Cocaine, a 4 per cent, solution, hypodermically along the course 
of the nerve, affords instant relief (Wa). Gelsemium, has been used with vary- 
ing success. Nux Vomica, is often successful in chronic sciatica (Wa). 
Belladonna, has afforded relief (R) ; Atropine, hypodermically, is curative, gr. 
To t0 t& * n tne vicinity of the nerve (B). Stramonium, gr. % to yi every 3 or 
4 hours for 4 or 5 doses, often affords decided relief, but should be stopped 
when the slightest symptoms of narcotism appear (P). Duboisine, is a good 
substitute for Atropine, and equally effective. Veratrine, in strong ointment 
or oleate locally ; the tincture of Veratrum Viride internally is also recom- 
mended (R). Aconite, locally (P) ; as ointment controls sciatica in some cases 
(R) ; valuable in many obstinate instances (Wa). Ammonium Chloride, in 
mild forms (R) ; in cases occurring in the young (Anstie). Iodides, in syphi- 
litic or metal poisoned subjects (B) ; often fails (R) ; Potassium Iodide in daily 
doses of Z] dissolved in Decoction of Sarsaparilla, most efficacious in sub- 
acute or chronic (Wa). Turpentine, causes an exquisite sensibility along the 
track of the great nerves (Tr) ; occasionally of great value in sciatica, yet not 
a specific, nor have we scientific indications for its use (P) ; ^ss doses for 4 to 
8 successive nights (R). Sulphur, locally, believed to relieve the pain ; effect 
probably due to the flannel surrounding it (R); is worthy of trial after active 
symptoms are subdued (Wa). Phosphorus^ in neuralgic form ; less satisfac- 
tory in sciatica than in other neuralgias (R). Rhus Toxicodendron, a very 
powerful therapeutic agent in various rheumatic affections of the fibrous tissues 
(P). Cimicifuga, is highly extolled (R). Nitroglycerin, in doses of try thrice 
daily, gradually increased to tti,v, of a one per cent, solution, promptly curative 
in a long-standing and severe case (Lawrence) ; its powerful anti-neuralgic 
properties were well exhibited in 3 cases which would not respond to other 
agents, two being cured and one remarkably improved thereby (Mikhalkine). 
[See formula below.] Cold of intense degree, produced by refrigeration of 
limb by Methyl Chloride, extremely efficient (Jacoby) ; has been found effectual 
when applied to the sound limb. Cantharides, as counter-irritant, to free vesi- 
cation (R). Aquapuncture, has had extraordinary success (B). [See under 
Neuralgia.] Acupuncture, occasionally affords instant relief (B) ; often 
cures cases of long standing (R). Nerve-stretching, by forcibly flexing the 
thigh on the abdomen (Lange). Poultices, applied very hot (R). Turkish- 
Baths, are often very useful (R). Electricity, produces excellent results (B) ; 
does great good, but often aggravates ; the continuous current best, when stage 
of acute inflammation past (W) ; galvanism often quickly relieves the pain 
(Pepper). Cod-liver Oil, should always be tried in obstinate cases (W). [Com- 
pare Neuralgia, Rheumatism chronic] 



Prescriptions. 



R- . Tinct. Colchici Seminis, 

Tinct. Belladonnae, 

Tinct. Aconiti, . . . . aa gj. 
M. Sig. — TTlvj every 6 hours. Remark- 
ably efficient. (Metcalf.) 



R. Tinct. Trinitrini (I p.c.) . ^jss. 

Tinct. Capsici, ^ij. 

Aquae Menthse Piper. , . . j§ iv. 
M. Sig. — 5 to 10 drops to be taken 
three times a day. {Mikhalkine.) 



7j8 SCLERODERMA SCLEROSIS SCROFULOSIS. 



Scleroderma. 

Cod-liver Oil, our sheet-anchor, used internally and locally (B). Electricity, 
is used successfully (B) ; with stimulating inunctions offers the best prospect of 
improvement (Bulkley). Strontium Iodide, has been used, with varied results. 



Sclerosis. 

Aurum, the preparations of Gold are among the remedies which are believed 
by some writers to retard the progress ; others being Arsenic in full doses, 
Silver Nitrate in % grain doses, Physostigma and Ergot (Osier) : Gold is a 
specially curative agent in all forms of sclerosis, including cirrhosis of the 
liver, interstitial nephritis, cirrhosis of the lungs, etc.; and Dr. Barclay's 
Liquor Auri et Arseni Bromidi is very efficient in these affections, and much 
superior to the Chloride of Gold and Sodium (E. A. Wood). [Compare the 
titles mentioned in this article, also Locomotor Ataxia, Atheroma, 
Paralysis Agitans.] 



Scrofulosis. 

Ammonium Iodide, when glandular enlargement ( Wa) ; Ferrous Iodide, 
when debility and emaciation, a powerful and efficacious remedy ; also in 
anaemia of scrofula, the syrup HLxx-3j ter die (Wa) ; useful in simple gland- 
ular hypertrophy, but disappointing in scrofulous (B). Strontium Iodide has 
been used with varied results in scrofulous otorrhcea. Iodine, tinct. or oint. 
applied over scrofulous glands — take care not to increase inflammation (R) ; 
Iodine and Iron the best remedies, but all medicines utterly useless without 
strict hygiene (A). Aurum, the Bromide of Gold and Arsenic has rendered 
good service in a case of adenitis with enormous enlargement of the neck (E. 
A. Wood). Calcium Salts, the Chloride in doses of gr. x-xx in milk after food, 
when glandular enlargement of neck and chronic diarrhoea ; the Phosphate of 
great use for sores (R) ; is of eminent service as a palliative (Wa). [See Sul- 
phides below.] Spongia Usta, formerly held in high repute ; has fallen into 
perhaps unmerited neglect; contains Sodium Iodide, Magnesium Bromide, 
Calcium Phosphate, and Ferric Protoxide, in small quantities (Wa). Iron, 
Ferrum and Calcium Phosphates combined give good results, also chalybeate 
waters (B); must be long continued (R). Sulphides, for sores, abscesses, sup- 
purating glands ; gr. fa or fa of Calcium Sulphide every hour or two (R). 
Coniine, gr. *4 to 3j of Almond Oil locally, two or three times a day to con- 
junctivae in " scrofulous" photophobia; has proved very successful (P). Cod- 
liver Oil, the best remedy to promote assimilation (B) ; of great service in the 
various manifestations of this disease (R). Stillingia, a domestic remedy, used 
with much success (B). Capsicum, in scrofulous and fistulous ulcerations, a 
weak infusion becomes a useful stimulant (P). Mezereum, strongly recom- 
mended (P). Sarsaparilla, useful by reason of its tonic and alterative proper- 
ties (P). Hyoscyamus, the bruised leaves as cataplasm for scrofulous ulcers 
(P). Prunus Virginiana, is found very useful in the hectic (P). Chimaphila, 
holds a certain amount of reputation as a useful remedy (P). Tussilago, was 
employed by Cullen (P). Gentian, is valued ; the infusion a useful vehicle for 
chalybeates, etc. (P). Blisters, for scrofulous glands (R). Grape-cure, renders 
much service (B). Alcohol, no doubt as to its great value ; with Cod-liver Oil, 
or in small amounts at meals (Wa). Phosphorus, eminently serviceable in 
scrofuloderma, gr. x in 01. Olivae ^j, doses of HL V-X > thrice daily after meals 
(Broadbent). Phosphates, see above, under Calcium and Iron. Aliment, 
raw or broiled meat, the latter for children. Abundance of fresh air and sun- 
shine. Sea-air, sunlight, moderate exercise, and light digestible food are nec- 
essary. [Compare Cachexia, Coxalgia, Glands, Ophthalmia.] 



SCURVY SEA-SICKNESS — SEBORRHCEA SHOCK. 779 

Scurvy. 

Citric Acid, used with great advantage, though inferior to Lemon-juice (Wa). 
Lemon- or Lime-juice, of the utmost value, both as preventive and a curative 
agent ; its efficacy believed to be due to its Potassium salts ; Oranges are highly- 
useful (Wa). Acids, especially Vinegar, to prevent scurvy, in the absence of 
lime-juice or fresh vegetables (R) ; dilute Muriatic Acid, gtt. v, thrice daily 
with juice of three lemons daily, vegetables and fresh meat (Da C). Potas- 
sium Chlorate, is probably a remedy of some value (Wa) ; is not (W). 
Cinchona, a decoction, or the dilute tincture with Myrrh or the Chlorates, a 
very useful gargle. Quinine, internally when much prostration, combined 
with mineral acids (Wa). Alcohol, diluted, as gargle (R). Atropine, hypo- 
derm, for salivation (R). Alum, a solution in water with Tinct. Myrrhse ^ss, 
several times daily as lotion for ulceration of the gums (W). Liquor Sodae 
Chloratae, £vj ad ^xij aquae, as a mild application to gums (Wa). Dietetic 
Treatment, alone required ; Lemon-juice play r s no essential part in the treat- 
ment ; the full diet of an hospital, comprising fresh meat, vegetables, and milk, 
is generally sufficient. [Compare Cancrum Oris, Purpura.] 

Sea-sickness. 

Antipyrin, is successfully employed. Chloral, the most effective remedy ; 
gr. xv-xxx every four hours (R). Staphisagria, has given relief (P). Creo- 
sote, checks the vomiting (R). Chloroform, drop doses pure (R) ; TT\jj-v on 
sugar (B). Atropine, hypodermically, gr. -^^ in epigastrium, will relieve (B) ; 
S r - "sw t0 2W given with Strychnine, gr. y 1 ^ to ^j hypodermically, is really 
specific in most cases, and in some if given before sailing, will prevent for the 
whole voyage, though but one dose be administered. Bromides, in full doses 
(Beard) ; the Sodium Bromide preferred, in doses of 30 grains thrice daily for 
3 days before sailing and continued for the first 3 or 4 days of the voyage, is 
by far the most effective treatment, and never produces evil effects (Rockwell). 
Cocaine, is quite efficient : the Hydrochlorate 1 in water 100, of which rr\jv-v 
on a bit of ice thrice daily (Otto) ; a 2 per cent, solution, as spray high up into 
nasal passages, is specific against nausea. [See under Nausea.] Morphine, 
gr. -j^ to ^ hypodermically, will often relieve severe cases (B) ; often fails (Wa). 
Amyl Nitrite, by inhalation (B) ; is strongly recommended, but must be cau- 
tiously used. Champagne, iced ; tablespoon doses every quarter-hour (B). 
Calumba, a few drops of the tincture will sometimes relieve (B). Spinal Ice- 
bag, often successful (R). Cocaine, is reported quite successful. Bromides, in 
full doses (Beard). [Compare Nausea, Vomiting.] 



Seborrhcea. 

Glycerin, especially useful ; with Lead Acetate, Borax or Zinc, diminishing 
secretion ; also acts efficiently when there is a want of sebaceous secretion 
(Wa). Zinc Oxide, Z], Plumbi Carbonat. 3j, Cetacei ^j, 01. Olivae q. s. Ft. 
unguent. (B). Oleate of Arsenic, is of benefit (Wa). Mercury, an ointment 
of the White Precipitate is serviceable on the scalp, with an occasional shampoo 
with tar soap or soft soap in solution, followed later by mildly stimulating 
lotions (Bulkley). [Compare Acne, Pityriasis.] 



Shock, Surgical. 

Codeine, in large dose, gr. j, hypodermically, immediately after laparotomy, 
quiets pain, prevents intestinal contraction, and relaxes the tonic spasm of the 
vessels which forms the first stage of shock, shown by the small and rapid 
pulse, before the second stage, that of paresis of the vaso-motor system, sets 



78O SICK-ROOM SNEEZING SOMNAMBULISM. 

in, as shown by the soft, compressible pulse ; Morphine is the ideal relaxer of 
spasm, but has many objectionable qualities which Codeine is free from (Boise). 
Amyl Nitrite and Glonoin, relax arterial spasm, and are indicated in the first 
stage of shock. Strychnine hypodermically, is the best medicinal agent in the 
second or paretic stage of shock, when the vessels are relaxed and the pulse 
is soft and compressible ; a full dose, gr. -^, is necessary, and may be repeated 
in y 2 hour (W). Digitalin, hypodermically, may also be of great service in 
the second stage. Alcohol, as Brandy or Whiskey, hypodermically or by 
enema, is exceedingly useful. Heat, is a potent preventive of shock ; the room 
should be warmed to 72 F., exposed limbs should be wrapped in cotton bat- 
ting, and hot water bottles wrapped in towels should surround the patient's 
body both during and after operation. Hot Water as clyster, a pint injected 
into colon, and repeated as required, after laparotomy, in which operation the 
handling of the intestines sets up irritation of the sympathetic system, and is a 
potent cause of shock ; this acts as a sedative thereto, and restores fluid to the 
blood, allaying thirst and supporting patient. Normal Salt Solution, consist- 
ing of }{d of one per cent, of Sodium Chloride in sterilized water, intraven- 
ously, to raise the volume of the pulse, stimulate the heart and restore volume 
to the blood, renders good service in the second stage of shock. 



Sick-room. 

Every home of any pretensions should contain a room especially arranged 
and kept ready for the use of sick members of the family. Such a room should 
be on the upper floor, and preferably in the south-east corner, so as to have 
the best sunny exposure ; or still better, should be itself the upper floor of a 
two-story annex, separate from the main building, but joined thereto by a 
light, latticed bridge. It should have no upholstered furniture, a bare but 
painted floor, and rough-plastered and painted walls and ceiling, without pic- 
tures or paper, curtains or hangings. It should contain no sink, wash-basin, 
water-closet or any other convenience which connects with the sewers, and 
should communicate with the kitchen by a dumb-waiter, or have connected 
with it a smaller room, furnished with a gas-stove and the other requirements of 
a diet-kitchen. It should contain everything requisite for nursing a case of 
typhoid fever, scarlatina, diphtheria, measles or small-pox ; and all its arrange- 
ments should be supervised by the family physician. The possession of such 
an appendage to the home would enable the owner to defy the mandate of a 
Health Officer, in regard to removing an inmate thereof to a public pest- 
house, as it could be shown to the satisfaction of any reasonable court, that 
therein a case of infectious disease could be better isolated, and more humanely 
treated, than in any " pest hospital " ever yet erected by our political adminis- 
trators of health laws (Potter). 

Sneezing. 

Arsenic, a drop of Liquor Arsenicalis three times a day in paroxysmal sneez- 
ing, allied to asthma (R). Potassium Iodide, gr. x, several times a day (R). 
Iodine inhalations, in paroxysmal sneezing with itching of nose (R). Camphor, 
in incessant sneezing, with profuse running from eyes and nose ; the powder 
should be snuffed, or the alcoholic solution inhaled (R). [Compare Catarrh, 
Hay-fever, Influenza.] 

Somnambulism. 

Potassium Bromide, will give decided relief in the somnambulism of children 
allied to epilepsy, often with squinting, which may become permanent, generally 
the result of deranged digestion ; the nightmare of adults will usually yield to 
the same drug (R). [Compare Nightmare.] 



SPASM SPERMATORRHEA. 78 



Spasmodic Affections. 

Aconite, externally and internally for spasms not of a severe type (P). Aconi- 
tine, as ointment in the most severe, as well as in the milder local spasmodic 
affections ; in angina pectoris, spasmodic asthma, cough, etc. (P) ; in spasmodic 
laryngitis has good effect (R). Camphor is said to relieve in many forms, as 
strangury, etc. (R). Hyoscine, is used with advantage in various spasms (Erb). 
Belladonna, of. value for spasms of sphincter muscles, especially those of pel- 
vic organs (P) ; Atropine hypodermically in local spasm (R). Strychnine, of 
great value in spasmodic asthma (P) ; also in tetanus, chorea, and epilepsy 
(Pf, S). Veratrine, as solution, brushed over lids once a day in painful spas- 
modic contraction of the orbicularis (Wa). Opium, very useful as an anti- 
spasmodic, especially if given with a stimulant, as Alcohol, Ether, or Chloro- 
form (R). Ipecacuanha, in spasms of respiratory organs, of great value (P). 
Chamomile Oil, in spasms of hysterical persons, in 4 to 6 minim doses a very 
excellent remedy ; also useful in pseudo angina pectoris (P). Lobelia, a valu- 
able antispasmodic in cautious hands (P). Lupulin, in gouty spasms (P). 
Tobacco, in spasmodic asthma, and for relaxation of muscular spasms (P). 
Sumbul, is of use in gastric spasms (P). Cardamom, is usefully employed in 
gastric spasms (P). Ammonia, useful in children's colic (R). Chloroform, in- 
haled for intestinal spasm (R). Sulpho-carbolates, in flatulent "spasm," 
sometimes Phosphorus better (R). Mustard Poultice, an excellent counter- 
irritant in spasmodic affections (P), [Compare list of Antispasmodics on page 
36, and in this section the titles Angina Pectoris, Asthma, Chorea, Colic, 
Cough, Convulsions, Croup, Dysuria, Epilepsy, Gastrodynia, Hydro- 
phobia, Hysteria, Laryngismus, Pertussis, Stammering, Tetanus, Tor- 
ticollis, Trismus.] 

Spermatorrhoea. 

Potassium Bromide, when due to plethora, erections normal, but persistent 
and teasing; is harmful in debilitated states, or daily losses (B) ; combined 
with cold sponging and the use of a hard bed (R). Digitalis, Z) or ij of the 
infusion twice or thrice daily; few remedies are more successful in arresting 
spermatorrhea (R, P) ; when feeble erections, frequent emissions, cold hands 
and feet (B). Cantharis, deficient tone of seminal vesicles, erections feeble, 
sexual feeling torpid ; the tincture gtt. ij-iij ter die (R) ; with Iron internally in 
emissions (R). Phosphorus, for the induced physical and mental debility ; 
also, Hypophosphites of Lime and Soda (R). Gelsemium, as anaphrodisiac, 
may be combined with Belladonna or Cimicifuga (B). Nux Vomica, relaxa- 
tion and atony (B). Strychnine, in large doses, especially when impotence (R). 
Quinine, has been recommended (R). Belladonna, gr. % of extract with gr. 
jss of Zinc Sulphate, three or four times a day, often successful in nocturnal 
emissions (R). Atropine, relaxed genitalia, no dream or orgasm (B). Camphor 
Bromide, has been useful (W). Lupulin, is a good anaphrodisiac ; with 
Camphor, when a genital sedative is required (B). Iron, the Iodide, useful in 
anaemic cases (B). Ergot, beneficial in relaxed state (B). Hydrastis, is a use- 
ful injection, gtt. x of the fluid extract through a urethral tube to the prostatic 
portion of the urethra (B). Cimicifuga, useful in weak, relaxed conditions (B) ; 
when hypochondriasis exists it is very beneficial (P). Hyoscine, is a most use- 
ful remedy through its influence on the spinal centres (W). Silver Nitrate, a 
vesicating solution applied to perineum generally useful, and without danger 
(B); in solution, gr. xxx to the 5, applied by urethral syringe to the prostatic 
portion of the urethra, is Lallemand's treatment, and still finds favor with many 
surgeons (Whitla). Arsenic, when from weak and relaxed seminal vesicles. 
Kind Advice, frequently the best treatment, as this affection is often due to the 
phantasms of a morbid imagination. Bladder should be emptied after the 
first sleep. [Compare Emissions, Hypochondriasis, Impotence, also the List 
of Anaphrodisiacs on page 56.] 



782 



SPINA BIFIDA SPINAL PARALYSIS. 



Prescriptions. 



R 



M 

time. 



Potassii Bromidi, . . . . 3J. 
Sodii Bicarbonat, . . . . gr. xv. 

Infusi Digitalis, 3 ss. 

Atropinse Sulphat. , . . . gr. -g-L. 
Sig. — One dose, to be taken at bed- 
( Gross. ) 



U . Tinct. Gelsemii, .... gj. 
Tinct. Belladonnas, . . . 3 ij. 
M. Sig. — 15 drops thrice daily. (B. 



R . Lupulini, .... 

Pulv. Camphorae, . 

Ext. Belladonnas, . 
M. ft. pil. no. xij. Sig. 
daily. 



B 



. . gr. x. 

• • gr- vj. 

• • gr- ij- 
-One pill thrice 



Tinct. Cantharidis, . . . 3 i j . 

Tinct. Ferri Chloridi, . . gvj. 
M. Sig. — 20 drops in water thrice daily. 
In impotence with spermatorrhoea, of great 
utility. (H. C. Wood.) 



Spina Bifida. 

Iodine, injected into the sac, 3ss of tincture, or gr. ss, with Potassium Iodide 
gr. v, aquae Z), has cured numerous cases (B) ; Iodi gr. }i, Pot. Iod. gr. % ad 
aquae 3j (Wa). Collodion, as a means of compression (B). Bayer's Operation, 
treats the tumor as if it were a hernia ; he dissects out two lateral flaps from 
the skin covering it and removes the sac, leaving only two lateral flaps of the 
dura, which he sews together, afterwards bringing the skin and muscles together 
separately. 

Spinal Concussion. 

Lead-water and Opium, as lotion over the seat of injury (A). Leeches, if 
pain persistent (A). During the early stage the treatment of shock must be 
instituted, stimulants and restoratives being freely administered ; traumatic 
neurosis may be treated with electricity, massage, hydropathy and the rest- 
cure ; inflammatory symptoms require the treatment for acute or chronic 
myelitis (Lyman). [Compare Myelitis.] 



Spinal Congestion. 

Ergot, gives excellent results (Brown-Sequard). Turpentine, as hot epithems, 
useful (Wa). Antiphlogistic measures, with rest and absolute diet ; wet cups 
or leeches to the column ; cool affusions or ice-bags to the spine while patient 
is in a warm half-bath (Ros). [Compare Meningitis, Myelitis.] 



Spinal Irritation. 

Aconite, as ointment locally (R). Belladonna preparations, locally, gen- 
erally are better than Aconite (B). Ignatia, in small doses diminishes irrit- 
ability of cerebro-spinal axis (Pf). Strychnine, persistently, will ameliorate 
wandering neuralgic pains due to irritability of nervous system (B). Ergot, 
large doses for congestion (Hammond). Conium, in functional derangement 
of the cord, with excessive irritability of the reflex function (Wa). Firing, 
sometimes very beneficial (B). Electricity, the inverse galvanic current 
gives much relief (Hammond). Blisters, with hot-water bag to spine, large 
doses of Strychnine, Phosphorus, Phosphoric Acid and Opium, are the methods 
based upon the anaemic theory of the disease ; out of 156 cases so treated 133 
were thoroughly cured (Hammond). [Compare Meningitis, Myelitis, Neu- 
ritis, Neurasthenia.] 



Spinal Paralysis and Softening. 

Ergot, to starve the inflammation by occluding the spinal arteries (Ham- 
mond). Electricity, best ; galvanic current from spine to nerves and muscles 



SPLENIC AFFECTIONS — STAMMERING. 783 

(Ros). Mercury and Potassium Iodide, a thorough course, in spastic para- 
plegia when syphilis is suspected (O). Massage, with forcible flexion and ex- 
tension and proper apparatus, to overcome rigidity and contracture in infantile 
spastic paraplegia, have often enabled a patient to get around comfortably (O). 
Baths, warm, of every description, are useful in spastic spinal paralysis (Ly- 
man). Suspension, has been tried with some degree of success (Id). In 
softening the treatment must be palliative and supporting only (H). [Compare 
Locomotor Ataxia, Myelitis.] 

Splenic Affections. 

Mercury Biniodide, gr. j to 3j of ointment, rubbed in before a hot fire, has 
given excellent results in chronic malarial enlargement of the spleen (Wa). 
Quinine, in simple malarial enlargement (B) ; gr. xv or xx or more daily, one 
of the most effectual remedies (Wa). Ergot, the most effectual remedy for 
enlarged spleen (Da C). Ammonium Iodide, effective in chronic splenitis, with 
Unguent. Hydrarg. Iod. Rubri externally ; also small doses frequently repeated 
in all splenic derangements from malaria (B). Iodine, locally in chronic forms 
(B). [Compare Leucocyth^emia.] 

Sprains. 

Arnica, is very useful ; the infusion internally and externally (P) ; the tinc- 
ture diluted as lotion is very effectual (Wa). Aconite, the liniment to painful 
sprains, often affords speedy relief (Wa). Turpentine, as a liniment (P). 
Ammonium Chloride, in solution, as lotion, or with bread as poultice, to re- 
move discoloration due to sprains (W). Rhus Toxicodendron, the tincture 
£ss to Oj of water is a good external application to sprains. Oil of Bay, as a 
stimulating liniment (P). Cold Douche, salt may be added ; the force must be 
regulated by the condition of the tissues (R). Heat, by fomentations alternated 
with cold affusions (D). Rest, is the most essential measure and should be 
perfect ; a roller bandage with splints may be required to secure rest of the 
part. 

Stains. 

Silver Nitrate Stains may be removed by washing with Potassium Cyanide 
3ijss, Iodine, gr. xv, Water, 3 iij ; or, after moistening the spots, drop on them 
a few drops of Tinct. Iodine, and wash out with a solution of Sodium Hyposul- 
phite, 3ss to ^j (B). Blood-stains, if on dark colored materials are best seen 
by an artificial light. After a few hours they become of a rusty, reddish-brown 
color, which they maintain for years. The microscope shows the characteristic 
corpuscles. These stains when on Iron are difficult to distinguish from rust; 
the latter is not soluble in water, while blood is extremely so. Heat applied to 
the metal will cause the blood to peel off, unless the stain has been exposed 
long enough to have rust mingled with the blood. A solution of blood in water, 
heated, forms a coagulum which is soluble in hot caustic potash, the solution 
thus formed is green by transmitted light, and red by reflected light. Menstrual 
blood cannot be distinguished from that resulting from a wound (Husband). 



Stammering. 

Vocal Training, the rhythmical method, the most successful, the chief end in 
view being to regulate the precipitate, irregular form of respiration ; but long 
continuance necessary, six months, a year, or more, in special institutions 
(Ros). The patient must be taught the use of language anew, treated with 
especial kindness, and never subjected to mockery or punishment. [See Potter 
on Speech audits Defects, Lea Prize Essay, Philadelphia, 1882.] 



;8 4 



STERILITY STINGS AND BITES. 



Sterility. 

Aurum, cures sterility when dependent on chronic metritis or amenorrhcea 
or coldness, more certainly than any other remedy ; the Chloride, gr. -^ (B). 
Potassium Iodide, when due to syphilis (R). Dilatation of os and cervix care- 
fully when sterility depending on obstruction, with dysmenorrhcea (H). Ster- 
ility is frequently associated with uterine displacement (Meadows) ; less often 
with atresia. In persons of good health it may be caused by an acid discharge 
from the uterus, which kills the spermatozoa ; for this Vichy water internally 
and per vaginam, and alkaline baths (Charrier). Is due to aspermatism of the 
husband in more cases than generally believed (Gross). Many cases are due 
to blocking of the cervical canal with a morbid discharge from the cervical 
glands, and such may be relieved simply by repeated cleansing thereof with a 
cotton-wrapped probe or forceps. 



Stings and Bites. 

Quassia, a strong infusion used as a wash in Java on the mat-covered floors 
infested with fleas, the swarms vanishing as by magic (Neale). Ammonia or 
Alkalies, a weak solution, in stings of insects, to neutralize the formic acid (R); 
Ammonia, as nervine stimulant in snake-bites, more useful than brandy or any 
other stimulant ; n\x-xx of Liquor Ammonias in water or wine, every half hour 
or oftener ; also externally or hypodermically, I part to 2 aquae into a vein 
(Wa). Ammonium Carbonate, gr. v hypodermically, as used for wounds by 
poisoned arrows. [See under Wounds.] Carbolic Acid, a weak solution 
sponged over the body, to keep off mosquitoes (R). Salicylic Acid, I to 19 of 
flexible collodion, locally for bites of insects ; allays pain at once, and only in 
rare cases is the neighboring tissue swollen. Mercury, the Bichloride, 1 to 1000 
of flexible collodion, is equally effective. Potassium Permanganate, in strong 
solution, 1 to 6 locally, is promptly efficient for all reptile-bites and insect- 
stings ; if wound is small, make incision to enlarge it, and insert lint soaked in 
the solution ; if a rattlesnake-bite, inject the solution hypodermically above the 
wound (Dupon). Viola Cucullata, the common violet, is used as an internal 
remedy in Pennsylvania for rattlesnake-bite, and is successful in a remarkable 
degree ; the leaves are eaten, and a poultice of Indigo and salt is at the same 
time applied to the wound. Arsenic, 1 part to 5 of black pepper, is the Tan- 
jore Pill, highly esteemed in India for bites of venomous snakes (Wa). Cal- 
cium Chloride, a filtered solution injected into wound from snake-bite, success- 
ful in seventeen cases (Binz). Silver Nitrate, the sharpened stick applied to 
every sinuosity of the wound ; excision safer (Wa). Sugar, applied to stings 
of wasps, said to relieve almost instantly (Wa). Ipecacuanha, as poultice or 
paste, allays pain and irritation ; is regarded by some as almost specific (Wa). 
Antivenene (see page 155), is an effective antitoxin against the venom of 
several serpent species (Fraser). Stimulants, in snake-bites, freely, are most 
important ; Liquor Ammonias the best (Wa) ; stimulants are indicated in 
snake-bites, but there is no remedy of any value therefor (Gross). Sting, 
should always be removed if left in the wound ; pressing upon it with the bar- 
rel of a small key will expose it. [Compare Wounds.] 



Prescriptions. 



R . 01. Picis Liquids, 01. Olivse, 

01. Hedeomse, . . . . aa^j. 

Spt. Camphorae, 

Glycerini, aa 5 ss. 

Acidi Carbolici, . . . . . 5pj. 
M. Sig. — Shake well. Lotion against 
mosquitoes, for fishermen and hunters. 



R. Carbonis Vegetab. , . . . ft) j. 

Potassii Nitratis, . . . . 5ij. 

Acidi Carbolici, 3J SS « 

Persian Insect Powder, . . ^ viij. 

Mucil. Tragacanth., . . . q. s. 
To make fumigating pastilles for use 
against mosquitoes. 



STOMATITIS SUPPURATION. 785 

Stomatitis. 

Potassium Chlorate, locally and internally ; large doses necessary (gr. x-xx) ; 
in ulcerative stomatitis of nursing women, and aphthae ; of no value in mercu- 
rial form (R). Hydrastis, the fluid extract, locally in mercurial and aphthous 
stomatitis (B). Glycozone, frequently applied, is of benefit in ulcerative 
stomatitis (Edson). Carbolic Acid, a concentrated solution in glycerin, care- 
fully, as a mild caustic in aphthous stomatitis (Wa). Alcohol, Brandy-and- 
water an excellent lotion (B). Mineral Acids, pure Hydrochloric applied on 
pine wood to ulcers (B). Eucalyptus, a decoction of the leaves, an efficient 
local application (B). Glycerite of Tannin, in ulcerative stomatitis (R). Copper 
Sulphate, solution painted over edges of gums in ulcerative stomatitis; gener- 
ally dry Alum better (R). Alum, in ulcerative form, applied dry with the finger 
several times a day, especially when disease affects one-half the jaw (R). 
Salicylic Acid, to ease the pain of catarrhal stomatitis ; one part, dissolved in 
sufficient Alcohol, to 250 parts of water (R). [Compare Aphthae, Cancrum 
Oris.] 

Strabismus. 

Belladonna, for the strabismus of encephalitis (P). Atropine, with strong 
convex glasses, to suspend accommodation for months, or years if necessary ; 
may cure convergent strabismus in its earlier stages, in children of 3 years of 
age or younger (Green in C). Operation, required in most cases, especially 
when of congenital origin. Glasses, properly adjusted to sight, serve to 
strengthen the weak muscles in children, and to pull the axes right (Gould). 

Strophulus. 

Nitric Acid, Ac. Nitrici Dil. ^ss-j, Bismuthi Subnit. gss, Tinct. Digitalis $j, 
Glycerini ^ss, Aquas Rosas gvij, applied to the affected parts frequently (Wa). 
Zinc Oxide, dusted freely over the part. Magnesia, or some other mild alkali, 
with improved feeding and aperients, to which measures this affection gener- 
ally yields in infants. Lancing the gums, is proper (H). [Compare Lichen.] 

Sunstroke. 

Veratrum Viride, and Gelsemium, as sedatives, instead of stimulants, when 
the pulse is full and strong (Ely). Water, as cold affusion when the patient is 
stricken down unconscious (R) ; absolute rest and quiet, free air, loose clothes. 
Potassium Bromide, in cold water by enema. Stimulants when the pulse is 
frequent and feeble. Chloroform, if convulsions. Leeching, in stage of re- 
action (Wa). 

Suppuration. 

Sulphides, small doses (gr. ss-j), frequently repeated, are very serviceable 
(B). Calcium Sulphide, when ichor secreted instead of pus ; also arrests sup- 
puration, or if that is impossible will hasten maturation (R). Quinine, recom- 
mended in profuse suppuration (R) ; to sustain system when suppuration pro- 
longed (B). Sarsaparilla, is very useful (P). Phosphates, Parrish's to repair 
waste from suppuration (B). Iron and Manganese Iodide, the Syrup in cachec- 
tic states resulting from suppuration (B). Hydrogen Dioxide, is a most ener- 
getic pus-destroyer ; the solution may be applied in full strength, or diluted 
with an equal part of water. Glycozone, acts similarly but more slowly ; after 
cleansing by Hydrogen Dioxide solution, the application of Glycozone stimu- 
lates healthy action and hastens the cure ; for which purpose it has no superior 
in the entire range of therapeutics (Edson). Bismuth Subiodide, dusted over 
a suppurating surface after cleansing, is highly efficient as an antiseptic and a 

5o 



?S6 SURGICAL FEVER SYCOSIS — SYNCOPE SYNOVITIS. 

stimulant of healthy granulation. Nuclein, has been used successfully in sup- 
purative disorders (Vaughn). [Compare Abscess, Boils, Carbuncle, 
Pyemia.] 

Surgical Fever. 

Aconite, quickly and repeatedly in early stages, during chill or soon after, 
the safest treatment (P). Salicylic Acid, or Sodium Salicylate, especially use- 
ful as an antipyretic (B). Chloral, gr. xv-xxx every 2 hours ; there is no better 
treatment (Wa). 

Sycosis. 

Nitric Acid, %j to Oj aquae, as wash, used frequently (R). Boracic Acid, 
3jss finely powdered and incorporated with %} of Vaselin, is found most use- 
ful (Wa). Salol, as an antiseptic powder, has done good service. Mercury, 
Citrine Ointment has been extensively employed, also the Oleate of Mercury, 
both with good results (Wa). Arsenic, the Oleate is found beneficial, and the 
Solution of Arsenic and Mercury, Donovan's solution, internally is highly 
useful. Mercurial Ointments, are extensively employed (Wa). Sodium Sul- 
phite, 3j» Glycerin, ^j, Aqua, giij, locally^ when of parasitic origin (Wa). 
[Compare Condylomata, Mentagra.] 

Syncope. 

Nux Vomica, in drop doses of the tincture every 5 minutes, to restore the 
cardiac action in extreme cases of syncope approaching heart-failure, especially 
when of neurotic origin ; is promptly efficient (Macfarlan). Cinnamon, the Oil, 
as a powerful stimulant, sometimes employed (P). Alcohol, as brandy, or 
wine, when heart suddenly enfeebled from fright, etc. (R). Amyl Nitrite, in 
some forms, especially in anaemic subjects, its inhalation speedily restores con- 
sciousness (O'Neill). Atropine, gr. tt?tj— iV subcutaneously, the best means of 
resuscitation, there being no medicine which so promptly exalts the force and 
rapidity of the heart's action (Harley). Duboisine, may be used instead of 
Atropine. Ammonia, internally, or breathed into the air-passages (R) ; the 
Carbonate as " smelling salts " (Wa). Lavandula, the compound tincture 
(Wa). Chloroform, internally, for hysterical people, as cardiac stimulant (R). 
Position, leaning forward, with head as low as possible (R). Galvanization, of 
pneumogastric (B). Cold Water over the face, and volatile substances to the 
nose (B) : cold affusion always (Wa). [Compare Heart Affections.] 



Synovitis. 

Potassium Iodide, with Iron and Quinine, in syphilitic patients with consti- 
tution broken down (D). Iodine, in chronic synovitis, painted around joint ; 
the solution injected into white swelling (R). Quinine, and free stimulation in 
all cases of pyasmic synovitis, such as occurs in acute rheumatism of gonor- 
rhceal causation, occasionally in typhoid fever, and may result from a trifling 
injury in strumous subjects. Mercury, and Morphine, the Oleate locally (R) ; 
an elegant and efficient application (B) ; in syphilitic cases Mercury internally 
when acute symptoms have subsided (D). Aconite, for pains in inflamed 
joints (R). Silver Nitrate, locally to vesication almost, often very beneficial 
(Wa). Carbolic Acid, injected into joint (B). Alcohol, and water, equal parts, 
an excellent evaporating lotion (B). Blisters, a flying blister every night in 
chronic synovitis (R). Cod-liver Oil, in strumous cases (B). Surgical Treat- 
ment, splints to keep the limb motionless in all cases arising from injury ; during 
acute stage splint should be fastened at some distance above and below the 
joint, and not touch the joint itself; straight position, leeches to the joint, or 
cupping near it ; ice, evaporating lotions or hot fomentations ; blisters inappli- 



SYPHILIS. 787 

cable until the acute stage subsides (D) : if suppuration occurs the joint must 
be dealt with as any other abscess cavity (MacCormac). Heat, as fomentations 
or poultices in the acute form. Bandage, or Strapping, to cause absorption of 
fluid ; bandage with cold water after alternate bathing with hot and cold water, 
in chronic synovitis. [Compare Coxalgia, Joint Affections.] 



Syphilis. 

Mercury, the mainstay in the earlier and later stages ; the Protiodide in pills 
of gr. x /e each, one after each meal increased by one every third day, until teeth 
get sore or bowels disordered, then drop two pills from each dose (Keyes) ; the 
best remedy for primary and secondary forms, not so in tertiary ; small doses 
are best, to stop short of ptyalism (B) ; Blackwash, Calomel, or Citrine Oint. 
very useful in mucous sores, tubercles, and elevated indurations ; in syphilitic 
ozasna, psoriasis, rashes, condylomata, etc., the Bichloride, gr. ij-v in ^j of 
Alcohol, painted over syphilitic mouth lesions daily (Keyes) : Mercury believed 
to be a true vital antidote against the virus (R) ; used for at least two years can 
eradicate it (Keyes) : internal administration best because most practicable ; 
the two great preparations are the Bichloride and Protiodide, of the former the 
curative dose for a man is about ]/ z grain daily, for a woman y^ grain, below 
which the drug has no active effect on the disease ; dose of the Protiodide is 
larger, for a man about 2 grains, for a woman gr. 1^ daily (Fournier). Nitric 
Acid, in secondary forms (R) ; holds a high place as an internal remedy (Wa) ; 
when sponginess of gums excessive, 3iv to ^ij aquae, teasp. 4 times daily ; 
also use locally (St); as cautery for the initial lesion, the fuming acid, if used 
at all, should be applied early and thoroughly, followed by Blackwash locally 
on lint (Bulkley). Potassium Iodide, is approached by no remedy in constitu- 
tional syphilis ; also for mercurial cachexia, syphiloma of nervous system, and 
many disorders of syphilitic origin ; will certainly arrest ulceration of nares, 
palate, etc., if given in large doses, gr. xx-3j every 4 hours (R) ; is of little 
value in early stages ; in the later should be combined with Mercury (St). 
Rubidium Iodide, is more pleasant than Potassium Iodide, having a milder 
taste, and is borne far better, especially by the stomach, and in regard to the 
production of iodism and cardiac difficulties (Neisser) ; is indicated in patients 
in a low state with weak cardiac activity (Mering) ; in doses of ^jss to ^iij of 
a 5 per cent, solution daily, gave the best possible results without troublesome 
disturbances (Bunge). 

Iodine, as gargle for ptyalism ; the tincture applied to syphilitic sores of the 
throat (R) ; or ^ss of tincture to ^iv Syr. Fusci., a teaspoonful well diluted ter 
die, after meals, when Pot. Iod. cannot be borne (St). Iodoform, powdered 
and dusted over ulcers (B). Aurum, after Mercury and the Iodides, in old 
cases of secondary and tertiary, ulceration of the throat, ozaena, phthisis, syph- 
ilitic bone-diseases (B) ; its beneficial action incontestable (Tr) ; the Bromide 
of Gold and Arsenic has rendered good service in trifacial neuralgia diagnosed 
as due to syphilis (E. A. Wood) ; Gold is unquestionably useful in the later 
stages, its best effects being obtained with very small doses (Pf) [see page 
175J : the Bromide of Gold, Arsenic and Mercury (Mercauro) is highly praised 
in the late manifestations of syphilis, especially in those affecting the nervous 
system. Stillingia, with Nitric Acid in chronic cases of broken-down constitu- 
tions from Mercury and Iodides has been most satisfactory (B). Cascara 
Amarga, is said to have remarkable powers as an alterative in syphilis, but to 
be useless if alcohol and tobacco are used at the same time. Sanguinaria, in 
secondary and tertiary forms is held to be very useful (P). Sarsaparilla, a 
most important remedy, as adjunct to, and in abuse of Mercury (P) ; with 
Guaiac and Mezereon, as the Compound Decoction of Sarsaparilla, in tertiary 
form (B). [See Guaiac, below.] Belladonna, with Mercurial Ointment, for 
secondary ulcerations of rectum (P) ; the tincture giv ad ^\j aquae, a teaspoon- 
ful 4 times a day in water, instead of mercurials (St). Iron, the Iodide in 
constitutional syphilis, to promote constructive metamorphosis (B) ; where 



788 



TABES MESENTERIC A. 



anaemia exists (R) ; the Potassio-Tartrate, gr. xv-xx, every 4 hours, especially 
in the gangrenous form (Otis). Guaiacum, in tertiary syphilis only, or as ve- 
hicle for Potassium Iodide and Mercuric Chloride (B). Carbolic and Salicylic 
Acids, locally to syphilitic abscesses, Carbolic best (B). Zinc Chloride, Iodide, 
Nitrate, locally to syphilitic ulcers (R). Syphilis Antitoxin, has' been used 
with encouraging results (see page 155). Denutrition, the Arabic "hunger- 
cure " efficient, but unpopular (B). Turkish Baths, or wet packing, ameliorate 
and aid cure of constitutional syphilis (B). Hygiene, is of the greatest import- 
ance in syphilis (Bulkley). Cod-liver Oil, remarkably improves condition 
resulting from prolonged use of Mercury and Iodides, the syphilodermata, and 
squamae ; internally and by inunction (R). [Compare Chancre, Condylo- 
mata, Ulcers, Ptyalism.] 

Prescriptions. 



R-. Hydrarg. Iodidi Rubri, . gr. iij. 

Potassii Iodidi, ^iij-vj. 

Tinct. Aurantii Cort. , 

Syrup. Aurantii Cort., . aa^j. 

Aquae, t !§ viij . 

M. Sig. — A teasp. thrice daily after 
meals. ( Otis, for the Mixed Treatment. ) 



R- . Hydrarg. Bichloridi, . . . gr. iv. 

Tinct. Benzoini, . . . . 5ss. 

Aquae Cologniensi, . . . 5j. 

Aquae Rosae, 3 ivss. 

M. Sig. — Apply locally with sponge to 
skin for 20 minutes. For squamous syphil- 
ides. (S. W. Gross.) 



B 



. Massae Hydrargyri, . 
Ferri Sulph. Exsiccat, 
Extr. Opii, 

In pill, thrice daily. 



gr- 



• J- 
■%■ 
{Otis.) 



R. 



M 



Hydrargyri Bichloridi, 

Ammonii Chloridi, . . aa gr. iij. 

Tinct. Cinchonae Comp., 

Aquae, aa 3 iij. 

Sig. — A teasp. thrice daily. Each 



3 contains gr. ^ of Corrosive Sublimate 
(Btcmstead. \ 



R. 



M. 
meal. 



Hydrarg. Iodidi Rubri, gr. ij. 
Ammonii Carbonatis, . . gr. xx. 

Potassii Iodidi, 3 iij. 

Tinct. Gent. Co., q. s., ad ]|iv. 
Sig. — A teasp. in water after each 
{Fox, for the Mixed Treatment.) 



R . Hydrarg. Chlor. Mitis. , 

Lycopodii, aa. ^ ij . 

M. Sig. — Use as snuff thrice daily, in 
lesions of the nostrils. [Diday.) 



The Three Eights. 



R . Hydrarg. Chlor. Corr., . . gr. viij. 
Potassii Iodidi, .... 3 viij- 
Syr. Sarsaparillae Co. , . . 3 viij. 
M. Sig. — A teasp. thrice daily. 



R . Potassii Iodidi, 3 ij. 

Ammonii Carb. , . . . . ,^ss. 

Tinct. Cinchonae Comp., . £iv. 

Glycerini, ....... 3J. 

Syr. Aurantii Cort., . .. ^jss. 

M. Sig. — A teasp. in plenty of water 

after each meal. {Keyes.) 



Tabes Mesenterica. 

Calcium, the Chloride and Phosphate (R) ; the Chloride is a powerful remedy 
if kept up (Wa). [See Scrofulosis.] Iodine, by inunction with Cod-liver Oil 
(El) ; locally over glands ; carefully, lest inflammation be increased (R). Potas- 
sium Iodide in small repeated doses, valuable (Wa). Mercury, Corrosive 
Sublimate with bark, gr. j ad gij Tinct. Cinchonae, after meals, for chronic gland- 
ular disease (D). Phosphates, for malnutrition (B) ; the Hypophosphites act 
slowly but surely (Wa). Iron and Iodine, in various forms are the most useful 
remedies in scrofulosis, but medicine is powerless without strict hygienic meas- 
ures (A) ; the Iodide or Phosphate of Iron and Cod-liver Oil, as for tubercle 
elsewhere (El). Fel Bovinum, is worthy of trial, though at best a palliative 
(Wa). Cod-liver Oil, is the best remedy to promote assimilation (B) ; of great 
service (R). Chaulmoogra Oil, is of benefit, used by inunction (Wa). Aliment, 
raw meat, cream, chocolate, and cocoa, are valuable nutriments in these cases 



TASTE TEETH TESTICLES — TETANUS. 789 

(El); peptonized foods are of inestimable value (Wa). Hygiene, change of 
air, especially to sea-air, is all-important (El). [Compare Scrofulosis.] 

Taste, Disordered. 

Mercury or Podophyllin, as purgative for cankery taste unconnected with 
alcoholism ; or half-glass of pure cold water daily half an hour before break- 
fast (R) ; yi gr. of Gray Powder 3 or 4 times a day will generally remove the 
disagreeable taste in the mouth due to dyspepsia, in the course of chronic dis- 
ease, or in early convalescence from acute illness (R). Electricity, faradiza- 
tion as a stimulant of the nerves in the tongue, may aid the recovery of function 
when loss of taste is due to nerve disease (Gowers). 



Teeth. 

Potassium Iodide, in doses of gr. x, thrice daily, often cures looseness of 
teeth from periostitis of alveolar processes (Wa) ; Iodine, the tincture painted 
over gums close to the teeth when the gums begin to recede ; also to remove 
tartar (R). Cinchona, powdered bark often used in tooth-powders (R). Col- 
lodion, on cotton, as stopping for carious teeth (P). Liquor Sodse Chloratae, 
3yj ad gxij aquae, a highly useful application in fetid discharges from carious 
teeth (Wa). [Compare Dentition, Gums, Odontalgia.] 



Testicles. 

Mercury, the ointment, locally in indurations and enlargements of testes 
(Wa) ; Corrosive Sublimate, with Cinchona or Sarsaparilla in sarcocele (D). 
Camphorated Naphtol, used hypodermically in tuberculosis of the testis with 
very gratifying results (Reboul). Aurum, is highly recommended in hypochon- 
driasis accompanying testicular disease, and as a tonic for low-spirited, pining 
boys with undeveloped testes. Water, cold applications in neuralgia of testes 
with tonics and neuralgic treatment generally (D). Suspensory Bandage, with 
rest, in many affections of the testes (D). [Compare Hydrocele, Orchitis, 
Varicocele.] 

Tetanus. 

Potassium Bromide, not less than ^ss during the day, with Chloral at night 
as a hypnotic : out of 21 cases so treated but 3 died; its physiological action 
indicates it to be the best remedy known (W) ; in very large doses, Z) every 3 
or 4 hours, has given better results than any other remedy (B). Chloral, in 
large doses, gr. xx, no remedy more effectual (B) ; has sometimes cured (R) ; 
best used in combination with Potassium Bromide (W). Chloroform, in small 
and frequently repeated inhalations, also by friction, has been useful in many 
instances (Wa) ; anaesthetics give temporary relief (B) ; four cases of acute tet- 
anus treated successfully by chloroform inhalations, the daily dose varyingfrom 
3ij to iv ( Preobrajensky). Paraldehyde, promises well, in full doses, ^ij— ijss, 
and does not depress the heart, as chloral and the bromides do (B). Strych- 
nine, of decided service (P) ; cured 8 cases of traumatic form in doses of gr. 
-^ to |- (S) ; the evidence as to its curative power is of doubtful credence, but 
it is most successful in spontaneous and in chronic cases rather than in the 
traumatic form (B). Aconite, has benefited many cases (P) ; its success war- 
rants further trial (W). Belladonna, successfully used in many cases ; the ex- 
tract, internally, and locally to wound (Wa) ; Atropine, gr. T ^ injected into 
muscle (B) ; bleeding, vapor-baths, and large doses of Belladonna have cured 
tetanus (Tr). Nicotine, by rectum or hypodermically, appears to be useful in 
many cases (R) ; much evidence for it as the best remedy (P) ; effective but 
dangerous (B) ; Physostigma better (Wa). Physostigma, has been used with 



790 THIRST THROAT, SORE. 

excellent results (P) ; the fluid extract by mouth if possible, at very beginning, 
and must be pushed until just short of arresting breathing (B) ; evidence is dis- 
crepant (W). Apomorphine, may prove antagonistic (P). Curare, hypoder- 
mically, has much evidence for its power (P). Cannabis Indica, used with 
marked success in traumatic form (P) ; it is difficult to obtain an active extract 
(W). Cocaine, and Morphine, of each a 5 per cent, solution, 3 syringefuls 
hypodermically, immediately relieved and finally cured a bad case of idiopathic 
tetanus unrelieved for 3 days by chloral, morphine, etc. (Lopez). Gelsemium, 
has cured several cases (P) ; its spinal action is opposed to that of tetanus (B). 
Hyoscyamine, or Duboisine, gr. -£% gradually increased to gr. y 1 ^, is very efficient 
(Oulmont). Antipyrin, antagonizes excitability of the motor nerve centres, 
and has been used with benefit. Amyl Nitrite, used in 3 cases with marked 
benefit as spinal sedative (W) ; has been used with success (R). Morphine, 
hypodermically, deeply into tetanized muscles, and if possible to the point of 
entrance of the nerves, used with successful results (Demarquay); as ordinarily 
used is of no value (Wa). Tetanus Antitoxin, is unquestionably the most effi- 
cient remedy known for this disease (see page 152). Conium, is indicated, 
but has not been successful (B). Water, as warm baths, and cold, or ice, af- 
fords only temporary amelioration (B). Spinal Ice Bag, extremely useful (R). 
Division, orstretching of any nerve-trunk connecting the wound with the spinal 
cord. [Compare Spasmodic Affections.] 



Thirst. 

Acid Drinks, allay thirst by promoting the secretion of the alkaline saliva ; 
but excessively used will derange the stomach (R). Bitters, in drinks with 
acids slake thirst most effectually (R) ; a weak infusion of Cascarilla or Orange- 
peel, acidulated slightly with HC1 acid, an efficient thirst- quelling drink for 
fever patients (Graves). Ice, sucked, is very grateful and allays thirst in fevers 
(R). Tepid Drinks, are useful in the thirst of diabetes (Prout). Fruit Juices, 
or these made into drinks, but the most harmless agents must be used in mod- 
eration, and their consumption has to be checked, otherwise patients will take 
them to excess and may thus do themselves considerable injury (Fenwick). 



Throat, Sore. 

Aconite, when temperature high, half-drop doses of the tincture, every ^ hour 
for 2 hours, then every hour, will almost certainly prove efficacious (R) ; valu- 
able in ordinary sore throat (P). Belladonna, is very admirably adapted to the 
treatment of ordinary sore throat; when much fever combine with Aconite 
(R, P). [See Catarrh, Acute.] Nitre, dissolved in mouth, to abort a sore 
throat (Wa). Tannic Acid, as powder, gargle, spray (P) ; the Glycerite of Tannin, 
after acute inflammation; in ulceration of aphthous sore throat daily when 
tendency to catarrh (R). Ipecacuanha, the wine as spray, in non-inflammatory 
sore throats and hoarseness from congestion of vocal cords (R). Capsicum, Z) 
of tincture to 0% aquae as gargle, in some sore and malignant sore throats (R, 
P). Potassium Chlorate, in grain doses every half-hour (Smith). Alum, dry, 
or in solution (R). Myrrh, as gargle in ulcerated sore throat (P). Guaiac, the 
compound guaiac gargle (see page 538) is often very efficient in simple sore 
throat and commencing tonsillitis. Chloral, internally and locally, is an ex- 
cellent remedy for ulcerated sore throat (Brodnax). Cimicifuga, in simple sore 
throat (P); also in malignant forms when the mucous membrane is dry and 
spotted with inspissated mucus (R) Mercury, in acute tonsillitis, which see (R) ; 
the Bichloride as a gargle (see below for formula), in ulcerated forms of syphi- 
litic sore throat (Sir Chas. Bell). Rhus Glabra, a decoction, ,^j to Oj boiled to 0%. , 
with Potassium Chlorate £ss, is a very efficient gargle (W). Arsenic, in medic- 
inal doses, for sloughing of throat or malignant sores (R) : the Iodide is an 
excellent remedy for the so-called diphtheritic sore throat, gr. iij triturated with 



TIC DOULOUREUX TINEA. 79 1 

gr. xx of sugar of milk, one-half of which is dissolved in ^iv of water, and a 
teasp. given every hour or so. Methylene Blue, in simple, non-diphtheritic 
ulceration of the throat, patients would express themselves with delight as 
being cured, after one or two applications of the solution (Rose). Iodine, the 
tincture, locally to sores, whether syphilitic or not(R). Nitric Acid, undiluted, 
to sloughs (R). Silver Nitrate, locally, in early stage of inflammation, may 
cut it short (R). Sulphurous Acid, by inhalation, spray, or fumigations for 
malignant sore throat, scarlatinal or otherwise (R). Water, cold compress 
nightly, to harden the throat when tendency to catarrh (R). Ice, constantly 
sucked (R). [Compare Diphtheria, Pharyngitis, Tonsillitis ; also the 
formulae for Gargles on page 538.] 

Prescriptions. 

R. Tinct. Guaiaci Amnion., R. Hydrarg. Bichlor gr. iv. 

Liq. Potassce, aa^iij. Alcoholis, J;ij 

Tinct. Opii, t ^ij. Solve, et adde — 

Aq Cinnamorai, . q. s. ad^v'n]. Decocti Cinchonse, Mellis Rosse, 

M. ft. gargarysma. Tinct. Myrrhas, . . . . aa^ij. 

Sig. — To be used as a gargle, every hour, M. ft. gargarysma. Sig. — Gargle, to be 

in clergyman's sore throat. {Garner.) \ diluted if too severe. (Sir Chas. Bell.) 



Tic Douloureux. 

Croton-Chloral, has special effect on the 5th nerve (B) ; is palliative in doses 
of gr. v every }i hour till gr. xxx taken (W). Salicylates, in large doses, 
cured a case of 12 years' standing. Stramonium, gr. %. to x / z of the extract 
every 3 or 4 hours for 4 or 5 doses, often affords decided relief; stop if narcotic 
symptoms appear (P). Laurocerasus, sometimes removes (P). Arsenic, cures 
by influencing nutrition (B). Phosphorus, is useful in doses of gr. y^, to gr. T Vj 
every 3 hours (R). Morphine, with Atropine hypodermically, gives relief (B). 
Aconitine, has lately been given with good results (B). Antipyrin, and 
Acetanilid, are sufficiently analgesic to relieve the pain in many cases. Iodides, 
are promptly curative when tic is due to syphiloma of the nervous system, the 
pain being nocturnal chiefly (B). Cimicifuga, is frequently very effective (B). 
Turpentine, when rheumatic in origin or produced by fecal accumulations (B). 
Quinine, holds a foremost place in the list of remedies (Wa). Ammonium 
Chloride, in doses of 30 grains 4 times daily, is of great service in numerous cases, 
especially when the pain partakes more of a rheumatic than of a neuralgic 
character (Sir Thos. Watson). Cannabis Indica, gr. ]l to ]/ 2 rarely gr. j of a 
good extract, is very effective and ranks in value next to morphine and atropine 
(Reynolds). Physostigma, a few drops of a solution of the extract, 1 in 30, or 
one or more gelatine discs of Physostigmine introduced within the eyelids of 
the affected side, effectively relieved or cured several cases (Munro). Chloro- 
form, the liniment applied with friction is sometimes serviceable (Wa) ; a few 
drops by deep injection in the vicinity of the nerve trunk (B). Galvanization 
of the fifth nerve, gives decided relief to the pain, and frequently results in 
permanent cures in cases which belong to the category of the so-called essen- 
tial neuralgiae (B). [Compare Hemicrania, Neuralgia, Neuritis, Odon- 
talgia.] 

Tinea Circinata — Ringworm of the Body. 

Mercury, the Bichloride, 1 part to 250 of water, as parasiticide application, 
after depilation (A); Calomel, as ointment, 3j to the g, is useful (B) ; strong 
Citrine ointment rubbed in twice daily is often effectual (Wa) ; the ointment of 
the Red Oxide often cures ringworm on the body or limbs when other remedies 
fail (Wa). Carbolic Acid, 3j to the % of glycerin, or equal parts of each, is a 
very efficient application (B). Boric Acid, is an excellent topical application, 
especially in that form affecting the scrotum and inner side of the thigh 



79 2 TINEA. 

(Watson). Copper Acetate, in ointment, gr. x to the ^, is a very effective 
application (B). Sulphites, are used in parasitic skin diseases to destroy the 
parasites (B). Sulphurous Acid, is better than Carbolic and safer (A) ; must 
be fresh to be of use (Bulkley). Cocculus Indicus, the decoction locally, after 
washing the skin well (P). Oil of Cade, the best depilatory known (A). 
Arsenic will not cure, but may do service as a nerve tonic or an improver of 
nutrition, in connection with other remedies (Bulkley). Iodine, as liniment 
once applied (R) ; with Oil of Tar, i to 4, is excellent (Wa). Kamala, used 
locally by the Hindoos (P). Tar Ointment, is used with good effect (P). 
Acetic Acid, strong, applied to ringworm of any part of the body except the 
scalp ; no treatment is easier, more speedy or certain in its action (R). 
Sodium Chloride, common salt in ointment is very effective (see below under 
Tinea Tonsurans). Cod-liver Oil, is a powerful auxiliary in weakly and 
cachectic subjects ( Wa). Diet and Hygiene, are important ; the food should 
be nutritive and abundant, especially animal fats ; daily baths, out-of-door 
exercise. Fungus, is the Tricophyton tonsuraiis (A). 

Tinea Decalvans — Alopecia Areata. 

Parasiticide Lotions, must be used after epilation and washing of head daily 
with soft or black soap. Collodion, with Cantharidal Ether, equal parts, as a 
stimulant after the fungus is destroyed (A). Oxygen, locally applied to the 
scalp by a close-fitting rubber bag, to restore the hair (see under Alopecia). 
Tonics, are necessary, especially for the nervous system (Bulkley). Fungus — 
Microsporon Audouini (A) ; but I have never seen it, though having made 
repeated and thorough searches (Bulkley). 

Tinea Favosa — Favus. 

Mercury, is efficient when used early ; the Bichloride, gr. xx to 3J of simple 
cerate (B) ; or gr. ij to the ^ of water applied after each epilation (R). Myrtol, 
is curative of favus (B). Carbolic Acid, in glycerin or cod-liver oil, as a local 
application (B). Sulphurous Acid, as a parasiticide ; Acidi Sulphurosi Dil. ^ss, 
Sodii Hyposulphitis 3 i i j , Aquae q. s. ad ,^xvj (Startin) ; is useful in favus, but 
when cases are unusually obstinate its action should be assisted by epilation (R). 
Simple Oils, to soften and facilitate the removal of scabs (R). Poultices, are 
useful preparatory to epilation (R). Iron, the tincture of the Chloride, internally 
in doses of ir^x thrice daily for a child ten years old ; and combined with cod- 
liver oil if the disease is associated with scrofula (Sir E. Wilson). Sulphur 
Iodide, in weak ointment, gr. xx to the ^, well rubbed in after removal of 
crusts, is the most reliable preparation of its class (Whitla). Epilation, must be 
resorted to and carried out with care and patience (Id). All the remedies use- 
ful for ringworm of the scalp may be used against favus, and success depends 
upon the judicious way in which these agents are used one after the other than 
in the persistent use of any one of them (Id). It is clearly demonstrated that 
the disease is conveyed from the mouse to the cat and then to the children who 
play with or nurse the affected cat (Id). Fungus — Achorion Schonleinii (A) ; 
a very rare affection in this country (Bulkley). 

Tinea Tonsurans — Ringworm of the Scalp. 

Mercury, the Bichloride, gr. xx to the ^ of simple ointment, is an effective 
application when used early (B) ; must be used with caution. Carbolic Acid, 
3j in the S5 of glycerin (B). Sulphurous Acid, the acid of the Brit. Phar. with 
an equal part of glycerin, is useful ; must be assisted by epilation when the 
affection is obstinate (R) : or Startin's formula (see above under Tinea Fa- 
vosa). Potassium Sulpho -cyanide, ,fss in glycerin ^j and water ^vij, as lotion 
applied on lint covered with oiled silk, after washing the patches twice daily 



TONGUE TONSILLITIS. 793 

with warm water and soap and drying (Gee). Sodium Chloride, in ointment, 
equal parts of common salt finely powdered and vaselin, thoroughly mixed, 
and well rubbed in night and morning after shaving the part, until the skin 
becomes very sore; is most efficient even in apparently intractable cases 
(Perkins). Iodine, 3>ij to the 5j of the oil of wood tar, is an efficient applica- 
tion, producing no pain and preventing the extension of the disease (R). 
Arsenic Iodide, is the best constitutional remedy ; gr. ^ increased to gr. ^ for 
an adult, gr. ^j to ^ for children, with alkaline lotions locally (Wa). Viola 
Tricolor, the leaves are employed in Italy for tinea capitis (P). Cocculus In- 
dicus, a decoction locally applied after washing the part well, is efficient (P). 
Quinine, dissolved in glycerin, or a mild mercurial pomade, as grease to the 
hair of the patient and uncontaminated members of the family, to prevent the 
sporules reaching unaffected parts (R). Oils, may be used to facilitate the re- 
moval of the scabs (R). Cleanliness, and free use of soap and water, is a sine 
qua non, and in some cases of tinea may be alone sufficient to produce cura- 
tive results. Isolation of person, and brushes, towels, etc., necessary to prevent 
infection. Fungus — T?'icophyton tonsurans (A). [Compare Tinea Cir- 
cinata.] 

Tongue. 

Potassium Chlorate, gr. v internally and 3J — ij ad Oj aquae locally ; in ulcers 
of tongue (Wa) ; also in rawness of tongue in advanced phthisis. Potassium 
Iodide, in syphilitic ulcers of tongue (D) ; and in hypertrophy (A). Potassium 
Bromide, 3j to ^vj water as wash, may soothe morbid sensibility of the tongue 
(A). Borax, Sodii Boratis gr. xl, Glycerini ^j, Aquae ^iv, as application in 
cracked tongue (Wa). Iodine, the tincture locally by a fine brush, or as a 
gargle with 7 or 10 parts of water and some honey, has given uniform success 
in malignant ulcers (Wa). Aurum, internally and locally, has cured hyper- 
trophy of the tongue with induration thereof in scrofulous subjects, also stru- 
mous ulceration of the tongue. Conium, is thought to act specifically with 
benefit in ulcer of the tongue (Wa). Cinnamon, the oil as a powerful stimulant 
in paralysis of tongue (P). Ginger, Cochlearia, Pyrethrum, as gargles. Cloves, 
Mezereon, Pepper, as masticatories, in paralysis (P). Fraenum, should be 
divided in tongue-tie ; use blunt-pointed scissors, directing the points down 
close to the jaw, so as to avoid wounding the ranine artery (D) ; better to cut 
as little as possible, and that directly backwards, as the artery of the fraenum 
may proceed from the sublingual (Holmes). [Compare Glossitis, Ranula.] 



Tonsillitis. 

Aconite, when accompanied by fever and elevated arterial tension, relieves 
greatly, gtt. ss-j of tincture every J^-hour or hour (B) ; every %-ho\n for 2 hours, 
then every hour, will almost certainly prove efficacious (R). Belladonna, of 
surprising efficacy, gtt. v of tinct. every 3 hours in !|ss aquae (P). Mercury, 
often speedily removes, Calomel, gr. ^, or Hydr. cum Creta, gr. ^ every 2 
hours ; not in chronic forms (B) ; gr. y z of Gray Powder every hour when 
tonsils almost meet, has marked effect ; the Oleate of Mercury and Morphine 
in obstinate and painful tonsillitis (R). Silver Nitrate, locally may abort, if 
applied early (R) ; the solid stick, once thoroughly applied in first stage, rarely 
fails to prevent suppuration (Howard). Guaiac, disagreeable, but very effec- 
tive (P) ; ^ss doses of tincture every 4 hours has remarkable power; should 
be given in emulsion with mucilage or yolk of an egg (B) ; makes an excellent 
gargle. [See page 538 for formula] : the tincture of Guaiac and glycerin, equal 
parts, in Z doses every hour or two, gives excellent results in acute tonsillitis. 
Opium, gr. v-x of Dover's powder at bedtime, is in many cases curative (Shoe- 
maker). Cocaine, in 10 per cent, solution, locally, at intervals of 15 minutes, 
removes pain at once and promotes resolution ; a very efficient application in 
5 or 10 per cent, solution, but causes temporary paralysis of palatal muscles, so 



794 TONSILS. 

that liquids regurgitate through nose (Bceckel) : a strong solution painted freely 
over the affected tonsil in cases which commence on one side of the fauces, 
will cut short the attack in most cases and prevent suppuration. Emetics, at 
the very onset of the disorder, will sometimes succeed in cutting it short (Sir 
Thos. Watson). Alum, dry or in solution (R). Potassium Iodide, locally, gr. 
j-v to the ^ , is useful (B). Potassium Chlorate, in grain doses every half-hour, 
very efficient (Smith). Capsicum, the dilute tincture in a gargle, or in powder 
applied on a swab, is useful in severe tonsillitis, especially in that accompanying 
scarlatina (W). Quinine, gr. x-xv will sometimes abort (B). Tannic Acid, is 
useful (P) ; as gargle. [See page 538.] Ice and wet pack, extremely grateful 
(B). Hydrogen Dioxide, the solution as gargle, is used with great benefit. Cold 
Wet Compress, around neck, covered with oiled silk and a dry bandage, ap- 
plied nightly, is very useful. Sodium Bicarbonate, locally by wetted finger to 
surface of tonsils every five minutes for ^-hour, then every hour during the 
same day, will prevent necessity for lancing (Lyon Medical). Incision of the 
tonsils gives immediate and marked relief in all cases especially those which 
are not amenable to ordinary treatment. 



Prescription 

R. Tinct. Aconiti, gss. 

Tinct. Guaiaci, 

Syr. Zingiberis, ... aa % ss. 

Syr. Simplicis, 25 ij. 



M. Sig. — 5 ss— ij every 2 hours, ac- 
cording to age. In severe cases, with high 
fever, bounding pulse, severe headache. 

{Shoemaker.) 



Tonsils, Enlarged. 

Ammonium Iodide, £ss m ^j f glycerin, applied every night by a camel's- 
hair brush, very efficacious (Wa). Baryta Iodide, in hypertrophy of the tonsils, 
effects a rapid diminution in their size, even when indurated for years (Hale). 
Liquor Ferri Chloridi, diluted, 3j-ij to the %, painted over tonsils twice daily, is 
one of the most effective astringents (Mackenzie). Aluminum Sulphate, a 
saturated solution applied daily by a brush, as a mild caustic (W). Ergot or 
Ergotin, by injections into tonsils (Meigs). Zinc Chloride, as caustic, the most 
efficient and least annoying method ; a saturated solution applied on a wire 
cotton-holder to each crypt and held there a few seconds; a few applications 
will shrink the gland in a week. Tannin, a strong solution touched daily to 
tonsils (H) ; a few sips of a saturated solution, ^ss in ^iij aquse, slowly sipped, 
will stop bleeding, if profuse (A) ; gr. xx to ^j aquae, hypodermically, as in 
nasal polypus. Silver Nitrate, touched daily to tonsils, will sometimes make 
them shrink (H). Catechu, a serviceable astringent gargle; the infusion ^vj 
with tincture of Kino 3ij, as gargle (Wa). Oxgall, locally, is praised (Wa) ; is 
of real utility (W). Citric Acid, rubbed daily to tonsils, is highly praised in 
enlargement thereof. Excision of a part of the tonsil (H) : Mackenzie's 
double guillotine removes both tonsils at once ; hemorrhage seldom happens, 
ice will generally check it (A). Surgical measures should receive unprejudiced 
consideration, as the medical treatment is tedious in the extreme. 



Tonsils, Ulcerated. 

Coptis, the infusion as a gargle (B). Sulphurous Acid, dilute, locally by 
spray, or a solution of Sodium Sulphite in water (3j - .f j) (B). Potassium Iodide, 
will arrest syphilitic ulcerations at once (B). Carbolic Acid, a 5 per cent, wash 
with Tincture of Myrrh, a good application by sponge to throat (Wa). Cimi- 
cifuga, a decoction of the root as a gargle (Wa). 



TORTICOLLIS TREMOR — TRICHINIASIS. 795 

Torticollis. 

Cimicifuga, has curative efficacy (P). Capsicum, a handful of the crushed 
pods infused for 36 hours in a pint of hot or cold water, and applied on lint 
covered with gutta-percha (R) ; gives striking results (Wa). Opium, as lini- 
ment with friction, or an opium plaster, is often serviceable (Wa). Potassium 
Bromide, in large doses, with Arsenic, may always be tried in the spasmodic 
form, which is sometimes one of the most obstinate complaints (Whitla). 
Gelsemium, some cases have been reported as cured by its hypodermic 
administration after tenotomy or myotomy had failed (Id) ; very large doses, 
n\jij of Wyeth's fluid extract thrice daily, increased until eight times this 
amount is taken, so as to produce very pronounced physiological symptoms, 
in spasmodic torticollis (Weir Mitchell). Surgical Treatment, by stretching or 
resection of a portion of the spinal accessory nerve, has succeeded sometimes 
in spasmodic torticollis, but it has also failed, and being so unsatisfactory 
should not be tried except as a last resort (Whitla). Electricity, galvanization 
of the affected muscles and faradization of the opposed ones, quickly 
relieves (B) ; has given excellent results in spasmodic torticollis, and if resorted 
to early may succeed, but must be persisted in for some time (Whitla). 



Tremor. 

Hyoscyamus, the tincture in full doses will palliate mercurial tremor; or 
Hyoscyamine, gr. -^ gradually increased to ^ (B). Hyoscine, is a useful 
drug in diseases in which tremor is a marked symptom, as disseminated 
sclerosis, delirium tremens, etc., having also the great advantage of being 
usually quite safe (W T eatherly). Coniine, will control excessive tremor in 
many instances. Gelsemium, in full doses may palliate excessive tremor ; a 
combination of Hyoscyamus, Conium and Gelsemium, the first to keep the 
brain quiet, the latter to quiet the nervous irritation at both the central and 
peripheral extremities (Lavers). Cocaine, influences alcoholic and senile tremor 
more favorably than any other remedy ; large doses and frequent adminis- 
tration are unnecessary (B). Veratrine, has been used successfully in alcoholic 
tremor and that of disseminated sclerosis, also in the trembling weakness 
of typhoid fever (Ferris). Calcium Salts, were given by me in one case of 
tremor at the beginning of general paralysis, resulting in its cessation for 
several months (Br). Arsenic, ttijj-iij of Fowler's solution, diluted with two 
parts of water and given hypodermically, was successful in several cases 
(Eulenberg). Phosphorus, in alcoholic and mercurial tremor (De Mussy). 
Silver Nitrate, gr. ^-iij daily, used in six cases of mercurial palsy with fairly 
rapid recovery (Sementini). Zinc Phosphide, is effective in the tremor of 
mercurial and arsenical poisoning (De Mussy); not so in the tremor of 
sclerosis (P). [Compare Chorea, Delirium tremens, Paralysis agitans ; 
also Brnntori 's Pharmacology, 3rd edition, page 133, for the Pathology of 
Tremor.] 



Trichiniasis. 

Benzol, in doses of nix, every hour or two, up to 3jss daily, followed by a 
brisk laxative, has been very successful in 27 cases, treated simultaneously 
(Putter). Purgatives, as Rhubarb and Senna, or an occasional dose of Calo- 
mel, to thoroughly evacuate the gastro-intestinal canal. Glycerin, in large 
doses, to destroy the worm by its hygroscopic qualities, has been recommended 
The indications, in the stage of invasion, are to relieve the pains, to secure 
sleep, to combat the fever, and to support the patient's strength ; there are no 
medicines which have any influence upon the embryos in their migration 
through the muscles (O). 



yg6 TRISMUS TUBERCULOUS affections. 



Trismus. 

Aconite (A), Atropine (R), hypodermically. Cannabis Indica, has been 
used successfully in trismus neonatorum (B). Opium, nv^ doses of Laudanum, 
with Castor Oil and warm bath, in trismus infantum. Ether, Chloral, Gelsem- 
ium, Physostigma (B). Treatment of any kind is seldom effectual (D) ; is 
never effective (El). Trismus Neonatorum, lock-jaw of the new-born infant, 
may be due to many causes ; one of which is bathing in very hot water. A 
midwife, whose hands could not distinguish the difference of temperature of 
the bath, sent me over ioo cases (Weber). 



Tuberculosis, Acute. 

Quinine, to subdue the fever, also Salicylic Acid for the same purpose, with 
repeated blistering over different parts of the chest and many dry cuppings of 
the lower limbs and the trunk morning and evening ; this, with wine and alco- 
hol, broths, jellies, milk and peptonized foods, is my plan of treatment for 
acute miliary tuberculosis, by which one case was absolutely cured (Jaccoud). 
Arsenic, appears to reduce the temperature gradually and is useful in many 
ways (R). Cold, to the surface of the abdomen, with ice sucked freely, the 
body sponged with iced vinegar and water, food and drinks to be iced, and 
even iced enemata sometimes ; with Quinine, gr. x-xxx once in 48 hours, or the 
pill of Quinine gr. j, Digitalis gr. ss, and Opium gr. }( , every 4 hours, fluid food 
every hour or half hour day and night, in acute miliary tuberculosis, may bring 
about a cure if energetically followed from the beginning (McCall Anderson). 
[Compare Phthisis.] 

Tuberculous Affections. 

Arsenic, children affected with tuberculosis involving the lungs, intestines 
and peritoneum, have steadily and slowly improved and finally recovered 
under Arsenic treatment (R). Salicylic Acid, Unna's strongest plaster, applied 
repeatedly for several days, to remove the horny covering in tuberculosis 
verrucosa cutis ; this will remove much, and the rest is destroyed by the 
fuming Acid Mercuric Nitrate, applied to a small portion of the growth at a 
time as it is painful (Crocker). Camphorated Naphtol, hypodermically in 
tuberculosis adenitis, tuberculosis of the testis and of the bladder, etc. (see 
ante, page 351). Potassium Cantharidinate, gr. ^^ to gr. 3^ hypodermically, 
produces an exudation of serum throughout the body, and may cause a con- 
centration at an affected spot of efficacious substances which would not ordin- 
arily find their way there, but it should not be employed when kidney disease 
exists (Liebrich). Hydrargyrum Thymol-aceticum, in solution injected into 
the glutei muscles every eight days, followed after a few injections by Potassium 
Iodide, gr. iij thrice daily by the mouth, as a cure for tuberculosis (Tranjen, 
Ewald). Zinc Chloride, in dilute solution, deeply injected into the tissues sur- 
rounding tubercular deposits, in order to induce a condition of sclerosis fatal to 
the growth or existence of the bacilli ; in tuberculosis of the epididymis and in 
spina ventosa a 1 in 20 solution ; for tuberculous disease of the joints, ribs and 
glands a 1 in 10 solution, of which 20 drops to be injected in a number of places 
around the periphery of the diseased part (Lannelongue). Iodoform, a 10 per 
cent, emulsion filled into the cavity after free opening and scraping, the cavity 
being then sewn up, gives excellent results in tuberculous abscesses (Billroth) ; 
a sterilized 10 per cent, emulsion made with glycerin or olive oil, injected every 
14 days or oftener into tuberculous joints and abscesses after thorough aspira- 
tion, also in tubercular empyema (Bruns) ; this may be well employed for all 
forms of local tuberculosis of soft parts, as the glands, testes and lungs (Tren- 
delenburg). Cod-liver Oil, is the remedy from which we can expect the most 
good in the tuberculous diathesis (Wa). Antitoxin, Paquin's serum has given 
good results in knee-joint tuberculosis (Cale) ; also in other forms (see ante, 



TUMORS TYMPANITES TYPHOID FEVER. Jgj 

page 154). Antiphthisin, is doing good service in cases of pure tuberculosis 
(see page 476). Tuberculin, as a diagnostic agent for latent tuberculosis (see 
page 475). [Compare Laryngitis, tubercular, Lupus, Meningitis, tuber- 
cular, Peritonitis, tubercular, Phthisis, Scrofulosis, Tabes mesen- 

TERICA.] 

Tumors. 

Mercuric Bromide, in l / z grain doses, has benefited abdominal tumors (Wa). 
Chloroform, in diagnosis of abdominal tumors when deep-seated, and when 
walls of the belly are hard and rigid ; also in phantom tumors (R). Pepsin, 
hypodermically, to dissolve them. Hyoscyamus, the leaves as cataplasm or 
fomentations to painful tumors, afford great relief (Wa). Iron, the Liquor 
Ferri Chloridi is found to be valuable as a curative application to fungous or 
hemorrhoidal tumors (Wa). Galbanum, as plaster to indolent, non-malignant 
tumors, to diminish or cause their absorption (Wa). Electrolysis, is employed 
with more or less benefit in sebaceous, lipoma, bronchocele, enlarged glands, 
etc. (Wa) : Apostoli's method is now generally adopted for the dispersion of 
fibroid tumors ; it will dissipate pain, improve nutrition, and diminish size 
without danger to life (Bigelow) ; the treatment of fibroid tumors by the gal- 
vanic current has of late been universally recognized by the profession 
(Massey) ; solid tumors, as goitre, enlarged glands and similar growths have 
been repeatedly cured by electrolysis (B). [Compare Cancer, Cysts, Gland- 
ular enlargement, Goitre, Polypus, Uterine tumors, Wen.] 

Tympanites. 

Turpentine, often greatly benefits (P,Wa) ; gj every 6 hours in tympanites of 
typhoid, with prostration but without diarrhoea (R). Asafcetida, in hysterical 
tympanites, internally or as enema, beneficial (P) ; also in that of fever (Wa). 
Capsicum, gr. ss-ij, every 4 hours (P). Cocculus Indicus, a few doses of tinc- 
ture will often succeed in the tympanites of peritonitis and enteric fever (P). 
Ginger, with drastic purgatives (P). Aspiration, in extreme cases and as a last 
resort. [Compare Typhoid Fever, Peritonitis.] 



Typhlitis. 

Opium, of undoubted curative power (B). Purgatives, are inadmissible ; 
Epsom salt may be used, but no drastics (B). Leeches, should never be 
omitted when tenderness and fever begin (B). Ice-bag, over the swelling (B). 

Typhoid Fever. 

Guaiacol Carbonate, in two daily doses of 25 to 30 grains, is highly efficient, 
sixty cases treated thereby with no deaths ; is non-poisonous, but does not affect 
the temperature, hence antipyretics may be required (Hoelscher) ; is the princi- 
pal ingredient in the Woodbridge abortive treatment , which also includes Menthol, 
Thymol, Eucalyptol, Calomel and Podophyllum in combination [see formulae 
below], and aims at aborting the disease by intestinal antisepsis and elimina- 
tion ; Dr. Woodbridge and others report extraordinary success with this method. 
Guaiacol, 10 to 15 drops of pure Guaiacol painted over the skin of parts where 
it is readily absorbed, is very efficient in reducing temperature when exceeding 
102 (Montagnon). Carbolic Acid, Z] with tincture of Iodine 3ij, of which mix- 
ture 1 to 3 drops every two or three hours, is a very good plan of treatment 
(Da C) : all typhoid cases during the past year were treated with a mixture of 
Carbolic Acid and Chloroform, without the loss of a single case, by Dr. Quill 
of the Indian Army [see page 79]. Chloroform, the spirit in mixture with Car- 
bolic Acid (as above) ; a l / z per cent, solution of Chloroform will kill the bacillus 



?g8 TYPHOID FEVER. 

of enteric fever (Werner). Copper Arsenite, in divided daily doses of gr. y^, 
commenced early and continuously used, will maintain a moderately low tem- 
perature, a good pulse rate, comparative freedom from great abdominal pain 
and tympanites, and will lessen materially the number of stools, while it greatly 
improves their character and consistence (Aulde) ; used in 90 cases with but 
one death ; leaves an A excellent condition of the alimentary tract after the fever 
is over (Thomas). Salol is of great value as an intestinal disinfectant, promot- 
ing healing and preventing reinfection. Salophen has proven equally efficient. 

Nitro-hydrochloric Acid, is to be preferred overall other plans of treatment, 
20-drop doses in simple elixir ; Sulphuric is useful for intestinal hemorrhage 
(Da C). Mineral Acids, are very useful generally, especially HO acid (Wa). 
Thymol may also be employed, in doses of gr. ss-ij in solution (Da C). 
Sulphurous Acid, is highly praised by Dewar, and has real antidotal power ; 
TTLijss-xx every 4 hours according to age, continued for a week or ten days, 
until the patient's complaints show him to be saturated ; if diarrhoea be present, 
add Sulphuric Acid and Opium (Wilks). [See formulae below.] Cinnamon, 
the Oil is efficiently used to abort the disease (see ante, page 243). Potassium 
Bromide, is as much a specific for typhoid fever as Quinine Sulphate is for 
ague, aborting the fever in 8 or 10 days (Hawkins). Arnica is highly extolled ; 
its " picture" shows definite powers in this disease (P) ; small doses in asthenic 
conditions (B) ; when vital powers are greatly depressed (Wa). Baptisia is 
very useful in the early stage (W). Turpentine, invaluable when hemorrhage 
and extreme tympanites (P, R) : rr^xxx-lx in Starch mucilage, rt^x of Tinct. 
Opii (P) ; Tr^v-x frequently for hemorrhage or n\,x every 2 hours in advanced 
stage, with dry tongue (R) ; when coma, stupor, etc. ; often arouses the vital 
powers (Wa) ; rr^vij with gr. ■£% of Morphine ; of especial value when marked 
fever and congested lungs, as well as for the tympany (Da C). Chloral, is the 
best drug for nervous symptoms, but must not be used when the heart is weak 
(Da C). Opium, small doses at night, for insomnia with delirium ; also as in- 
jection for the diarrhoea (R) ; in one case when vital powers seemed hopelessly 
depressed, gr. }i caused improvement (Wa) ; for spreading tenderness (peri- 
tonitis), give 10-minim doses of the deodorized tincture, also gr.j in suppository 
every four hours (Da C). Belladonna, when contracted pupils, low, muttering 
delirium (B) ; is thought to counteract the poison of typhoid (Wa). Mercury, 
Corrosive Sublimate gr-Yijo every 2 or 3 hours for the diarrhoea; Calomel in 
small doses at onset (R), gr. x in one dose the first day, gr. iij per diem for 3 
or 4 days, the German " specific treatment" (B). Bismuth, gr. x-xxv of the 
Subnitrate with gr. y 2 -] of Opium every 3 hours for the severe diarrhoea (Da C). 
Ergotin, gr. ij-vj hypodermically, or 3j of the fluid extract of Ergot, for in- 
testinal hemorrhage (Da C). Tartar Emetic, with Opium, when wakefulness 
and delirium ; minute doses, gr. -^, frequently, are of great service (B) ; 
Antimony cuts the disease short with such certainty that it is almost doubtful 
whether the lesion of typhoid is specific or is not rather incidental or ad- 
ventitious (Lawrie) ; should be given with cardiac tonics. Digitalis, of value 
in many cases as a sustainer of heart power, but may be dangerous in the 
later stages (Anstie, Murrell) ; used by the Germans when there is no cardiac 
weakness ; gr. x-xx as antipyretic, over a period of 36 hours (P). Quinine, 
may have efficacy in typho-malarial fever, is less effective as the typhoid 
element predominates, useless in purely continued fevers (B) ; is justly 
abandoned, but may be used to maintain the circulation, in tonic doses, gr. 
vj-x in the 24 hours (Da C). 

Antipyrin, Phenacetin, Acetanilid, are extensively used as antipyretics ; 
for the dangers depending on the extensive employment of the latter drug see 
ante, page 68. Phenocoll Hydrochloride as an antipyretic, is used with marked 
success. Veratrum Viride, to reduce temperature (R) ; for delirium ferox (B) ; 
strongly recommended (Wa) ; its efficacy difficult to believe (S). Serpentaria, 
useful when much depression exists, cautiously, if intestines at all irritable 
(B). Hydrastine, when copious sweats (P). Lead Acetate, with Opium, for 
the purging (R) ; also Alum (R). Lime-water, as an astringent and antacid, 
is efficient. Ergot, for intestinal hemorrhage, hypodermically, if symptoms 



TYPHOID FEVER. 



799 



urgent (R). Sodium Chloride, should not be withdrawn from the food (Wa). 
Aromatic Spirit of Ammonia, for great accumulation of mucus in the throat 
(Da C). Copper Sulphate, gr. y 1 ^, with Opium, gr. }{, for the diarrhoea (Da C). 
Strychnine, is the remedy for the functional palsies (Da C). Purgatives, only 
the very mildest, and they with the greatest caution (Wa). Medicine, will 
never abort a case of true typhoid, its natural duration is from 28 to 30 days 
(Sir Wm. Jenner). Typhoid Antitoxin, has been used in a few cases, apparently 
with good results (see page 156). Cold Baths, when the temperature rises 
above 102 , a most important agent (B) ; in mild cases, cold wet compresses or 
wet sheets, or washing with cold water ; in severe cases, affusion, shower, or 
general cold bath, 50 to 55 F., or better 95 cooled gradually to 6o° (R) ; this, 
the Brand (more justly Currie's) method, increases the flow of urine and its 
toxicity, restoring the latter to normal and sometimes to double the normal, 
thereby clearing the system of a large quantity of toxins (Ausset). Stimulants, 
freely, with Quinine, for pysemic cases, showing joint complications (see under 
Synovitis). ~ Aliment, by Milk alone, or alcohol with milk, eggs, broth (B) ; 
Coffee, a better stimulant than alcohol (P) ; Alcohol is needed to sustain the 
heart's action (Da C) ; Milk must be used with great caution ; if the curd be un- 
digested great evils arise ; give essence of meat alone (Sir Wm. Jenner) : 
avoid the extremes; an absolute milk diet required if intestinal symptoms are 
grave ; no solid food until health is restored fully ; a scalded-milk diet exclu- 
sively may be depended on. Adjuvants, water, especially the abdominal 
compress, cleanliness, ventilation, absolute rest and quiet. Discharges should 
be received in vessels containing Carbolic Acid or a solution of Corrosive 
Sublimate, and buried instantly. [Compare Hemorrhage intestinal, Rec- 
tal ULCERATION, TYMPANITES.] 



Prescriptions. 



R. Resin. Podophylli, . . . gr. -§\^. 

Hydrarg. Chloridi Mitis, 

Guaiacoli Carbonatis, 

Mentholi, aa gr. T ^. 

Eucalyptoli, . . . . q. s. 

Ft. tabella no. j. Sig.i — One or more of 

these tablets every ^ hour during the first 

3 days, to secure 5 or 6 free evacuations 

daily. ( Woodb ridge A T o. /.) 

R. Resin. Podophylli, • . . gr. ^^. 

Hydrarg. Chloridi Mitis, 

Mentholi, 

Thymoli, aa gr. y L. 

Guaiacoli Carbonat., . . . gr. ^. 

Eucalyptoli, q. s. 

Ft. tabella no. j. Sig. — One tablet every 
hour or two, after third or fourth day, re- 
duced so as to gradually lessen frequency 
of evacuations, until the temp, is normal. 
(Woodb ridge No. 2.) 



R . Mentholi, ....... gr. ss. 

Thymoli, gr. j. 

Eucalyptoli, Tr\,v. 

Guaiacoli Carbonat., . . . gr. iij. 
Ft. capsula no. j. Sig. — One capsule 
every 3 or 4 hours, alternating with the 
tablets, after the fourth or fifth day of treat- 
ment. All the medicines to be washed 
down with large draughts of distilled or 
sterilized water. ( Woodbridge No. j>.) 



R . Tinct. Iodi, 

Acidi Carbolici, .... aa p. aeq. 
M. Sig. — gtt. j-ij every 4 or 6 hours. 
In typho-malarial fever, and in typhoid. 



R 



M 



4 hours. 



R 



Acidi Sulphurosi, 

Acidi Sulphurici Dil., aa gij. 

Tinct. OpiiDeodor., . . . ir^xx. 

Syr. Aurantii, £ n j- 

Aquae, ... . q. s.ad^v]. 
Sig-. — One-sixth to be taken every 



( Wilks. 



Acidi Sulphurosi, .... tr^xv. 

Syr. Aurantii, ziij. 

Aquse, q. s. ad§). 

M. Sig. — For infants, one-sixth every 
four hours. ( Wilks.) 



R. Ant. et Potassii Tartrat., . gr. j-ij. 

Morphinae Sulphat., . . . gr. ss. 

Aquae Laurocerasi, . . . Jjj. 

M. Sig. — A teasp. every two, three 
or four hours. 



R 



gr. 



Quininae Sulphatis, . . 
Acidi Hydrochlor. Dil., 
Vel Ac. Sulphurici Dil., 
Syr. Aurantii, .... 
Aquae Carui, . . q. s. 
M. Sig. — A tablesp. in an equal quan- 
tity of water, every three or four hours. 

[Murchison.) 



Is 

ad ^ vj. 



800 TYPHUS FEVER ULCERS AND SORES 



Typhus Fever. 

Phenacetin, is extensively used for the pyrexia. Baptisia, is said to have 
proved very useful (W). Belladonna, to cleanse and moisten the tongue ; 
controls the delirium, slows and strengthens the pulse, reduces the tempera- 
ture, shortens course of disease (R, P) ; in the early stages, relieves severity 
of symptoms (P) ; give when contracted pupils (Wa). Arnica, very highly ex- 
tolled (P, Wa). Hyoscyamus, for mild brain symptoms (P). Opium, fulfils 
many important indications ; never give when pupils are contracted (Wa). 
Mineral Acids, their use recommended in all countries (Wa). Tartar Emetic, 
with Opium in the delirium with insomnia (R). [See Typhoid.] Chloral, to 
produce sleep, and allay violent delirium (R, Wa) ; its use has often been 
followed by amelioration of the symptoms (Wa). Antipyrin or Quinine, as 
antipyretics, it being more necessary than in typhoid to keep the temperature 
within safe limits (B). Podophyllin, gr. x /b-% as mild laxative at onset, when 
constipation, congestive headache, biliary derangement (P). Digitalis, in 
large doses, a favorite remedy in Germany (P). Rhatany, as tonic, in ad- 
vanced stages (P). Serpentaria, in low stages, delirium, watchfulness, tongue 
dry and brown, or black ; combine with Ammonium Sesquicarbonate (P) ; is 
given occasionally to excite diaphoresis, and support the vital powers (Wa). 
Camphor, a remedy of considerable value, but contraindicated when flesh-red 
tongue, tender abdomen, diarrhoea (Wa). Purgatives [see under Typhoid 
Fever]. Coffee, better than alcohol for the adynamia (P). Stimulants, are not 
needed under the use of mineral acids and a supporting diet, in many cases 
(Wa) ; are needed sooner than in typhoid, as the adynamia is more profound 
and appears sooner (B). Diet, nutritious persistently, beef-tea, egg-riog, nutri- 
ent enemata. Isolation, imperative, as the disease is eminently contagious 
(B). [Compare Delirium, Typhoid Fever.] 

Ulcers and Sores. 

Arsenic, improves rodent ulcer (B). Belladonna, has a remarkable influ- 
ence over various ulcerative processes (P). Chloral, as lotion for sluggish sores, 
5 to 20 grains to the 5 of water (Keyes) ; is highly efficient in ulcerated sore 
throat or ulceration from any cause (Brodnax). Mercury, Calomel finely levi- 
gated and dusted on, is highly efficient in ulcer of the conjunctiva; Calomel 
Ointment or Black Wash in scrofulous or tuberculous lupus, and in open scrofu- 
lous sores (R) ; Corrosive Sublimate, in 1 per cent, solution, as application to 
syphilitic ulcers (Fox) ; the Ung. Hydrarg. Nitratis, for serpiginous ulcerations 
diluted one-half, or the Iodide, gr. xx-xl to the 3 of vaselin, in syphilitic ulcer- 
ations (Keyes). Lime, as the Carbonate or Lime-water to check discharge; the 
Sulphide when thin ichorous discharge ; the Phosphate has influence on scrofu- 
lous sores (R). Phytolacca, as a local application (B). Hamamelis, employed 
with satisfaction in varicose ulcers (Pf ). Opium or Morphine, with glycerin, 
as an application to relieve pain (R) ; gr. j-ij, daily, also locally, has a decid- 
edly curative value in phagedenic and indolent ulcers ; not so useful in so- 
called irritable ulcers (Pf, P). Ichthyol, pure as oint. or with Lanolin, has done 
excellent service in ulcers of the leg. Thiol, the dry form, as dusting powder, 
has been of great benefit. Piperazin, in 1 per cent, solution, locally to gouty 
sores, relieves the pain and reduces the inflammation. Resorcin, in strong or 
supersaturated solution, locally applied to tuberculous and other ulcerations of 
the larynx, is efficient and painless (Tymowski). Tannin, or Glycerite of Tan- 
nin, to coat over wounds, or discharging sores (R). Potassium Chlorate, in so- 
lution as a wash to clean and stimulate foul ulcers (R) ; in impalpable powder, 
a better application than Iodoform (B). Cinchona, powdered Bark dusted over 
foul, indolent, sloughing, and gangrenous ulcers, promotes healing (R). Conium, 
locally, by means of a poultice, will ease pain and improve the sore (R). 
Chlorine, in solution as a wash for sloughing and indolent sores (R) ; the gas as 
a local stimulant to promote healing in old ulcers, is highly efficient (for the 



ULCERS AND SORES. 



801 



method of application see page 233). Iodide of Starch, cold, as a poultice (R). 
Acetanilid, in fine powder, dusted on, is an excellent application to ulcers and 
sores, mucous patches and ulcers of the rectum (see page 69). Lead, the solu- 
ble salts of lead as lotions to unhealthy over-secreting sores (R). Pyrogallic 
Acid, is an excellent application to venereal ulcers (Vidal). Nitric Acid, as 
escharotic, applied with a glass rod, Oil to protect the surrounding tissues ; ar- 
rest by alkaline wash ; ^j to Oj is a good acid lotion for washing (B) ; the lotion 
for indolent and painful ulcers (R). Hydrastis, internally and externally, em- 
ployed with excellent results in rodent ulcer, and ulcers of legs, rectum, and 
uterus (R). Sanguinaria, locally, to repress fungous granulations of indolent 
ulcers, 1 part to 80 of glycerin (P). Carbolic Acid, and Salicylic, locally (B) ; 
the Glycerite of Carbolic Acid a good application to fetid sores (R). Balsams 
of Peru and Tolu; excellent (P). Camphor, dusted over indolent sores (R). 
Charcoal, locally to sloughing sores (R). Alcohol, locally to cover sores with 
thin protecting layer of coagulated albumen (R). Alum, dry or in solution, 
applied to relaxed and abundantly-secreting sores (R). Turpentine, internally 
for ulceration of bowels (P). Collodion, as protective covering (P). Capsicum, 
a weak solution useful as a stimulant in scrofulous or fistulous sores (P). Savine, 
as acrid (not chemical) caustic (P). Potassa Fusa, or the milder Vienna 
paste, as escharotic ; to arrest its action a dilute acid (B). Zinc Chloride, the 
most efficient escharotic consistent with safety (B). Zinc Sulphate, dried, 
dusted over sores (R). Iodoform, dusted over surface (B) ; prevents granulation 
in all ulcers, and does no good except to relieve pain (Gross). Aristol, is 
highly praised ; an excellent substitute for Iodoform, being quite as efficient, 
and odorless ; has given excellent results in treatment of indolent soft ulcers, 
syphilitic ulcerative processes, etc. Silver Nitrate, as caustic, quickly rubbed 
over surface (B) ; applied to unhealthy ulcers, also ulcers of the mouth (R). 
Copper Sulphate, to indolent ulcers : touch with a crystal, or frequently apply 
a solution, gr. ij-x to the ^ (R). Coptis, the infusion has high reputation (B). 
Chimaphila, Copaiba, Catechu, Myrrh, Rhatany, Rhubarb, Storax, Benzoin, Tar- 
water,locally, are useful (P). Oxygen, to atonic, painful ulcers (R); locally applied 
to ulcers (see page 372) is highly efficient (Stoker). Nuclein, locally applied, 
cured an ulcer of 20 years' standing in 4 months (Vaughn).. Aurum, locally 
and internally, is highly recommended in scrofulous ulceration. Galvanic 
Couplet (see under Bedsores). Yeast, as a poultice (R) ; its action probably 
due to the Nuclein contained in it. Section of exposed nerve-filament, in irri- 
table ulcer, by bistoury passed beneath the sore (Hilton). Cod-liver Oil, espe- 
cially for ulcerations of the glands, or indolent ulcers with excoriated edges, 
lupus, etc. Water, is sufficient as dressing in the majority of cases. Rest and 
support of great value ; cleanliness, bandaging and recumbent position in ulcer 
of legs, facilitate recovery ; also daily washing to restore the lost vitality of 
parts; elastic stockings, and the Esmarch bandage in chronic cases. [Com- 
pare Chancre, Chancroid, Bedsores, Throat, Gastric, Intestinal, and 
Uterine Ulceration, Syphilis.] 



Prescriptions . 



R . Iodoformi, ^ij. 

Mucil. Acacia;, rrixv. 

01. Mentha? Pip, .... rrijj. 

Glycerini, Tt\xx. 

M. Sig. — For unhealthy ulcers. 

(Bronson. ) 



R. Emplas. Plumbi, . . . . 5ij. 
Ung. Hydrargyria . . . . 5SS. 

Olei Cadini, 3 ij. 

M. Sig. — Spread on linen, and apply to 
inflamed patches on palms from syphilis. 

(Bumstead and Taylor.) 

51 



R. 



Cor. 



Hydrarg. Chlor. Lor., . . gr. xv. 
Acidi Carbolici, .... Ti\xx. 
Aquas, . . . . q. s. ad ^iv. 
M. Sig. — For syphilitic ulcers, pack on 
cotton, and renew daily. (Box. ) 



R. Ung. Petrolei, gij. 

Ung. Hydrargyri, . . . . ^iv. 

Olei Cadini, gij. 

M. Sig. — Apply after removing scales 
to chronic palmar and plantar lesions. 

[Bumstead and Taylor.) 



802 URAEMIA URETHRAL STRICTURE URETHRITIS. 



Uraemia. 

Pilocarpine, as an active diaphoretic, on the first appearance of uraemic 
symptoms (headache, drowsiness, convulsions), and free purgation by salines 
or Elaterium (Y) ; a weak or fatty heart is a positive contraindication for this 
drug (B) ; it must not be used if oedema of the lungs exists, as further oedema 
and death will result (Whitla). Digitalis, the infusion internally, or a poultice 
of the leaves to the back and abdomen, to procure free action of the lddneys 
(B). Morphine, hypodermically, is most efficient (Loomis, Scanzoni); in acute 
not in chronic uraemia (Pf ) ; is of remarkable value in uraemic convulsions (B). 
Oxygen, by inhalation, 10 litres thrice daily, is used with success (Jaccoud) ; is 
as useful in practice as it is rational in theory (Carter) ; used with remarkable 
success in a very bad case of uraemic coma (Macalister). Sodium Benzoate, 
15 grains 4 times daily, has been found very serviceable in threatening uraemia 
(Whitla). Sodium Bromide with Chloral, in full doses, by the bowel, for 
uraemic convulsions (Id). Potassium Salts given in Bright's Disease increase 
the danger of uraemia, hence Sodium salts are preferred (Id). Naphtalin, also 
Iodoform and Charcoal, as intestinal disinfectants, as much of the toxic material 
in the blood has been reabsorbed from the bowel (Bouchard). Amyl Nitrite or 
Nitroglycerin, and brisk purgation, to relieve the dyspnoea. Ether, in doses of £j 
for the dyspnoea. Saline or Hydragogue Cathartics, are of great importance to se- 
cure elimination by the intestinal canal and to relieve the blood-pressure (B); pur- 
gation by salines on the first appearance of uraemic symptoms (Y). Colchicum, 
is an excellent derivative in these cases and acts best when combined with 
other purgatives (B). Elaterium, gr. y 1 ^ to \, to procure free watery evacua- 
tions, — cautiously ! (B) ; the compound powder of Elaterin, gr. \ to iij, may be 
thrown on the tongue and washed down with a teaspoonful or two of water (Y). 
Transfusion, in uraemic convulsions (B). Hot Pack or vapor-bath, to induce 
powerful diaphoresis (B) ; the hot wet-pack or hot air bath, may be given daily 
or oftener when uraemia is threatening. Milk is the only admissible food. 
Venesection, 10 to 20 ounces of blood from the arm gives striking relief in acute 
forms of uraemia in the robust (Y) ; leeches to the temples for the headache 
(Id). [Compare Coma, Convulsions, Bright's Disease, Scarlet Fever, 
and the Lists of Diaphoretics and Diuretics on pages 52 and 54.] 



Urethral Stricture. 

Aconite, is of great service in spasmodic stricture (P). Cocaine, locally by 
catheter (Smith). Buchu, in irritable urethra, spasmodic stricture, and gleet 
(P). Opium, in full dose or an opiate suppository, with fomentations and a 
warm bath, will often suffice in spasmodic stricture (CI). Catheterization, under 
an anaesthetic in spasmodic stricture if other measures fail to relieve ; also for 
gradual dilatation in organic stricture, the safest and most generally applicable 
treatment (CI). Oil, injected before dilatation (Wa). Thorough Division, by a 
dilating urethrotome the best operation for a radical cure ; 600 cases thus 
treated without a death or permanent disability (Otis). Electricity, a weak 
galvanic current, with negative pole to the stricture, will destroy it in 2 or 3 
sittings by electrolysis, and if carefully done, is the most efficient and least 
painful method of treatment for radical cure. 



Urethritis. 

Aconite, is used to advantage in urethral fever ; also for prevention of chill 
after passage of sound (Pf, W). Strophantus, efficient in preventing rigors 
after instrumentation on the urethra, the tincture in doses of 5 minims (Fen- 
wick). Silver Nitrate, locally, very efficient in chronic urethritis in females 
(W). Tannin, on bougies, once a week for 15 minutes, most efficient for 



URINARY DISORDERS. 



803 



urethritis in the female (Wa). Zinc Sulphate, cast in sticks, for introduction 
into the urethra (Wa). Myrtol, internally, in chronic inflammation of the bladder 
and urethra (Br). Potassium Bicarbonate, with Potassium Acetate, aa gr. x in 
a large cup of flaxseed tea or a glass of Vichy water, every 4 to 6 hours ; with 
absolute rest in bed, a calomel purge, and urination under hot water, sufficient 
for most cases of urethritis, which may arise from lithiasis, leucorrhcea in fe- 
males, etc. ; many cases of aborted gonorrhoea (so-called) were really simple 
urethritis (Otis). [Compare Gonorrhoea.] 



Urinary Disorders. 

Aconite, of great service in sub-inflammatory retention from chill (P). Tur- 
pentine, in hematuria and chronic catarrh of the bladder, incontinence from 
atony, etc. (B). Strychnine, sometimes employed with marked benefit in 
retention or incontinence of the old (P). Cantharis, frequent or involuntary 
micturition, especially when coughing, in women from weakness of sphincter ; 
one or two drop doses (R). Cannabis Indica, in retention from spinal dis- 
eases (R). Diuretin, a remarkably efficient diuretic in cardiac and renal 
dropsy, 15 grains several times daily will increase the urine three and fourfold. 
Digitalis, holds high rank as a diuretic, Z] °r ij of the infusion night and morn- 
ing, or oftener if necessary ; in sudden suppression from cold or damp, or after 
scarlatina if danger threatens (P). Benzoic Acid, or Sodium Benzoate, in 10 
to 15-grain doses, to render alkaline urine acid, and check the formation of 
phosphates (B) ; this acid and its salts are the only certain means we possess 
by which to neutralize morbid alkalinity of the urine (see page 184). Salol, is 
quicker in its action on the urine than Ammonium Benzoate (see page 53). 
Nitro-hydrochloric Acid, dilute, gtt. x-xv thrice daily in water, for phosphatic 
deposits (Mears). Ammonium Carbonate, in 6-grain doses, 3 or 4 times a day, 
to make acid urine alkaline. Triticum, a favorite remedy with Sir Henry 
Thompson, in pint doses daily of its infusion or decoction (^ij-iv ad Oj), for 
strangury, cystitis, and many other complaints, connected with the urinary ap- 
paratus. Alkalies, to neutralize acid urine, and control chronic cystitis ; the 
Liquor Potassse preferable to the bicarbonates, tartrates, and citrates, which 
all have diuretic action and increase the frequency of micturition ; Liquor 
Potassse mixed with the tinctures of Hyoscyamus or Belladonna, may undergo 
chemical changes, but the combination materially controls painful and frequent 
micturition in bladder troubles (Thompson). Buchu, renders more help than 
any drug known in incontinence or retention from catarrh of bladder implicat- 
ing the ureters, and even the kidneys (P). Water, copious injections are bene- 
ficial in some cases of suppression (R). [Compare the Lists of Diuretics and 
other agents acting on the urine, on pages 52 et seq. also the articles entitled 
Bladder irritable, Bladder paralysis of, Chyluria, Cystitis, Dia- 
betes insipidus, Dysuria, Dropsy, Enuresis, Hematuria, Lithiasis, 
Nephritis, Oxaluria, Uraemia, Urethral Stricture.] 



Prescriptions. 



Pulv. Scillae, 

Pulv. Digitalis, 

Hydrarg. Chlor. Mitis, aa gr. xij. 



M. ft. pil. no. xij. 
diuretic twice daily. 



Si 



. — One pill as a 
{Sir A. Clark.) 



Be . Potassii Citratis, ,^j. 

Sodii Bicarbonat., . . . . 3 v. 

Syr. Limonis, ^j. 

Aquae, . . . . . q. s. ad !|iv. 
M. Sig. — A teasp. every 2 hours, to 
render the urine alkaline. {Roberts.) 



R . Tinct. Digitalis, .... 3 ss-j. 
Spt. ^Etheris Nitrosi, . . giij. 
Liq. Ammon. Acetat., . . ^ ss. 

Aquae, q. s. ad ^vj. 

M. Sig. — One-sixth every 3 hours, to 
re-establish the renal secretion. 

(Goodeve.) 

R • Potassii Bicarb. , .... 3 iijss. 

Acidi Acetici, zvj. 

Aquae, ^iij. 

M. Sig. — Teasp. doses as required, as 
a diuretic. Each dose contains about gr. 
x of Potassium Acetate. 



804 



URTICARIA UTERINE AFFECTIONS — CANCER. 



R . Acidi Benzoici, . . . 

Sodii Boratis, 

Aquae, 

M. Sig. — A teasp. in 
daily, to keep urine acid. 



• • 3 X1 J- . 
water, thrice 
(Emmett.) 



R. Ext. Belladon. Fl., . . . gss-j. 
Ext. Buchu FL, .... %]. 

Spt. .Etheris Nitrosi, . . ^ij. 
M. Sig. — A teasp. 3 or 4 times daily, 
for dysuria in women. 



Urticaria. 

Antipyrin, internally, is promptly efficient in urticaria, also in the urticaria- 
like eruptions of children. Chloroform, as ointment to allay itching (R). 
Potassium Cyanide, or Hydrocyanic Acid (R). [See Prurigo.] Nitric Acid, 
as dilute wash, controls itching and prevents wheals (R). Benzoin, the com- 
pound tincture painted on the skin for itching (R). Sodium Salicylate, gr. ij 
every % hour, is remarkably efficient (Smith) ; gr. xx thrice daily is effective. 
Copaiba, in full doses will produce urticaria, but drop-doses every y z hour will 
sometimes control it (Smith). Strychnine, with emetics and purgatives, when 
the affection is chronic (Guibout). Colchium, in gouty persons (R). Lead, in 
lotions to ease itching (R). Alkalies (R). [See Prurigo.] Warm Baths, 
may be employed with benefit. 

Prescriptions . 



R. Acidi Benzoici, gr. viij. 

Aquae, £iv. 

M. Sig. — Lotion for urticaria. 

{Squire. 



R . Atropine Sulphat. , . . . gr. l /e. 
Aq. Destil., Glycerini, . aa^ss. 
Pulv. Tragacanthae, . . . q.s. 



Ft. pil. no. 



Sig. One bis die. 



Uterine Affections. 

Cimicifuga, to prevent miscarriage in irritable uterus and prolapsus (R) ; 
promises to be a valuable remedy in uterine affections (Wa) ; is remarkably 
efficient in neuralgia and sympathetic pains arising from an irritable uterus, no 
matter what their precise character (P). Belladonna, with Tannin, as supposi- 
tory in uterine neuralgia (R) ; as vaginal or rectal injections, in neuralgic or 
inflammatory pains (Tr). Arsenic, in irritable uterus, of decided benefit ; gr. 
-£$ ter die, after meals (Wa). Carbonic Acid, injected up the vagina for neu- 
ralgia of the uterus (R). Opium, with Starch as injection into the rectum, will 
subdue the pain of uterine diseases (R) ; gives more speedy relief than any 
other remedy in irritable uterus, but long-continued is one of the worst (Wa). 
Iodized Phenol, has proved the most generally efficient agent for intra-uterine 
use during eight years' experience, applied by hard rubber probes wound with 
cotton-wool ; it removes cervical mucus, gives freedom from pain, softens and 
dilates the cervix, heals abrasions, removes induration and villosities, regulates 
the menses, improves appetite and digestion, acts as a general alterative, over- 
comes barrenness, etc., if used long enough, but rapid results are not attainable 
by any method of treatment (Battey). Lead, as plaster, for pain in the back 
due to uterine disease (R). Chloroform, spray, in uterine neuralgia (R). Aqua- 
puncture, has had extraordinary success in uterine colic (B). Baths of warm 
salt water remarkably useful in nervous or inflammatory hysteralgia (Tr). [See 
Abortion, Amenorrhea, Climacteric, Dysmenorrhcea, Endometritis, 
Hemorrhage post-partum, Leucorrhcea, Menorrhagia, Menstrual 
Disorders, Metritis, Metrorrhagia, Prolapsus uteri, etc.] 



Uterine Cancer. 

Conium, useful as a palliative, 3iij-iv ad Oj aquae, as injection for the ex- 
treme pain of uterine cancer (Wa). Arsenic, small doses for a long time, with 
a strong solution of Iodine and Glycerin locally (Atlee); is believed to retard 
the growth of uterine cancer (Br). Carbonic Acid, injected vaginally, to relieve 
the pain (R). Opium, stands first in the list of palliatives, quieting irritation, 
allaying pain (Wa). Morphine, the specific action thereof upon the uterine 
circulation should be utilized in hopeless cases of this disease (Lutaud). [See 



UTERINE CONGESTION AND HYPERTROPHY 



805 



page 367.] Carbolic Acid, a weak solution as injection, an excellent cleanser, 
healer, disinfector and allayer of pain (R). Bromine, the best escharotic for 
destruction of the mass (E). Glycerite of Tannin, checks discharge and stench ; 
is still better if mixed with Glycerite of Carbolic Acid (R). Iodoform, with 
cocoa-fat as bolus inserted into excavation produced by cancer (R) ; gr. v-x in 
each bolus (W). Iodine, the saturated tincture thoroughly applied to the 
entire surface of the mass, is frequently of great use in checking hemorrhage, 
and seems to temporarily check the extension of the disease (E). Chloral, as 
anodyne, will agree with most persons (E) ; relieves the pains (W). Chloro- 
form Spray, for some minutes (R). Cannabis Indica, to allay the pain (W). 
Thyroid Extract, used internally with apparent curative results in three cases 
of carcinoma of the cervix (Bell). Surgical Measures, are to be advised, as 
medicines can only serve as palliatives. 



Uterine Congestion and Hypertrophy. 

Aurum Salts, often beneficial in chronic metritis with scanty menstruation 
(B). Ergotin, long continued, successful in chronic metritis ; lessens con- 
gestion (B) ; long continued has produced remarkable results in fibroids and 
polypi and chronic metritis, large, spongy, subinvoluted uterus (P) ; by inter- 
stitial injection into the cervix, has been of great benefit (G). Carbolic Acid, 
undiluted, on cotton-wrapped probe, no better treatment for uterine catarrh (B). 
Iodine, has proved the most valuable of all remedies as a local stimulant, and 
a reliable alterative (E) ; and excitant of uterine contraction ; use a saturated 
tincture to any part not exposed to the air (E) ; may be injected into cervix (G). 
Iodo-tannin, or Iodoformi 3j. Ac. Tannici 3J, a serviceable application in many 
inflammatory and hypertrophic conditions ; Iodoform suppositories in chronic 
metritis (P). Potassium Bromide, our main stand-by in uterine troubles ; 
apart from its soothing properties it seems to divert the blood from the womb, 
and to lessen uterine congestion (G) ; a specific cure for simple subinvolution, 
the benefit being derived from the potash (Tait). Digitalis, in subinvolution 
(B). Glycerin, on cotton tampon to cervix as local hydragogue (Thomas). 
Glycozone, as an application in tumefied conditions of the cervix and uterus, 
is far superior to pure glycerin (Edson). Potassa, Caustic Potassa and Potassa 
cum Calce, are said to be effective in chronic metritis ; must be used cautiously 
(B). Chromic Acid, a strong solution to interior of uterus, a very useful appli- 
cation. Ipecacuanha, in subacute metritis of the puerperal state (Tr). Iron, 
locally in uterine catarrh (R) ; as a tonic, Iron and other restoratives, a cardinal 
rule in the treatment of all uterine disorders, with Ergot, Quinine, Arsenic or 
Potassium Bromide, whenever the womb as a whole is congested or hyper- 
trophied ; Syr. Ferri Iodidi, with Cod-liver Oil, wins half the battle (G). Zinc 
Valerianate, in 2- to 4-grain doses thrice daily, is one of the best nervines in 
these cases (G). Mammary and Parotid Extracts, used with signal benefit as 
internal remedies in several cases of subinvolution and menorrhagia (Bell). 
Scarification, after dry cupping, in chronic metritis (Thomas). Electricity, in 
chronic congestive enlargements galvanic current of moderate intensity, slowly 
interrupted (B). Water, hot injections or douche, also cold alternately, one of the 
most effective measures, a gallon very hot ter die (R) ; especially valuable in con- 
gestion, which is generally venous ; elevated hips a necessary part of treatment 
(E); cold water is often better than hot (G). Rest, to the patient and the 
organ, is of prime importance, abdominal bandage, skirt-supporters, pessary 
if anteversion or retroversion, abstinence from sexual intercourse (Thomas). 



B 



Prescriptions. 



Ext. Humuli, 



Elix. Amnion. Valerianate 
Syr. Lactucarii, . . . . aa t ^ ss. 
M. Sig. — A dessertsp. at bedtime, or 
during the day when needed, as an anti- 
spasmodic. ( Go ode II. ) 



R. Iodi, 

Potass. Bromidi, . . . aa gr. xx. 

Tinct. Iodi, ^j. 

Aq. Destillat., . . q. s. ad ^iv. 
M. Sig. — rr^xxx to be injected into the 
cervix by 3 to 5 punctures. [Coodell.) 



806 UTERINE DISPLACEMENTS TUMORS ULCERATION. 



Uterine Displacements. 

Anteversion, without prolapsus, is not a mal-position (E). Ice, locally when 
parts inflamed (R). Hot-water injections, to give tone to the vessels, essential ; 
also valuable after reduction of mal-positions (E). Mechanical Means, only- 
reliable or safe in retroversion and prolapse ;. the sound, as a means to restore 
a retro verted uterus to position, cannot be regarded as free from risk, even in 
skillful hands (E). Pessaries, harmful unless expertly fitted ; should be adjusted 
so as to restore the uterus to the normal line, where the circulation will be least 
obstructed, not too high ; should never be employed where cellulitis exists (E). 
Cotton Roll, as a substitute for the orthodox pessary, is far superior ; use 
Borated Cotton in flat sheets, rolling it into a roll 2 inches long by 1 inch 
diameter, and saturating in Boroglyceridi ^j, Alumini Acetatis §j, Glycerini 
Pur. q. s. ad Oj ; if an astringent is required, the Acetate may be replaced by 
Alumini Sulphas (Wylie). [Compare Prolapsus Uteri.] 



Uterine Tumors. 

Mercury, the Bichloride in small doses, long continued, of undoubted value 
in treatment of fibrous or polypoid growths ; gr. -^ every 6 hours, sometimes 
restrains the hemorrhage, when other remedies fail (Wa). Calcium Chloride, 
in 30-grain doses thrice daily, has by prolonged use cured uterine fibroids 
(Hewitt) ; calcifies uterine arteries, also those of the body generally, and is 
dangerous thereby (Tilt, Wells). Ergotin, hypodermically for fibrous tumor 
(R) ; gr. ij-vj, on alternate days, give excellent results (B) ; nine cases of 
fibroid treated thus by Hildebrandt with good results (P) ; this method often 
causes great pain and severe local inflammation (W) ; one grain each of 
Ergotin and Ferri Sulphas Exsiccat., in pill thrice daily, persistently, for uterine 
fibroids, using for the hemorrhages a tampon saturated with tincture of Iodine 
or Monsel's solution (Parvin). Opium, has specific action upon the uterine 
circulation, and in bleeding from hopeless cases of cancer or fibroid tumors 
should be used freely, regardless of the opium habit (Editorial, N. Y. Medical 
Record, Dec. 10, 1887). Mammary Extract, used as an internal remedy with 
signal benefit in two cases of uterine fibroid (Bell). Ammonium Chloride, in 
fibrous tumors, gives more benefit than any other remedy, gr. x, twice or thrice 
daily, for weeks and months consecutively (Atlee). Ferrous Subsulphate, in 
jected to restrain bleeding, cautiously ! (B) Saline Mineral Waters, especially 
those at St. Catherine's, Canada, are useful (B). Aliment, carefully regulated, 
chiefly animal food, with recumbent posture while flowing, and long-continued 
use of Ergot in small doses, may accomplish something (E). [Compare Cysts.] 



Uterine Ulceration. 

Hydrastis, quickly improves ; the fluid extract undiluted as a topical appli- 
cation in uterine and vaginal leucorrhcea, ulcerations and erosion of cervix (B). 
Carbolic Acid, pure, over the surface twice a week in simple ulceration (R). 
Silver Nitrate, a serviceable application, but is often abused (B) ; the solid stick 
applied to surface, after cleansing and drying with cotton-wool (Wa). Alum, 
as hip-bath, ft) j ad Cj, and vaginal injection, is of great utility in ulcerations 
of the os uteri, or of the uterine cavity (Recamier). Glycerin 25, Alcohol I2>£, 
and pure Creosote 1 part, an excellent application to ulcers of the neck. Gly- 
cozone, as an application to ulcerated cervix, is far superior to pure glycerin 
(Edson). [See under Leucorrhcea, for manner of application.] Bismuth 
Subnitrate, with enough glycerin to make a thick cream, is the best of all appli- 
cations for ulceration of the os and cervix uteri (Suesserott). Vegetable 
Astringents, infusions or decoctions of Galls, Oak-bark, Hamamelis, Geran- 
ium, Alum-root, etc. ; the Glycerite of Tannin, or Iodoform and Tannin, 
packed around the cervix (B). 



UVULA VARICELLA. 807 



Uvula. 

Tannin, Rhatany or Zinc, as astringent lozenges, for relaxed uvula (A). 
Cocaine combined with extract of Krameria, in a pastile, is often very 
effectual as a local astringent for elongated uvula (Hall) ; a 20 per cent, solu- 
tion applied by the spray or brush, will often suffice to give relief in acute uvu- 
litis (Id). Ammonium Bromide, gr. xx ad %j aquas, as gargle, is one of the 
best applications, being as soothing as it is astringent (Muirhead). Amputation 
of the elongated part (A) ; after applying a 20 per cent, solution of cocaine, by 
Mackenzie's uvulatome, or the uvula may be seized with forceps and a portion 
be cut off with scissors (Hall) ; the hemorrhage may be severe and may recur 
some hours after the operation, but will be arrested by slowly sipping a mix- 
ture of Tannin 360 grains, Gallic Acid, 120 grains and Water gj (Mackenzie). 



Vaccination. 

Aconite, with Belladonna Ointment for erysipelatous redness after vaccina- 
tion (R). Zinc Oxide, dusted over, to allay the subsequent local irritation 
(Wa) ; with Pulv. Amyli, equal parts, over the surface. Lead Acetate, Z] to 
Oj water, as lotion for irritable pock (Foster). Carbolic Acid, £j to Oj water, 
as lotion for excessive redness, with burning and itching. 



Vaginismus. 

Ether, as anaesthetic, to ascertain cause, usually a displacement, fissure, or 
cellulitis (E). Hygiene, sun-baths, hot-water injections, fresh air, removal from 
husband, etc. (E). Operation (Sims'), removal of hymen with scissors and 
insertion of glass plug till parts are healed, when the cicatrix is to be divided, 
etc. (E) : Atthill removed a narrow strip of mucous membrane on each side 
of the vaginal orifice with marked success in a very severe case. Cocaine, in 
ointment with Morphine and Conium, smeared over the painful spot with the 
finger ; or in a pessary with Iodoform and extract of Belladonna, may give 
speedy relief (Whitla). Iodoform, in suppository when redness and excoriation ; 
but Belladonna, the extract 1 part with 8 or 9 of fresh lard, when pain alone 
(Gallard). Tents, to gradually dilate the vagina, may be impregnated with 
various sedatives (Id). 

Vaginitis. 

Silver Nitrate, in solution, gr. xl to the ^, applied within the cervical canal 
and over the vaginal mucous lining (E). Pinus Canadensis, the concentrated, 
colorless extract, locally, has a very soothing effect in acute vaginitis. Tannin, 
the glycerite in chronic vaginitis of children (R). Emolients, with Opium, as 
injections (Goodsell). [Compare Gonorrhoea, Leucorrhcea.] 



Varicella. 

Ammonium Acetate, in diaphoretic and antifebrile mixture. [See Fever, 
Simple, for formula.] Inunction, with Camphorated Oil, or thin starch, to 
relieve itching and allay inflammation (P). Aconite, is of great value (B). 
Water, hot and cold baths and packs are of great utility ; cold, if hyperpyrexia ; 
cold compress if sore throat ; hot or warm pack when free diaphoresis required 
(B). Diet, no animal food, milk best, which, with careful attention to the 
bowels, patient to be kept cool with light covering, and use of a mattress rather 
than a feather bed, is all the treatment required (A). Saline Mixture, if high 
fever. Quinine, during convalescence. Complications to be treated symp- 
tomatically. 



808 VARICOCELE VARICOSIS — VARIOLA. 



Varicocele. 

Hamamelis, appears to have permanently cured one case (R). Ergot, gr. 
ij-vj of Ergotin hypodermically, the needle to be inserted among the affected 
veins, care being taken not to puncture a vein, is effective ; severe pain follows 
for a few hours (R). Water, cold douche to the perineum and buttocks, with 
suspension of testicles in cold water (R). Radical Cure, consists in obliterating 
the veins by wire ligatures, etc. (CI). 



Varicosis. 

Hamamelis, is employed with satisfaction in varicose veins and ulcers (Pf ). 
Digitalis, by fomentation, in acute inflammation from varicose ulcers (R). 
Ergotin, injected alongside of vein, but not within it, has cured (B). Bandage, 
or elastic stocking ; with cold sponging and rubbing upwards, as palliatives 
(CI). [Compare Hemorrhoids, Ulcers.] 



Variola. 

Cimicifuga, is given internally by some, who assert that it' prevents pitting 
(R). Mercury, in ointment or plaster, to prevent pitting in semi-confluent, or 
barely confluent cases (Wa) ; formerly used (R). Camphor, is said to restore 
the eruption, if retrocedent ; in confluent malignant smallpox, camphor alone, 
or with Opium, may be used for great depression of the vital powers (Wa). 
Belladonna, successfully used both as prophylactic and curative agent (Erasmus 
Wilson) ; gr. %.-) every 3, 4 or 6 hours, to dilatation of pupil and some stupor, 
found effectual (Wa). Carbolic Acid, is used with decided advantage (Wa) 
[See Measles] ; has been much used on theoretical grounds, but not with 
success (B). Ammonium Carbonate, has had cheering success (Wa). [See 
Scarlet Fever.] Quinine, small doses in adynamic states, larger in hyper- 
pyrexia (B). Chloral, temperature high, much delirium and restlessness (B). 
Opium, low, muttering delirium ; not so much used now as formerly (B) ; Mor- 
phine in the insomnia of the advanced stage, once or twice only, but not when 
copious salivation or mucous expectoration (Wa). Silver Nitrate, on a sharp- 
pointed stick, inserted into each vesicle after rupture, to prevent pitting (B) ; or 
simply paint skin with a solution of gr. xx to the ^ (R). Iodine, the tincture 
to prevent pitting, is painted ten times over face if on first day of eruption, 12 
if on the second day, 12-16 times if on third day (B). Collodion, or solutions 
of India-rubber or Gutta-percha in Chloroform, to prevent pitting ; or cotton- 
wool dipped into Lime liniment, applied to face or neck (R). Carron Oil (see 
page 200), makes a good dressing for the face. Vaccinia Antitoxin, has been 
used in a few cases with much success by Beclere (see page 156). Iron and 
Quinine, in large doses by the mouth, also Ergotin by deep parenchymatous 
injection, and Turpentine by the bowel, in the hemorrhagic form of the disease 
(Whitla) ; these two drugs are the most valuable antiseptics in variola (Moore). 
Eucalyptus, the Oil as inunction from the very commencement of the disease, 
is to be strongly recommended as an antiseptic application to the skin 
(Whitla). Water, as cold baths and cold pack, of great utility (B) ; packing 
especially on retrocession of rash (R). External Applications, as powdered 
starch, flour, or Zinc Carbonate, 3 parts to 1 of Zinc Oxide with Olive Oil ; cold 
or tepid water with vinegar, sponged over body twice or thrice daily (Wa). 
Diet, tea and dry toast, raw eggs beaten in cold milk, beef-tea, grapes, roasted 
apples, ripe fruits in season ; cold water may be drunk freely. Fats, bacon-fat 
smeared over the face, to allay itching and prevent pitting. Treatment, in no 
way differs from that of the other eruptive fevers. Stokes' three indications for 
treatment are accepted by other authorities and are : (1) exclusion of air, (2) 
keeping the parts in a permanently moist state so as to prevent hardening of 



VERTIGO VOMITING. 809 

the scabs ; and (3) lessening of the local irritation (Whitla). [Compare Vac- 
cination.] 

Vertigo. 

Digitalis, in small doses, alternately month by month with tincture of 
Larch, and a long course of Iron Citrate and Strychnine, in essential ver- 
tigo, without any other head symptoms, and with general depraved nutrition, 
the most effectual treatment (Wa). Potassium Bromide, often controls par- 
oxysmal vertigo, without coexistent spasm, or organic brain-disease (Wa). 
Ammonium Bromide, in an effervescing form with Cascarilla, for vertigo from 
overwork, where there is usually restlessness, insomnia, depression of spirits, 
with a sense of impending evil (Wa). Alkalies and Bitter Tonics, give the 
best results in vertigo of gastric origin. Sodium Bicarbonate, after meals, 
tonics before meals. Strychnine, with Iron, thrice daily, gives good results. 
Corrosive Sublimate, in small doses, with attention to the bowels and diet. 
Cod-liver Oil, for giddiness of the aged, when no serious brain- disease (R). 
Aurum, in vertigo and vertiginous sensations connected with gastric disorders 
or due to cerebral anaemia, which are often removed by a course of the salts 
of gold (B). Quinine, in aural vertigo (Meniere's disease), 10 to 15 grains 
daily, continued with intervals for several weeks (Charcot). Electricity, the 
constant current daily, anode over cervical vertebrae, cathode over the ear, the 
current strength being gradually increased to toleration and continued from 3 
to 5 minutes at a sitting, is of great benefit in aural vertigo, ameliorating the 
condition in most cases. Nitro-glycerin, gives good results in epileptic vertigo 
(Br). Vertigo is usually symptomatic of disorder of the stomach, or of the 
liver (cholsemia), sometimes of general debilitv, rarely of disease of the brain 
(H). 

Vomiting. 

Arsenic, in many forms of stomach vomiting, especially. that of alcoholism, 
and chronic ulcer (B), and in the vomiting of cholera (R) ; gtt. ss of Fowler's 
solution, every }i hour for 6 or 8 doses, often relieves vomiting after a debauch, 
the morning vomiting of drunkards, and that of pregnancy (Smith). Nux 
Vomica, stands next to Arsenic, is useful in many ways (B) ; may be given 
with Ipecac, especially when tongue coated (R). Ipecacuanha, in small doses, 
will arrest certain kinds — a curious fact ; especially useful in certain forms, 
Try of Vinum Ipecac every y z hour or more (B, R, P) ; in sick stomach of 
nervous origin, minute doses are of undoubted value (W). Cocaine, in doses 
of gr. % thrice daily, controlled the vomiting of gastric carcinoma, after all 
other means failed (Meigs); 10-minim doses of a 4 per cent, solution every 
hour, of inestimable value in the vomiting of yellow fever (Jennings). Potas- 
sium Nitrate, one of the surest remedies against vomiting and nausea, gr. % 
in ^ss of cold water every 4 or 5 minutes, until relieved, in all cases except 
reflex ones and those due to irritant poisons (Moore). Mercury, gr. y z of Gray 
Powder every two hours, especially in children with clayey stools (R) ; Calomel, 
gr. j to Oj aquae, first dissolved in 25J of Lime-water, a teasp. every ten minutes 
for the regurgitation of food in nursing children (Smith). Opium, will arrest 
many kinds, best in that of biliary or renal calculi, dysmenorrhcea, sea-sick- 
ness, pregnancy ; Morphine, hypoder. gr. ^ to ye (P). Codeine, in doses of 
gr. %, usually answers exceedingly well in vomiting from almost any cause 
(Braithwaite). Cocaine, in 2 per cent, solution as spray high up the nasal 
passages (see under Nausea). Bryonia, for bilious vomiting and headache 
(P). Veratrum Album, in vomiting and purging of summer diarrhoea (R). 
Hydrocyanic Acid, often very serviceable in nervous vomiting, acts promptly 
if at all (R). Hydrobromic Acid, gss j n |jj f water, four times daily, useful 
for the vomiting due to gastric ulcer. Chloroform, TTLij— v, on sugar, for non- 
inflammatory vomiting (R) ; [See Yellow Fever for formula.] Bromides, 
in cerebral vomiting only ; not in the gastric form (B) ; Potassium Bromide in 



8lO VOMITING OF PREGNANCY. 

that of uterine disease (W) ; Strontium Bromide is excellent in vomiting due 
to various causes ; gr. x-xv twice daily with meals. Phenocoll, with Piperazin, 
gr. xv of each daily in a pint or more of carbonated water, was of great service 
in a case of uncontrollable vomiting which had resisted every known remedy. 
Menthol, has successfully checked persistent vomiting after all the usual 
remedies had failed, in the hands of many well-known observers ; vr\,x of a 20 
per cent, solution in Olive Oil, dropped on powdered sugar, each dose being 
about 1 grain (Weil). Sulphurous Acid, tt\,v-o r j, well diluted, or less effec- 
tively, Sodium Sulphite ; Sulphites often curative in vomiting of sarcinae and 
acid matter, due to acid fermentation of starchy elements (B). Cocculus 
Indicus, efficient in cephalic vomiting (P). Iris, in vomiting with blinding 
right supraorbital pain, liver deranged (P). Bismuth, in many forms of vomit- 
ing in children, especially when from gastric catarrh (R). Carbolic Acid, 
with or without Bismuth (B) ; in nervous vomiting ( W). Creosote, in the 
vomiting of cancer, gastric ulcer, etc. (R) ; gtt. j-ij (W). Cinnamon or Cloves, 
will check vomiting (P). Calumba, in vomiting from kidney disease and renal 
calculi ; frequently allays that of pregnancy and dentition (P). Serpentaria, 
for bilious vomiting (P). Cerium Oxalate, in that of pregnancy and from 
cancer (B) : gr. j every three hours (R). Ammonium Carbonate, may relieve 
vomiting when the ejected matter is acid (B). Peptenzyme, is highly efficient. 
Pepsin, for vomiting of food after meals, gr. x-xv before or during meals. 
Lime-water, is a favorite remedy for vomiting, especially in children : Milk 
and Lime-water often relieve when other methods fail (B). Sodium Bicar- 
bonate, 3ss-j to a pint of milk, for infants, especially if constipated (R) ; the 
effervescing soda powders in the vomiting of acute diseases and the exanthe- 
mata (B). Kumyss, proves effective when no other food will be retained. 
Carbonated Water, is an efficient remedy. Ice, sucked, with horizontal 
posture, also absolute rest and quiet (Wa) ; iced champagne, ^ss every % 
hour (B). Alcohol, iced brandy or champagne in spoonful doses every y z hour 
in vomiting of cholera, pregnancy, and delirium tremens (B). Counter- 
Irritation, at epigastrium (R). Nutrient Enemata. (See under Enemata.) 
[Compare the list of Anti-emetics, on page 45, also the articles entitled 
Cholera, Hematemesis, Nausea, Sea-sickness, Vomiting of Pregnancy.] 



Prescriptions 

$. Ac. Hydrocyan. Dil., . . zj. 
Aqu?e Laurocerasi, . . . Jij. 
M. Sig. — A teasp. every 2 hours, for 
nervous vomiting. 



R . Ac. Hydrobromici Diluti, . ^ ij. 

Sig. — Half a teasp. in a winegl. of 
water, 4 times daily. 



Vomiting of Pregnancy. 

Ipecacuanha, or Nux Vomica, either will generally succeed where the other 
fails (R) ; no other remedy of equal value to Ipecac (P). Nux Vomica, is use- 
ful but often fails, gtt. ss-j every hour or two in water (R) ; in very minute 
doses (S) ; gtt. ij-iij of the tincture every two or three hours, or gtt. x before 
each meal, with very hot water as a drink, is the best treatment (Parvin). 
Arsenic, Fowler's solution, gtt. j before each meal, will often relieve, when 
vomiting of food, retching and straining, with blood and pain (B). Creosote, 
checks the vomiting (R). Carbolic Acid, drop-doses of crystals liquefied by 
heat, in mucilage ter die (Wa). Staphisagria, has subdued when other reme- 
dies failed (P). Cerium Oxalate, gr. j every three hours (R) ; ordinary doses 
far too small, give as high as 10 grains (B). Morphine, hypodermically, in 
severe vomiting (R). Pepsin, has been used with success. Ingluvin, seems 
almost specific (B). Potassium Bromide, is often efficacious (W) ; £ss doses 
thrice daily, exceedingly effective in the combined diarrhoea and vomiting of 
pregnancy ; the first dose should be given an hour before rising. Strontium 
Bromide, proved entirely successful in severe cases ; gr. xv in water with 
meals, twice daily, for a month. Hydrocyanic Acid, often the best remedy (P). 



VULVA AND VULVITIS WARTS. 8 I I 

[See ante, Vomiting.] Copper Sulphate, sometimes effective, not more than 
gr. ■£$ ter die (B). Iodine, tt\,v of the tincture in ^ss of sweetened water 
repeated in }4. hour, of magical effect in a bad case which had resisted every 
other treatment ; is often useful (B). Menthol, has proven very successful in 
obstinate cases (see formula below). Cocaine, locally to cervix, promptly 
cured a most intractable case of several months' duration, though it failed 
when used internally (Boys) ; has given excellent results when used internally 
in tablet triturates of ^ grain each (or see formula below) : a 2 per cent, solu- 
tion sprayed high up the nasal passages (see under Nausea). Calumba, as 
tincture often useful, drop-doses every hour or two (B). Bismuth, and Car- 
bolic Acid are effective (B). Atropine, frequently effective (R) ; never failed 
to give relief in many years of using it (Boys). Ether, sprayed over the epi- 
gastric region and the corresponding part of the spinal column, for 3 to 5 
minutes every 3 hours, gives immediate relief (Lubelsky). Pop-corn, is a god- 
send to this complaint, having acted marvellously in several cases in which I 
have used it (Sweringen). Peptenzyme, is said to be very efficient. Aconite, 
in full doses, is often very successful (W). Dilatation, of the cervical canal, 
by the index finger, is regarded as extremely efficient, and reasonably safe ; it 
may bring on abortion, if too extensive, but from records of several cases 
since 1875, ft ma Y De sa id tnat ft * s a sa fe an d sure remedy (Copman). Ice- 
bag to spine, an efficient measure (R). Vesication, a single blister over the 4th 
and 5th dorsal vertebras, never failed for many years to put an end at once to 
the sickness of pregnancy for the whole remaining period of gestation (Harkin, 
in Lancet). 

Prescriptions . 

R. Atropinae Sulphatis, . . . gr. j. I R- Cerii Oxalatis, gr. xij. 

Morphinae Sulphatis, . . . gr. iv. Ipecacuanha?, gr. xv. 

Acidi Sulphurici Aromat., ^iij. Creosoti, gr. xxiv. 

Aquae, 3 v. M. ft. pil. no. xij. Sig. — One every hour. 

M. Sig. — Ten to twenty drops, thrice (Goodett.) 



daily. [Boys.) 



R- . Cerii Oxalatis, ... . gr. xxiv. 



R. Bismuthi Subnitrat., . . . gr. clx. Ext. Hyoscyami, . . . . gr. xxxvj. 

Cerii Oxalatis, gr. xl. M. ft. pil. no. xij. Sig. — One pill twice 

Morphinae Sulphatis, . . . gr. jss. daily. [Goodett.) 
Syrupi, et Acaciae, q. s. ad^i]. 

M. ft. emulsura. Sig. — A teasp. every t> r ' • H rl 1 1 

mr nnf-il vnmitinrr r>*»ac*»c ( 1/nii Ifsilvrih \ ' **• ' _ __ _ J •>••&• 



hour until vomiting ceases. ( Van Valzah.) 



R. Mentholi, gr. xx. 

Alcoholis, H V J SS - 

Syr. Simplicis, . . q. s. ad^x). I to 20, in a little water every hour until re- 



Acidi Carbolici, .... ff^x. 
Aq. Cinnamomi, . . . . 5ss. 
Syr. Zingib., . . . q. s. ad^]. 
M. Sig. — 10 drops gradually increased 



M. Sig. — 3J every hour. [Potter.) lieved, then every 2 or 3 hours. [Potter.) 



Vulva and Vulvitis. 

Sodium Hyposulphite, an unfailing remedy'in lotion for aphthae of the vulva 
(R). Arsenic, much used for eczema (T). Lead Acetate, a concentrated solu- 
tion in glycerin locally for eczema of vulva (T). Alum, as lotion in vulvitis of 
children ; gr. lx to Oj aquae, or less strong if found to increase discharge (R). 
Lead, solutions of the Acetate as wash, after the acute stage has subsided. 
Lime-water, as wash (R). [Compare Pruritus, Prurigo, Vaginitis.] 



Warts. 

Thuja, worthy of recommendation in the highest terms, for the cure of warts 
with a narrow base and pendulous body ; a strong tincture locally three times 
a day, for one or two weeks, with 5 drops in a wineglassful of water internally, 



8 1 2 WEN — WORMS. 

night and morning (P). Iron, the tincture of the Chloride and dilute HC1 Acid, 
equal parts applied night and morning, very effective (Bulkley). Nitric Acid, 
3j-ij of the dilute acid to a pint of water, as wash to keep small syphilitic warts 
constantly moist (R). Sabina, as caustic (P) ; I part to 2 of Alum (Wa). Rue, 
the Oil, with honey, locally (P). Arsenous Acid, as a caustic ; enough to be 
used to excite active inflammation ; or Liq. Arsenicalis painted over warts (R); 
may be taken internally (B). Mercurial Ointment, containing 5 per cent, of 
Arsenic, or a plaster having in each 8 square inches 154 grains of Arsenic and 
77 grains of Mercury (Unna). Tannin, and Burnt Alum, equal parts, pow- 
dered over warts twice daily, gives good results. Chromic Acid, gr. 100 to ^j 
aquae, with a glass rod, to saturate diseased growth ; remove any superfluous 
acid, dress with dry lint (R, Wa). Mercuric Nitrate, locally (R). Silver 
Nitrate, as caustic, but is usually too superficial (R). Dermal Curette, is much 
used in Vienna to remove warts by enucleation. Strangulation by tying a 
string tightly around the base, will cause them to drop off in a few days. Heat, 
is a most thorough measure for their radical removal ; it may be best applied 
by touching the wart 3 or 4 times daily with the hot end of a cigar ; the first 
few applications only give pain. Caustic Alkalies, locally (R) ; a saturated 
solution of Potassa Fusa, carefully applied by a brush or sponge fastened to the 
end of a stick is to be preferred (Wilson). [Compare Condylomata.] 



Wen. 

Extirpation, the least troublesome and most speedily effective method. Run 
a scalpel through it, seize the cut edge of the cyst, and gently tear it out with a 
touch or two from the knife. Dressing of lint and Carbolic Oil to cause suppu- 
ration and contraction (D). 

Worms. 

Santonin, the best anthelmintic, a laxative in the morning, fast all day, a dose 
(gr. ss-v) of Santonin and Calomel, or Troches of Santonin (j-x), at bedtime, 
a Senna draught next morning, for ascarides (P) ; for round and thread-worms, 
give in Castor Oil by mouth, or as injection (R). Iron, the syrup of the Iodide 
internally and a solution of the tincture locally, for ascarides (B) ; the Tinct. 
Ferri Chlor. ^ss ad Oj aquae, a good injection for thread-worms, coagulating 
their albumen (R). Quassia, the infusion an effectual injection, conjoined 
with simple bitters internally, for ascarides (R). Lime-water, as injection for 
thread-worms (R); ^iij-iv repeated, for ascarides (Wa). Sodium Chloride, in 
3ss doses on empty stomach, expels ascarides and prevents reproduction (Wa). 
Quinine, as a tonic, also cold sponging, out-door exercise and judicious diet; 
useful probably by preventing the production of the abundant mucus which 
favors the growth of worms (R) ; especially useful for ascarides, also as injec- 
tion for thread-worms and taenia (Wa). Ignatia, for convulsive symptoms (P). 
Eucalyptus, as injection, for ascarides (B). Aloes, are efficacious for ascarides 
(P). Scammony, for thread-worms in rectum (R) ; with Calomel, effective 
(Wa). Tannin, as Catechu, Kino, Red-gum, Rhatany, Haematoxylum in injec- 
tions, to destroy thread-worms (R). Alum, as solution for injection (R). Am- 
monium Chloride, to prevent formation of thick mucus which serves as nidus 
for worms (R). Valerian, especially when convulsions (R). Myrtol, is efficient 
against ascarides and round worms (B). Filix Mas to be taken on an empty 
stomach for tape-worm, and followed by a purge (P). Pepo, ,^ij as emulsion, 
taken fasting, one of the most efficient remedies against taenia (B). Pelletierine, 
the alkaloid of Granatum, is by far the best vermifuge for a tape-worm, repeated 
after a week for a second worm, as many as 3 having been found in one 
patient (Da C) ; gr. xv-xx of the Tannate, followed in a few hours by Castor 
Oil (R). Chloroform, a very efficient taeniafuge, gj in f>) of mucilage, after 20 
hours' fasting, followed one hour later by ^j of Castor Oil, this is an adult dose, 
Z] should never be exceeded (Wilde). Kamala (Rottlera), excellent for taenia, 



WOUNDS. 



13 



requires no purge (P) ; gr. cl-clxxx for an adult (Wa). Cusso, the fluid extract 
in dose of 3u to 3J, or the same quantity of the flowers infused in ^iv of boil- 
ing water, for both varieties of the tape-worm [see page 264]. Naphtalin, an 
excellent all-round anthelmintic, of high value for ascarides and taenia, thor- 
oughly reliable for all kinds of intestinal worms, giving prompt and complete 
results invariably, with entire absence of all unpleasant symptoms ; a single 
dose of gr. xv removed tape-worms entire (Mirowicz) ; for adults a dose of 
Castor Oil should follow, but for children it is preferable to give both together 
(see page 350). Potassium Iodide, gr. xxxvj, Iodine, gr. xij, Water ^j, ten drops 
thrice daily in water, caused the expulsion of a tape-worm 11 yards long, of 
which there were no previous symptoms, and proved successful in other cases 
(Newington). Ailanthus, a decoction of the fresh bark, for taenia (B). Turpen- 
tine, as poison for tape- and thread-worms (R) ; for taenia (Wa). Tonics, as 
Iron, Cod-liver Oil, etc., to restore the intestinal canal to a healthy condition 
(R). [Compare Chyluria, also the List of Anthelmintics on page 49.] 



Presc 

R . Chloroformi, 

Ext. Filicis Maris, . . . aagj. 
Emulsi. 01. Ricini (50 per 

cent.), §iij. 

M. Sig. — One dose after 24 hours' fast- 
ing. Does just as well if Male Fern be 
omitted. [Smith.) 

R. Ext. Spigelian Fl., . . . . |j. 
Ext. Sennae Fl., ... Jss. 

M. Sig. — A teasp. to a child of 3 to 5 
years. [Smith.) 

R . Ext. Spigelian et Sennae Fl. , % j. 

Santonini, gr. viij. 

M. Sig. — A teasp. to a child of 5 years. 
(Smith.) 



iptions. 

R. Granati Corticis, ^ij. 

Ft. infusum. Sig. — To be taken before 
II A. M. — and followed after 2 hours by — 

R. 01. Ricini, giij. 

01. Terebinth., gj. 

Ext. Filicis Maris yEther., gj. 
M. ft. haustus. 

Fasting unnecessary. ( Wilde. ) 



R. Magnesii Sulphat, . . . . ^ij. 

Sodii Chloridi, ^ss. 

M. Sig. — An ounce in half a glass of 
water, with gtt. v of Carbolic Acid, night 
and morning, for ascarides. Persevere. 

(Barkley.) 



Wounds. 

Arnica, very useful for external bruises and cuts, also for internal injuries ; 
unites surfaces very rapidly after amputations ; the infusion or decoction best 
(P) ; very effectual (Wa). Aconite, valuable in surgical fever (P). Carbolic 
Acid solutions, check suppuration, and correct fetor (B). Bismuth Subiodide, 
dusted into a wound one of the most efficient antiseptics, non-irritant, and a 
prompt stimulant of granulations ; an excellent dressing for wounds after 
approximation of the edges, the powder to be dusted thickly over the edges, 
and thoroughly smeared with Flexible Collodion. Dermatol (Bismuth Sub- 
gallate), is an excellent non-irritant vulnerary, having great stability, and 
valuable drying and bactericidal qualities. Europhen, is an ideal application 
to sores and wounds, also for the many protective requirements of minor 
surgery ; is used as a dusting powder, or as a 5 to 10 per cent, ointment, with 
Lanolin, as a base. Aristol, is very efficient, or a mixture of Aristol and 
Europhen, equal parts of each ; Aristol is an excellent substitute for Iodoform, 
and odorless. Acetanilid, in fine powder dusted over the surface of wounds 
and other breaches of tissue (see page 69). Alumnol, a powerful astringent, 
dessicant and antiseptic, and reaches the deep recesses of wounds (see page 
121). Iodoform, powdered and dusted over sloughing wounds, irritable and ill- 
conditioned ulcers and sores (B) ; Iodoform 1, Collodion 9 parts, painted on a 
superficial wound while edges are held together (Gross) ; may be painted over 
edges when stitched together ; gives excellent results. Mercury, the Bichloride, 
gr. vijss to quart j of hot water, stirred with a stick, makes a solution of 1 to 
2000; the best of all antiseptics, for washing a wound or cavity, and for 



8 14 YELLOW FEVER. 

saturating the dressings (see List of Antiseptics on page 60). Boracic Acid, 
also applicable as Carbolic Acid (B). Balsam of Peru, excellent for closing 
recent wounds (P). Benzoin, the basis of all the healing balsams (P). Aloes, 
topically as a slight stimulant ; often purges (R). Gum Tragacanth, a thick 
aqueous solution to granulating surfaces, to protect them from the air (Wa), 
Opium, internally to quiet intestinal movements in wounds of the abdomen 
(R) ; forwards the reparative processes (P). Tannin, or Glycerite of Tannin, to 
coat over wounds (R). Collodion or Liquor Gutta-perchae, to secure primary 
union of incised wounds (B) ; as protective covering (P). Ammonium 
Carbonate, gr. v hypodermically in the vicinity of wounds caused by poisoned 
arrows, repeatedly used with success in saving life, by Dr. Parke, the surgeon 
to Stanley's last expedition in Africa. Sulphurous Acid, in solution, diluted or 
not, constantly applied (R) ; in solution or by fumigation, is regarded by 
some as superior in efficacy to Carbolic Acid, and less irritant (Wa). Salicylic 
Acid, Thiersch prefers it to Carbolic ; may be applied pure in powder to 
gangrenous and sloughing wounds (B). Formalin, is now the favorite surgical 
antiseptic (see ante, page 287). Aloes, pulverized fine, is an efficient dressing 
for wounds, closing them and favoring cicatrization, also relieving the pain at 
once, requires removal only at long intervals (Millet). Nitric Acid, as escharotic 
for gangrene (B). Turpentine, one of the most efficient applications in 
hospital gangrene (B). Galvanic Couplet, to wounds of indolent form (B). 
Alcohol, an excellent antiseptic dressing when suppuration ; also favors cica- 
trization of open wounds (B). Poultices, are often abused ; of Yeast or 
Charcoal best for foul wounds (B). Water, in universal use as dressing ; cold 
water often abused, hot-water dressing as advocated by Hamilton, promises 
better results (B). Turkish Baths, for pain in the seat of old wounds (R). 
Ice and Salt, applied to wounds prevents inflammation (R). [Compare Bed- 
sores, Gangrene, Hemorrhage, Inflammation, Pyaemia, Surgical Fever 
Ulcers.] 

Prescriptions. 



& . Acidi Tannici, ifij. 

Alcoholis Absolut., . . . 5 ss. 

^Etheris o^ ss - 

Collodii, 5 xij. 

M. Sig. — Styptic Collodion. 



R. Collodii, I). 

Olei Ricini, 

Acidi Carbolici, . . . . aa ^ ss. 
M. Sig. — Carbolized Collodion, for 
wounds. 



Yellow Fever. 

Treatment must all be done at the beginning, no time to be lost; cold 
sponging early and frequently repeated, Calomel, Quinine and Salines at the 
start, Potassium Acetate for the kidneys, Morphine for gastric irritation, the 
feet to be in mustard water (Da C). Diaphoretics and Diuretics, also Laxa- 
tives, are very important throughout the disease (Da C). Pilocarpine, in dose 
of gr. % hypodermically, in first stage, carried to the induction of emesis and 
catharsis, as well as that of diaphoresis, the most efficient treatment known, 
absolutely jugulating the paroxysm (Habersmith). Mercury, a Calomel purga- 
tive, gr. ss, 2 or 3 times on the first day, followed by a warm-water enema, is 
good treatment (B) ; has many advocates, and many opponents (Wa) ; should 
generally be abstained from (S). Duboisine, gr. g 1 ^, subcutaneously, the most 
efficient hypnotic and calmative (B). Turpentine, when cardiac weakness, 
depression of vaso-motor system, dissolved state of the blood ; tt^x-^ss ; small 
doses, with Tinctura Ferri Chloridi, in hemorrhagic form (B). Quinine, has 
some strong evidence in its favor as an abortive agent, one large dose, gr. 
xxx-xl, with Opium at outset (Wa) ; is not a specific ; may hasten recovery in 
mild cases (S) ; gr. xx per rectum, to reduce temperature (B). Lime-water, 
with milk, has been found efficient for the vomiting (Wa). Capsicum, to obvi- 
ate the black vomit, is highly spoken of (Wa). Cocaine, for the vomiting, 
nothing equals it in efficiency, it also acting as a diuretic, 10-minim doses of a 
4 per cent, solution, by mouth, every hour for 2 or 3 doses, acts like a charm 



YELLOW FEVER. 815 

(Jennings). Chloroform, for the vomiting, a few drops to prepare the stomach 
for reception and retention of food ; its effects transitory, has to be repeated 
before each meal (Wa) ; the Ammoniated Chloroform in zymotic pyrexia, its 
action is sedative, analgesic and antipyretic (Richardson). Carbolic Acid, by 
stomach and hypodermically, remarkably efficacious, even after the ominous 
"coffee-grounds" vomit (Lecaille). Chlorodyne, is excellent for restlessness, 
insomnia, irritability of stomach (A). Veratrum Viride, gtt. j-x hourly, accord- 
ing to age, till pulse and temperature subdued ; successfully used in connection 
with Mercury, etc. (White and Ford). Stimulants, only in the typhus form 
(B) ; in 3d stage must be bold, prompt, and continued (Da C). Diet, of the 
blandest description (A) ; Milk and Lime-water, half and half, in small quan- 
tities, is the best aliment; in convalescence, the utmost care is necessary in giv- 
ing aliments (B). Rest is very important (Da C). Iced Champagne, in table- 
spoonful doses every ^ hour, for the vomiting (B). Purgation, throughout the 
disease (Da C). [Compare Remittent Fever.] 

Pi-escriptions. 

R. Potassii Carbonat., . . . gr. xx. 

Tinct. Opii Camphorat., . £j. i R . Chloroformi, 

Aquae, 3 viij . Tinct. Cainphone, . . aa ^ ss. 

M. Sig. — ^j every hour or two, as a M. Sig. — Two drops as required for 

diaphoretic. {Dickson.') the vomiting. 



APPENDIX 



LIST OF CONTRACTIONS AND LATIN PHRASES USED IN 
WRITING PRESCRIPTIONS, WITH THE CORRESPONDING 
ENGLISH EQUIVALENTS. 



Contraction. 


Word or Phrase. 


English Equivalent. 


aa. 


Ana 


Of each. 


Abd. 


Abdomen, gen. inis 


The belly. 


Abs. feb. 


Absente febre 


Fever being absent. 


Ace. 


Accurate 


Accurately. 


Acerb. 


Acerbus, a, um 


Sharp, sour, harsh (to taste). 


Acerbit. 


Acerbitas, gen. atis. 


Sourness. 


Ad. 


Ad [prep. gov. ace.) 


To, up to. 


Ad concil. gust. 


Ad conciliandum gustum 


To suit the taste. 


Ad 2 vie. 


Ad duas vices 


At twice taking. 


Ad sec. vie. 


Ad secundum vicem 


To the second time. 


Ad 3 tiam vie. 


Ad tertiam vicem 


For the third time. 


Add. 


Adde, Addantur 


Add, Let them be added. 


Add. 


Addendus, Addendo 


To be added, By adding. 


Add. c. trit. 


Adde cum tritu 


Add with trituration. 


Ad def. an. 


Ad defectionem animi 


To fainting. 


Ad grat. acid. 


Ad gratam aciditatem 


To an agreeable sourness. 


Ad grat. gust. 


Ad gratum gustum 


To an agreeable taste. 


Adhib. 


Adhibendus 


To be administered. 


Adjac. 


Adjacens 


Adjacent. 


Ad lib. 


Ad libitum 


At pleasure. 


Admov. 


Admove, Admoveatur 


Apply, Let it be applied. 


Ad. part, dolent. 


Ad partes dolentes 


To the painful (aching) parts. 


Ad. sat. 


Ad saturandum 


To saturation. 


Adst. feb. 


Adstante febre 


The fever being on. 


Adv. 


Adversum 


Against. 


Mg. 


JEgzr 


The sick one, the patient. 


Aggr. feb. 


Aggrediente febre 


While the fever is coming on. 


Agit. 


Agita 


Shake, stir. 


Agit. 


Agitetur 


Let it be shaken or stirred. 


Agit. ante sum. 


Agita ante sumendum 


Shake before taking. 


Agit. vas. 


Agitato vase 


The vial being shaken. 


Alb. 


Albus, a, um 


White. 


Aliq. 


Aliquot 


Some. 


Alt. 


Alter 


The other. 


Alt. hor. 


Alternis horis 


Every other hour. 


Aluta 


Aluta 


Leather. 


Alv. 


Alvus 


The belly, the bowels. 


Alv. adst. 


Alvo adstricta 


The bowels being confined. 


Amp. 


Amplus 


Large. 


Ampul. 


Ampulla 


A large bottle. 


App. 


Appone, Applica 


Apply, Lay or put on. 


Aq. 


Aqua 


Water. 



816 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



817 



Contraction. 


Word or Phrase. 


English Equivalent. 


Aq. astr. 


Aqua astricta 


Frozen water. 


Aq. bull. 


Aqua bulliens 


Boiling water. 


Aq. com. 


Aqua communis 


Common water. 


Aq. ferv., vel ca.\id. 


Aqua fervens, vel calida 


Hot water. 


Aq. fluv. 


Aqua fluviatilis 


River water. 


Aq. font. 


Aqua fontana, vel fontis 


Spring water. 


Aq. gelid. 


Aqua gelidus 


Cold water. 


Aq. mar. 


Aqua marina 


Sea water. 


Aq. niv. 


Aqua nivialis, vel nivalis 


Snow water. 


Aq. phag. 


Aqua phagedaenica 


Yellow wash. 


Aq. pluv. 


Aqua pluvialis 


Rain water. 


Aq. pot. 


Aqua potabilis 


Drinkable water. 


Aq. satur. 


Aqua saturni 


Lead-water. 


Aq. urb. 


Aqua urbis 


City water. 


Aqual. 


Aqualis 


Pertaining to water. 


Aquil. alb. 


Aquila alba 


Calomel. 


Aut 


Aut 


Or. 


B. A. vel Bal. ar. 


Balneum arenae 


Sand-bath. 


B. M. vel Bal. mar. 


Balneum maris 


Salt-water bath. 


B. V. w/Bal. vap. 


Balneum vaporis 


Vapor-bath. 


Bals. 


Balsamum 


Balsam. 


B. B. 


Barbadensis 


Barbadoes. 


Bene 


Bene 


Well, good. 


Bib. 


Bibe, vel Bibatur 


Drink (thou), Let it be drank. 


Bid. 


Biduum 


Two days. 


Bis 


Bis 


Twice. 


Bis die 


Bis in die, vel dies 


Twice a day. 


Bol. 


Bolus 


A large pill. 


Bon. 


Bonus 


Good. 


Brach. 


Brachium 


The arm. 


Brev. 


Brevis 


Short. 


Bull. 


Bulliat, vel Bulliant 


Let it (or them) boil. 


But. 


Butyrum 


Butter. 


C. 


Cum 


With. 


Cc. 


Centimeter cubicum 


Cubic centimeter. 


Caerul. 


Caeruleus, gen. i 


Blue. 


Calef. 


Calefactus,£>?«. i 


Warmed. 


Calom. 


Calomel, vel Calomelas 


Mild Chloride of Mercury, Calomel. 


Calor. 


Calor, gen. oris 


Heat, warmth. 


Cap. 


Cape, vel Capiat 


Take (thou), Let him take. 


Cap. quant, vis 


Capiat quantum vis 


Let him take as much as he will. 


Capil. 


Capillus, gen. i 


A hair. 


Capsul. 


Capsula, gen. as 


A capsule. 


Caput 


Caput, gen. Capitis 


The head, of the head. 


Carbas. 


Carbasus, gen. i 


Linen, lint. 


Caute 


Caute 


Cautiously. 


Ccu. 


Cucurbita 


A cupping-glass. 


Celer. 


Celeriter 


Quickly, immediately. 


Cena 


Cena, vel Ccena 


Supper. 


Chart. 


Charta 


Paper. 


Chart, cerat. 


Charta cerata 


Waxed paper. 


Chartul. 


Chartula 


A small paper. 


Chin. 


Cbininum 


Quinine. 


Cib. 


Cibus, gen. i 


Food, victuals. 


Circit. 


Circitu 


Near, around, about. 


Cit. 


Cito 


Quickly. 


Cito disp. 


Cito dispensetur 


Let it be dispensed quickly. 


Clar. 


Clarus, a, um . 


Bright, clear. 


Claus. 


Clausus, a, um 

1 


Closed, inclosed. 



52 



8i8 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Coch., Cochleat. 


Cochleare, Cochleatim 


A spoonful By spoonfuls (^j). 


Coch. amp. 


Cochleare amplum 


A dessertspoonful (gij). 


Coch. mag. 


Cochleare magnum 


A tablespoonful ( ^ ss). 


Coch. med. 


Cochleare medium 


A dessertspoonful (gij). 


Coch. parv. 


Cochleare parvum 


A teaspoonful (gj). 


Coct. 


Coctio 


Boiling. 


Cog. 


Cogantur 


Let them be combined. 


Col. 


Cola 


Strain. 


Colatur. 


Colaturse 


To (or of ) the strained liquor. 


Colat. 


Colatus 


Strained. 


Colet. 


Coletur 


Let it be strained. 


Colent. 


Colentur 


Let them be strained. 


Coll. 


Collum, gen. i 


The neck. 


Collun. 


Collunarium, gen. i 


A nasal wash. 


Collut. 


Collutorium 


A mouth- wash. 


Collyr. 


Collyrium 


An eye-wash. 


Coloret. 


Coloretur 


Let it be colored. 


Commis. 


Commisce 


Mix together. 


Commod. 


Commode 


Rightly, properly, suitably. 


Comp. 


Compositus 


Compound, compounded. 


Con., Concis. 


Concisus 


Cut. 


Concus. 


Concuscus, gen. i 


Shaken. 


Concut. 


Concuti, Concutiatur 


Shake, Let it be shaken. 


Conf. 


Confectio 


Confection. 


Cong. 


Congius 


A gallon. 


Conquas. 


Conquassando 


By vigorous shaking. 


Cons. 


Conserva, Conserve 


A conserve ; keep, preserve. 


Consperg. 


Consperge 


Dust, sprinkle. 


Contere 


Contere 


Rub together. 


Cont. rem. 


Continuentur remedia 


Let the medicines be continued. 


Contus. 


Contusus 


Bruised. 


Coq. 


Coque, Coquantur 


Boil, let them be boiled. 


Coq. ad med. con- 


Coque ad medietatis con- 


Boil to the consumption- of half. 


sump. 


sumptionem 




Coq. S. A. 


Coque secundum artem. 


Boil according to art. 


Coq. in S. A. 


Coque in sufficiente aquae 


Boil in sufficient water. 


Coq. simul. 


Coquantur simul 


Boil them together. 


Cor. 


Cor, cordis 


The heart, of the heart. 


Cort. 


Cortex, corticis 


The bark, of the bark. 


Cot. 


Cotula 


A measure. 


Cox. 


Coxa 


The hip. 


Cras. 


Cras, Crastinus 


To-morrow. 


Cras mane sumend. 


Cras mane sumendus 


To be taken to-morrow morning. 


Cras nocte 


Cras nocte 


To-morrow night. 


Cras vesp. 


Cras vespere 


To-morrow evening. 


Crast. 


Crastinus 


For to-morrow, early. 


Cru. 


Cruor 


Blood, gore. 


Cucur. 


Cucurbitula 


A cupping-glass. 


Cuj. 


Cujus, Cujus-libet 


Of which, of any. 


Cum 


Cum 


With. 


Curs. hod. 


Cursu hodie 


During the day. 


Cyath., C. vinar. 


Cyathus, vel C. vinarius 


A wine-glass (^j— ij). 


Cyatho these 


Cyatho these 


In a cup of tea. 


D. 


Dies, Dosis 


A day, A dose. 


Da, Det. 


Da, Detur 


Give, let it be given. 


De 


De {prep. gov. ablative) 


From, down. 


Deaur. pil. 


Deaurentur pilube 


Let the pills be gilded. 


Deb. spiss. 


Debita spissitudo 


To a proper consistence. 


Deb. 


Debitus, a, um 


Due, proper. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Dec. 


Decanta 


Pour off. 


Decern. 


Decern, Decimus, 


Ten, The tenth. 


Decoct. 


Decoctum 


A decoction. 


Decoq. 


Decoque 


Boil down. 


Decub. 


Decubitus 


Lying down. 


De d. in d. 


De die in diem 


From day to day. 


Dein. 


Dein, vel Deinde 


Thereupon, afterward, then. 


Deglut. 


Deglutiatur 


Let be swallowed. 


Dej. alv. 


Dejectiones alvi 


Stools. 


Dejic. 


Dejiciatur 


Let be purged. 


Dent. 


Dentes; Dentur 


The teeth ; Let them be given. 


Det. in dup. 


Detur in duplo 


Let twice as much be given. 


Dext. 


Dexter, Dextra 


The right. 


Dieb. alt. 


Diebus alternis 


Every other day. 


Dieb. tert. 


Diebus tertiis 


Every third day. 


Dies vel D. 


Dies, gen. diei 


A day. 


Dig. 


Digere, Digeretur 


Digest, Let it be digested. 


Diluc. 


Diluculo 


At break of day. 


Dil. 


Dilue, Dilutus, a, um 


Dilute (thou), Diluted. 


Dim. 


Dimidius, a, um 


One-half. 


D. P., vel Dir. prop. 


Directione propria 


With a proper direction. 


Disp. 


Dispensa, Dispensetur 


Dispense^ Let it be dispensed. 


Div. in p. aeq. 


Dividatur in partes 
aequales 


Let it be divided into equal parts. 


Divid. 


Dividendus, a, um 


To be divided. 


Dol. 


Dolor, Dolore 


Pain, In pain. 


Don. 


Donee 


Until. 


Don. alv. dejec. 


Donee alvus dejecerit 


Until the bowels move. 


Don. alv. sol. ft. 


Donee alvus soluta fuerit 


Until the bowels shall be opened. 


Don. dolor, neph. 


Donee dolor nephriticus 


Until the nephritic pain is removed. 


exulav. 


exulaverit 




Don. hab. colat. 


Donee habeas colaturse 


Until you have of strained liquor. 


Don. len. dol. 


Donee leniatur dolor 


Until the pain is relieved. 


Don. sint res. 


Donee sint residuse 


Until there is ... of residue. 


Dos. 


Dosis 


A dose. 


Dr., 3 


Drachma 


A drachm (60 grains). 


Dulc. 


Dulcis, Dulcitas 


Sweet, Sweetness. 


Dup. 


Duplico 


In duplicate. 


Dur. dolor. 


Durante dolore 


While the pain lasts. 


Ead. 


Eadem (fern.) 


The same. 


Eburn. 


Eburn eus 


Made of ivory. 


Ejusd. 


Ejusd em 


Of the same. 


Elect. 


Electuarium 


An electuary. 


Em. 


Emesis 


Vomiting. 


En. Enem. 


Enema, Enemata 


A clyster or enema, Enemas. 


Epistom. 


Epistomium 


A stopper, bung. 


Et 


Et 


And. 


Etiam 


Etiam 


Also, besides. 


Evan. 


Evanuerit 


Shall have disappeared. 


Ex 


Ex {gov. ablative) 


From, out of. 


Ex quib. sum. 


Ex quibus sumatur 


From which are given. 


Ex mod. p. 


Ex modo praescripto 


After the manner prescribed. 


Ex paul aq. 


Ex paululo aquae 


From (In) a very little water. 


Ex parte 


Ex parte 


Partly. 


Exhib. 


Exhibeatur 


Let it be exhibited. 


Exper. 


Experime 


Try (thou). 


Ext. 


Extende, Extendatur 


Spread, Let it be spread. 


Ext. sup. alut. 


Extende super alutem 


Spread upon leather. 


Ext., Extr. 


Extractum 


An extract. 



820 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Extr. 


Extrahe, Extrahatur 


Extract (thou), Let it be extracted. 


F. 


Fac 


Make (thou). 


F. L. A. 


Fiat lege artis 


Let it be made by the rules of art. 


F. pil. xij 


Fac pilulas duodecim 


Make 12 pills. 


Far. 


Farina 


Flour. 


Fas. lint. 


Fascia lintea 


A linen bandage. 


Fascic. 


Fasciculus 


A small bundle. 


Febr. 


Febris 


Fever. 


Febr. dur. 


Febre durante 


During the fever. 


Fem. intern. 


Femori interno 


To the inner thigh. 


Ferv. 


Fervens, ge?t. ends 


Hot. 


Fict. 


Fictilis, e 


Earthen, An earthen vessel. 


Fil. 


Filtra 


Filter (thou). 


Filt. 


Filtrum, gen. i 


A filter. 


Fistul. arm. 


Fistula armata 


A syringe ready for use. 


Flav. 


Flavus, a, um 


Yellow. 


Flor. 


Flores (//.) 


Flowers. 


Fluid. , Fl. 


Fluidus 


Liquid. 


Form. 


Formula, Formentur 


A prescription, Let them be formed. 


Frig. 


Frigor, gen. oris 


Cold. 


Frust. 


Frustillatim 


In small pieces. 


Ft. 


Fiat, Fiant {pi.) 


Let it [or them) be made. 


Ft. cerat. 


Fiat ceratum 


Let a cerate be made. 


Ft. chart, xij 


Plant chartulae duodecim 


Let 12 powders be made. 


Ft. collyr. 


Fiat collyrium 


Let an eye-wash be made. 


Ft. emuls. 


Fiat emulsum 


Let an emulsion be made. 


Ft. en. 


Fiat enema 


Let an enema be made. 


Ft. inject. 


Fiat injectio 


Let an injection be made. 


Ft. pil. xij 


Fiant pilulae duodecim 


Let 12 pills be made. 


Ft. pulv. 


Fiat pulvis 


Let a powder be m#de. 


Ft. pulv. xij 


Fiant pulveres duodecim 


Let 12 powders be made. 


Ft. sol. 


Fiat solutio 


Let a solution be made. 


Ft. suppos. viij 


Fiant suppositoria octo 


Let 8 suppositories be made. 


Ft. troch. xx 


Fiant trochisci viginti 


Let 20 troches be made. 


Ft. ung. 


Fiat unguentum 


Let an ointment be made. 


Ft. venesec. 


Fiat venesectio 


Let a bleeding be done. 


Fuerit 


Fuerit 


Shall have been. 


Fus. 


Fuscus, a, um 


Brown, dark. 


Garg. 


Gargarysma 


A gargle. 


Gelat. quav. 


Gelatina quavis 


In any kind of jelly. 


Ging. incid. 


Gingivas incide 


Lance (or cut) the gums. 


Gm. 


Gramma 


A gramme. 


g r - 


Granum, Grana 


A grain, grains. 


gr. vj pond. 


Grana sex pondere 


Six grains by weight. 


Grad. 


Gradatim 


By degrees, gradually. 


Grat. 


Gratus 


Pleasant. 


Gros. 


Grossus, a, um 


Large, coarse. 


Grum. 


Grumus 


A clot (of blood). 


Gtt. 


Gutta, Gutta?, Guttas 


A drop, Drops. 


Guttat. 


Guttatim 


By drops. 


Gtt. quibusd. 


Guttis quibusdam 


With a few drops. 


H. 


Hora 


An hour. 


Har. pil. 


Harum pilularum 


Of these pills. 


Haust. 


Haustus, gen. i 


A draught. 


H. p. n. 


Haustus purgans noster 


My own purgative draught. 


Hebdom. 


Hebdomada, Hebdomas 


A week. 


Herb. 


Herba, gen. se 


An herb. 


Herb, recent. 


Herbarum recentium 


Of fresh herbs. 


Heri 


Heri 


Yesterday. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



821 



Contraction. 


Word or Phrase. 


English Equivalent. 


Hie, Haec, Hoc 


Hie, Haec, Hoc 


This. 


Hirudo 


Hirudo, gen. inis 


A leech. 


Hirud. app. 


Hirudines appone 


Apply leeches. 


Hor. 


Hora, gen. se 


An hour. 


Hor. decub. 


Horae decubitus 


At bedtime. 


Hor. j spat. 


Horse unius spatio 


After one hour. 


Hor. interna. 


Horis intermediis 


In the intermediate hours. 


Hor. som. 


Hora. somni 


At the hour of sleep. 


Hor. xj matut. 


Hora undecima. matutina 


At the eleventh hour of the morning. 


Id. 


Idem 


The same. 


Iden. 


Identidem 


Repeatedly, often. 


Idon. 


Idoneus, a, um 


Suitable, proper, convenient. 


Idon. vehic. 


Idoneo vehiculo 


In a suitable vehicle. 


111. 


Illico 


Then, immediately. 


Immit. 


Immitatur 


Let it be placed in. 


Imp. 


Impone 


Lay on, Apply. 


Impr. 


Imprimis 


First, chiefly. 


In 


In 


In, within, upon, not. 


Inc. 


Incide, Incisus 


Cut (thou), Being cut. 


Ind. 


In dies 


Daily, or From day to day. 


Inde 


Inde 


Therefrom. 


In fun. 


Infunde 


Pour in. 


Infus. 


Infusum 


An infusion. 


Ing. 


Ingere, Ingerendus 


Put into, Putting into. 


Injec. 


Injectio 


An injection. 


Injic. enem. 


Injiciatur enema 


Let a clyster be injected. 


In lag. bene obt. 


In lagena bene obturator 


In a well-stoppered bottle. 


In loco frig. 


In loco frigido 


In a cold place. 


In mass. cog. 


In massam cogantur 


Let them be combined in a mass. 


In pulm. 


In pulmento 


In gruel. 


Instar 


Instar 


As big as, the size of. 


Inter 


Inter 


Between. 


Int. 


Internus, a, um 


Inner, internal, between. 


Intus 


Intus 


Inwardly. 


Invol. gelat. 


Involve gelatina 


Coat {or cover) with gelatin. 


Invor. 


Invoruntur 


Let them be moistened. 


Ita 


Ita 


In such manner. 


Iter. 


Iteretur, Iterentur 


Let it (them) be repeated. 


Jam 


Jam 


Now'. 


Jentac. 


Jentaculum, gen. i 


Breakfast. 


jucund. 


Jucunde 


Pleasantly. 


Jul. 


Julepum 


A julep. 


Juscel. 


Juscellum 


A broth. 


Juscul. 


Jusculum 


Soup. 


Jux. 


Juxta, Juxtim 


Near to, close by. 


K. 


Kali, Kalium 


Potassa, Potassium. 


Kal. ppt. 


Kali praaparata 


Potassium Carbonate. 


Lac. 


Lac, gen. Lactis 


Milk, of milk. 


Lag. 


Lagena, gen. se 


A flask, or bottle. 


Lam. 


Lamella 


Plate, leaf, layer, scale. 


Lan. 


Lan a, gen. ae 


Flannel, wool. 


Lang. 


Languor, gen. oris 


Faintness. 


Lapid. 


Lapideus, a, um 


Stony, made of stone. 


Larg. 


Largus, a, um 


Abundant, plentiful. 


Larid. 


Laridum, gen. i 


Lard. 


Lat. 


Latus, a, um 


Broad, wide. 


Lat. 


Latus, £•<?«. eris 


The side. 


Lat. admov. 


Latere admoveatur 


Let it be applied to the side. 


Lat. dol. 


Lateri dolenti 


To the painful side. 



822 



LTST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Lax. 


Laxus, a, um 


Loose, open. 


Lb., tt> 


Libra 


A pound. 


Lect. 


Lectus, gen. i 


Abed. 


Len. 


Leniter 


Easily, gently. 


Len. ter. 


Leniter terendo 


By rubbing gently. 


Lev. 


Leviter 


Lightly. 


Lig. 


Ligatura 


A ligature. 


Linct. 


Linctus, ge7i. i 


A linctus. 


Linim. 


Linimentum, gen. i 


A liniment. 


Lint. 


Linteum, gen. i 


Lint, linen. 


Liq. 


Liquor, gen. oris 


A solution. 


Lot. 


Lotio 


A lotion. 


Lut. 


Luteus, a, um 


Yellow, golden yellow. 


M.,TT\, 


Minimum, ^z. i 


A minim. 


M. 


Misce 


Mix (thou). 


M. 


Manipulus,£<f«. i 


A handful. 


Macer. 


Macera 


Macerate (thou). 


Mag. 


Magnus, a, um 


Large. 


Man. 


Manipulus, gen. i 


A handful. 


Mane 


Mane (indecl.) 


Morning, in the morning. 


Mane primo 


Mane primo 


Early in the morning. 


Manus 


Manus, gen. i 


The hand. 


Mass. 


Massa, gen. ce 


A mass, a pill-mass. 


Mat. 


Matula,£?«. se 


A vessel, a chamber-pot. 


Matut. 


Matutinus 


In the morning. 


Med. 


Medius, a, um 


Middle. 


Mens. 


Mensura 


By measure. 


Mic. pan. 


Mica panis 


A crumb of bread. 


Min. 


Minimum 


A minim. 


Minut. 


Minutum* 


A minute. 


Mis. 


Misce, Miscetur 


Mix (thou), Let it be mixed. 


Mis. bene 


Misce bene 


Mix well. 


Mis. caut. 


Misce caute 


Mix cautiously. 


Mist. 


Mistura 


A mixture. 


Mit. 


Mitte, Mittatur , Mit- 


Send (thou), Let it be sent, Let 




tantur 


them be sent. 


Mit. sang, ad uncias 


Mitte sanguinem ad uncias 


Take away blood to 12 ounces at 


xij salt. 


duodecim saltern 


least. 


Mit. tal. 


Mitte tales 


Send of such. 


Mod. diet. 


Modo dictu 


As directed. 


Mod. pr. 


Modo prsescripto 


In the manner prescribed. 


Modic. 


Modicus, a, um 


Moderate-sized, middling. 


Mol. 


Mollis, Molle 


Soft. 


Mor. 


Mora, gen. se 


Delay. 


Mor. diet. 


More dictu 


In the manner directed. 


Mor. sol. 


More solito 


In the usual manner. 


Mort. 


Mortarium, gen. i 


A mortar. 


Natr. 


Natrium, gen. i 


Sodium. 


Ne tr. s. num. 


Ne trades sine nummo 


Do not deliver without the money. 


Necn. 


Necnon 


And also, and yet. 


Nig. 


Niger, nigra, nigrum 


Black. 


Nisi 


Nisi 


Unless. 


No. 


Numero, Numerus 


In number, A number. 


Noct. 


Noctis 


Of the night! 


Noct. maneq. 


Nocte maneque 


At night and in the morning. 


Non 


Non 


Not. 


Non repetat. 


Non repetatur 


Let it not be repeated. 



*This is medical Latin, 
pars horce. 



"bog- Latin." The proper Latin for a minute of time is Sexagesin, 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



823 



Contraction. 


Word or Phrase. 


English Equivalent. 


Noxa 


Noxa, gen. se 


An injury. 


Nucha 


Nucha 


The nape of the neck. 


Nunc 


Nunc 


Now. 


Nut. 


Nutricius, a, um 


Nutritious. 


Nutrit. 


Nutritus, gen. us 


Nutriment. 


Nux 


Nux, gen. nucis 


A nut. 


Nux Mosch. 


Nux Moschata 


A nutmeg. 


0. 


Octarius 


A pint (fxvj). 


Obd. 


Obduce 


Cover, conceal, coat. 


Obduct. 


Obductus, a, um 


Covered, coated. 


Obtrit. 


Obtritus, a, um 


Crushed. 


Occlus. 


Occlusus, a, um 


Enclosed. 


Oct. 


Octo, Octavus 


Eight, Eighth. 


Octup. 


Octuplus 


Eight-fold. 


Ocul. 


Oculus,^«. i 


The eye. 


Odor. 


Odora, Odoretur 


Perfume, Let it be perfumed. 


Odorat. 


Odoratus, a, um 


Perfumed, odorous. 


01. Lini sine ig. 


Oleum Lini sine igne 


Cold-drawn Linseed Oil. 


01. 0. Opt. 


Oleum olivae optimum 


Best olive oil. 


011a 


011a, gen. se 


A pot, a jar. 


Ollic. 


Ollicula, gen. se 


A little pot. 


Oran. hor. 


Omni hora 


Every hour. 


Omn. bih. 


Omni bihorio 


Every two hours. 


Omn. quadr. hor. 


Omni quadrante horae 


Every ^ hour. 


Omni mane 


Omni mane 


Every morning. 


Omn. noct. 


Omni nocte 


Every night. 


Op. 


Opus 


Need, occasion. 


Opt. 


Optimus, a, um 


Best. 


Oryza 


Oryza, gen. se 


Rice. 


Os 


Os, gen. oris 


The mouth. 


Ov. 


Ovum, gen. ovi 


An egg. 


P. 


Pondere 


By weight. 


P. P. A. 


Phiala prius agitata 


The bottle having been first shaken. 


P. r. n. 


Pro re nata 


Occasionally, as needed. 


Pab. 


Pabulum, gen. i 


Food. 


Pallid. 


Pallidus, a, um 


Pale. 


Pan. 


Panis, Pannus 


Bread, A cloth or rag. 


Para, Parat. 


Para, Paratus 


Prepare, Prepared. 


Par., Pt. 


Pars, Partis 


A part, Of a part. 


Pt. aeq. 


Partes sequales 


Equal parts. 


Pt. affect. 


Parte affecta 


On the affected part. 


Part. vie. 


Partitis vicibus 


In divided doses. 


Parv. 


Parvus, a, um 


Little. 


Parvul. 


Parvulus, a, um 


An infant, a parvule. 


Pastil. 


Pastillus, Pastillum 


A pastille, a lozenge. 


Pauc. 


Paucus, a, um 


Little, few. 


Paul. 


Paulatim 


Little by little, gradually. 


Pect. 


Pectus, gen. oris 


The breast. 


Pediluv. 


Pediluvium 


A foot-bath. 


Penicil. cam. 


Penicillum camelinum 


A camel' s-hair pencil or brush. 


Per 


Per {prep. gov. accus.) 


Through, by means of, very. 


Peract. operat. emet. 


Peracta operatio emetici 


When the emesis is finished. 


Percalef. 


Percalefactus, a, um 


Thoroughly heated. 


Percol. 


Percola 


Strain through, percolate. 


Per deliq. 


Per deliquium 


By deliquescence. 


Per fistul. vit. 


Per fistul am vitream 


Through a glass tube. 


Perg. 


Perge, Pergetur 


Proceed, Let be continued. 


Perind. 


Perinde 


Just as. 


Permit, vir. 


Permittentibus viribus 


The strength permitting. 



824 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Perpur. 


Perpurus, a, um 


Very clean. 


Pervesp. 


Pervesperi 


Very late in the evening. 


Pes 


Pes, gen. pedis 


The foot. 


Pess. 


Pessarium, Pessulum 


A pessary. 


Ph. 


Phiala, gen. se 


A vial, a bottle. 


Pil. 


Pilula, gen. ae 


A pill. 


pa. 


Pilus, gen. i 


The hair. 


Ping. 


Pinguis, gen. is 


Fat, grease. 


Pist. 


Pistillum, gen. i 


A pestle. 


Plac. 


Placebo 


I will satisfy (please). 


Plas. 


Plasma, Plasmetur 


Mould, Let it be moulded. 


Plen. 


Plenus, a, um 


Filled. 


Poc. 


Poculum, Pocillum 


A cup, A little cup. 


Pon., P. 


Pondere 


By weight. 


Pon. civ. 


Pondus civile 


Civil weight (avoirdupois). 


Pon. med. 


Pondus medicinale 


Medicinal (apothecaries') weight. 


Pone aur. 


Pone aurem 


Behind the ear. 


Post cib. 


Post cibos 


After meals. 


Post sing. sed. liq. 


Post singulas sedes liquidas 


After every loose stool. 


Postrid. 


Postridie 


On the next day. 


Pot. 


Potus, gen. us 


A drink. 


Prse 


Proe {prep. gov. ad/.) 


Before, very. 


Prsep. 


Prseparatus, a, um 


Prepared. 


Prand. 


Prandium, gen. i 


Dinner. 


Prid. 


Pridie 


On the previous day. 


Prim. man. 


Primo mane 


Very early in the morning. 


Primus 


Primus, a, um 


The first. 


Pro 


Pro {adv. and prep. gov. 
ad/.) 


For, before, according to. 


Prop. 


Proprius, a, um 


Special, particular. 


Pro rat. set. 


Pro ratione setatis 


According to the age of the patient. 


Pro r. n. 


Pro re nata 


Occasionally, as needed. 


Prox. 


Proximo 


Nearest. 


Pug. 


Pugillus 


A pinch. 


Pulm. 


Pulmentum, gen. i 


Gruel. 


Pulv. 


Pulvis, gen. eris 


A powder. 


Pulv. gros. 


Pulvis grossus 


A coarse powder. 


Pulv. subtil. 


Pulvis subtilis 


A smooth powder. 


Pulv. ten. 


Pulvis tenuis 


A fine powder. 


Pulvz. 


Pulverizatus, a, um 


Powdered. 


Pur. 


Purus, a, um 


Pure, clean. 


Purg. 


Purgativus, gen. i 


A purgative, a purging. 


Pyx. 


Pyxis, gen. idis 


A small box, a pill-box. 


Q- 


Quadrans, gen. tis 


A fourth part, a quart. 


Q. lib. 


Quantum libet 


As much as you please. 


Q. p. 


Quantum placet 


a a a <« (< 


Q. q. 


Quoque 


Also. 


Qq. 


Quisque, Quaque 


Each, or Every. 


Qq. hor. 


Quaqua hora 


Every hour. 


Q. s. 


Quantum sufficiat 


As much as is sufficient. 


Q. s. 


Quantum satis 


ii a n tt tt 


Q. v. 


Quantum vis 


As much as you please. 


Q. vol. 


Quantum volueris 


a a tt tt << 


Quad. 


Quadruplo 


Quadruple, in four- fold. 


Quam 


Quam 


As much as. 


Quart. 


Quartus, gen. i 


Fourth. 


Quat. , Quater 


Quatuor, Quater 


Four, Four times. 


Quibus 


Quibus 


From which. 


Quinq. 


Quinque 


Five. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



825 



Contraction. 


Word or Phrase. 


English Equivalent. 


Quint. 


Quintus 


The fifth. 


Quoq. 


Quoque 


Also. 


Quor. 


Quorum 


Of which. 


Quotid. 


Quotidie 


Daily. 


Quoties req. 


Quoties requiritur 


As often as is required. 


E 


Recipe 


Take (thou), A recipe. 


Rar. 


Rarus, a, um 


Loose, thin, rare. 


Rat. 


Ratio, gen. onis 


Relation, proportion. 


Rec. 


Recens, gen. entis 


Fresh, recent, newly. 


Red. in pulv. 


Redactus in pulverem 


Reduced to powder. 


Redig. in pulv. 


Redigatur in pulverem 


Let it be reduced to powder. 


Reg. umbil. 


Regio umbilici 


The umbilical region. 


Rel. 


Relectus, a, um 


Opened, loosened. 


Reliq. 


Reliquus, gen. i 


Remaining, the remainder. 


Renov. 


Renova, Renovetur 


Renew, Let it be renewed. 


Renov. semel 


Renovetur semel 


Let it be renewed once only. 


Rept. 


Repetatur, Repetantur 


Let it (them) be repeated. 


Res 


Res, gen. rei 


A substance, thing, affair. 


Resid. 


Residuus, a, um 


Residual, remaining. 


Respon. 


Responde 


Answer (thou). 


Retin. 


Retinetur 


Let it be withheld. 


Rict. 


Rictus, gen. us 


A wide (distended) opening. 


Rig. 


Rigidus, a, um 


Rigid, hard, inflexible. 


Rub. 


Ruber, Rubra, Rubrum 


Red, ruddy. 


Rudic. 


Rudicula, gen. se 


A spatula. 


Rudis 


Rudis, gen. is 


A stirring-rod. 


Rum. 


Rumen, gen. inis 


The throat. 


S. expr. 


Sine expressione 


Without expressing. 


S. A. 


Secundum artem 


According to art. 


S. L. 


Secundum legem 


According to law. 


S.N. 


Secundum naturam 


According to nature. 


S. S. S. 


Stratum superstratum 


Layer upon layer. 


S. V. R. 


Spiritus vini rectificatus 


Alcohol. 


S. V. T. 


Spiritus vini tenuis 


Proof spirit. 


Sac. lac. 


Saccharum lactis 


Sugar of milk. 


Sac. sat. 


Saccharum saturni 


Sugar of lead. 


Saep. 


Ssepe 


Frequently. 


Sal 


Sal, ge?i. salis 


Salt. 


Sal am. 


Sal amarum 


Magnesium sulphate. 


Sal mir. 


Sal mirabile 


Sodium sulphate. 


Sal vol. 


Sal volatile 


Ammonium carbonate. 


Saltern 


Saltern 


At least. 


Saltim 


Saltim 


By leaps. 


Sang. 


Sanguis, Sanguineus 


Blood, Bloody. 


Sap. 


Sapor, gen. oris 


A flavor, delicacy. 


Sat. 


Satis 


Enough, sufficient. 


Saturat. 


Saturatus, a, um 


Saturated. 


Scarif. 


Scarifica 


Scarify (thou). 


Scarif. expl. 


Scarificatione explicata 


Scarification having been effected. 


Scat. 


Scatula, gen. se 


A box. 


Scil. 


Scilicet 


Namely. 


Scrap., 9 


Scrupulum, gen. i 


A scruple (20 grains). 


Scut. pect. 


Scuto pectori 


For protection to the breast. 


Sec. 


Secundo, Secundum 


Secondly, According to. 


Secund. 


Secundus 


Second. 


Sed. 


Sedes, gen. is 


The fundament, the feces. 


Semel 


Semel 


Once. 


Semidr. 


Semi-drachma 


Half a drachm. 


Semih. 


Semi-hora 


Half an hour. 



826 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Sensim 


Sensim 


Gently, gradually, slowly. 


Separ. 


Separatim 


Separately. 


Sept. 


Septem 


Seven. 


Septim. 


Septimana 


A week. 


Sero 


Sero 


Late, at a late hour. 


Sesq. 


Sesqui 


One and a half. 


Sesqh. 


Sesquihora 


An hour and a half. 


Sesunc. 


Sesuncia 


An ounce and a half. 


Sev. 


Sevum, gen. i 


Suet, tallow. 


Sex, Sext. 


Sex, Sextus 


Six, Sixth. 


Si 


Si 


If. 


Sic! 


Sic! 


So, thus. 


Sic. 


Sicca, Siccetur 


Dry (thou), Let it be dried. 


Sic. 


Siccus 


Dry, dried. 


Sig. 


Signa, Signetur 


Write (thou), Let it be marked. 


Sig. nom. prop. 


Signatur nomine proprio 


Let it be written upon (marked) with 
its proper name. 


Sign. 


Signanter 


Clearly, distinctly. 


Sile hujus ! 


Sile hujus ! 


Keep silence concerning this. 


Simp. 


Simplex, gen. simplicis 


Simple, unmixed. 


Simul 


Simul 


Together. 


Sin. 


Sine 


Without. 


Sing. 


Singulorum 


Of each. 


Si non val. 


Si non valeat 


If it does not answer. 


Si op. sit. 


Si opus sit 


If necessary. 


Si vir. perm. 


Si vires permittebant 


If the strength will permit. 


Sit 


Sit 


Let it be. 


Sit in promp. 


Sit in promptu 


Let it be in readiness. 


Sitis, Siti 


Sitis, Siti 


Thirst, For thirst. 


Sol. 


Solus 


Alone, only. 


Solat. 


Solatium, £-«?«. ii 


A soothing, assuaging. 


Solit. 


Solitus, a, um 


Accustomed, ordinary. 


Solut. 


Solutus, a, um 


Dissolved. 


Solut. 


Solutio, gen. onis 


A solution. 


Solv. 


Solve, Solvetur 


Dissolve, Let it be dissolved. 


Solv. c. calor. 


Solve cum calore 


Dissolve with heat. 


Som. 


Somnus, gen. i 


Sleep. 


Spiss. 


Spissus, a, um 


Dense, hard. 


Spt. 


Spiritus, gen. us 


Spirit. 


Spt. vin. rect. 


Spiritus vini rectificatus 


Rectified spirit of wine (Alcohol). 


Spt. vin. ten. 


Spiritus vini tenuis 


Proof spirit. 


Spt. vinos. 


Spiritus vinosus 


Ardent spirit (of any strength). 


ss. 


Semis, Semissis, Semi- 


A half. 


St. 


Stet, Stent 


Let it (or them) stand. 


Stat. 


Statim 


Immediately. 


Stib. 


Stabium, gen. ii 


Antimony. 


Stillat. 


Stillatim 


By drops, drop by drop. 


Stom. 


Stomachus, gen. i 


The stomach. 


Strat. 


Stratum, gen. i 


Layer, stratum. 


Strat. superst. 


Stratum superstratum 


Layer upon layer. 


Suav. 


Suavis 


Pleasant, agreeable. 


Sub 


Sub 


Under, somewhat. 


Subact. 


Subactus 


Subdued, sinking. 


Sub. fin. coct. 


Sub finem coctionis 


When the boiling is nearly done. 


Subind. 


Subinde 


Frequently. 


Subtil. 


Subtilis 


Fine, smooth, nice. 


Sue. 


Succus, gen. i 


Juice, sap. 


Suggil. 


Sugillationi 


To the bruise. 


Sum. 


Sume, Sumat 


Take (thou), Let him take. 



LIST OF CONTRACTIONS AND LATIN PHRASES. 



%2J 



Contraction. 


Word or Phrase. 


English Equivalent. 


Sum. 


Sumatur, Sumantur 


Let it (them) be taken. 


Sum. tal. 


Sumat talem 


Let him take one like this. 


Sumend. 


Sumendus 


To be taken. 


Summit. 


Summitates 


The highest points, summits. 


Sum. mane sum. 


Summo inane sumendus 


To be taken very early in the morning. 


Summ. 


Suramus, a, um 


Highest, summit. 


Sup. 


Super, Supra 


Above, upon, over. 


Sup. bib. haust. 


Superbibendo haustum 


Drinking afterwards this draught. 


Suppos. 


Suppositoria, gen. se 


A suppository. 


Suppos. rect. 


Suppositoriae rectales 


Rectal suppositories. 


Suppos. ureth. 


Suppositoriae urethrales 


Urethral suppositories. 


Syr. 


Syrupus, gen. i 


Syrup. 


T. d., velT. i. d. 


Ter die, vel Ter in die 


Thrice daily. 


Tab. 


Tabella, gen. se 


A lozenge, tablet. 


Tal. 


Talis, gen. is 


Of such, like this. 


Tarn 


Tam 


So far, in so far. 


Tan. 


Tandem 


At last, finally. 


Tant. 


Tantum, gen. i 


So much, so many. 


Teg. 


Tegmen, gen. inis 


A cover. 


Temp. 


Tempus, gen. oris 


Time, temple. 


Temp. dext. 


Tempori dextro 


To the right temple. 


Ten. 


Tenuis 


Fine, weak, thin. 


Tep. 


Tepidus, a, um 


Tepid, lukewarm. 


Ter 


Ter 


Thrice, three times. 


Tere, Teret. 


Tere, Teretur 


Rub (thou), Let it be rubbed. 


Tere sim. 


Tere simul 


Rub (thou) together 


Teres 


Teres, gen. etis 


Rubbed, smooth, polished. 


Tert. 


Tertius 


Third. 


Test. ov. 


Testa ovi 


An egg-shell. 


Thion. 


Thionas, gen. atis 


Sulphur, sulphate. 


Tinct., vel Tr. 


Tinctura, gen. se 


Tincture. 


Tinct. Herb. Recent. 


Tincturae Herbarum Re- 
centium 


Tinctures of Fresh Herbs. 


Tinct. Theb. 


Tinctura Thebaica 


Laudanum. 


Tr. 


Tres, Tria 


Three. 


Trid. 


Triduum, gen. ui 


The space of 3 days. 


Trit. 


Tritura, Trituretur 


Triturate, Let it be triturated. 


Troch . 


Trochiscus, Trochisci 


A lozenge, or troche, Lozenges. 


Turn 


Turn 


Then, next, furthermore. 


Turb. 


Turbidus, a, um 


Turbid, muddy. 


Tus. 


Tussis, gen . is 


A cough. 


Tuto 


Tuto 


Safely. 


Ubi 


Ubi 


Where, wherever, whenever. 


Uln. 


Ulna, gen. se 


The arm, elbow. 


Ult. 


Ultime, Ultima 


Lastly, at the last. 


Ult. praesc. 


Ultimo prasscriptus 


The last ordered. 


Una 


Una 


Together. 


Unc, I 


Uncia, gen. ae 


An ounce. 


Unct. 


Unctus, a, um 


Anointed, besmeared. 


Unctul. 


Unctulus, a, um 


<■<■ " 


Ung. 


Unguentum, gen. i 


An ointment, unguent. 


Unguil. 


Unguilla, gen. se 


An ointment-box. 


Urg. 


Urgens, gen. entis 


Pressing, urgent. 


Ust. 


Ustus, a, um 


Burnt. 


Ut 


Ut, Uti 


That, so that, in order that. 


Ut diet. 


Ut dictum 


As directed. 


Utend. more sol. 


Utendus more solito 


To be used in the usual manner. 


Utere 


Utere 


Use (thou), make use of. 


Vas 


Vas, gen. vasis 


A vessel, utensil, bottle. 



828 



NUMERALS. 



Contraction. 


Word or Phrase. 


English Equivalent. 


Vas vit. 


Vas vitreum 


A glass vessel. 


Vehic. 


Vehiculnva., gen. i 


A vehicle, menstruum. 


Vel 


Vel {or Ve as a suffix) 


Or. 


Venaesec. brach. 


Venaesectio brachii 


Bleeding in the arm. 


Venen. 


Venenum, Venenosus 


A poison, Poisonous. 


Ver. 


Verus, a, um 


True, real, genuine. 


Vesp. 

Vesper. 

Vic. 


Vesper, gen. eris 
Vesperma, gen. se 
Vicis, Vices 


The evening. 
Supper. 
Change, changes. 


Vin. 


Vinum, gen. i 


Wine. 


Vir. 
Virid. 


Vires {pi. of Vis) 
Viridis, Viride 


Strength, vigor, life. 
Green. 


Vis 
Vitel. 


Vis, gen. viris 
Vitellus, gen. i 


Strength, vigor, life. 
Yolk. 


Vitel. ovi 


Vitellus ovi 


Yolk of egg. 


Vitel. ovi sol. 


Vitello ovi solutus 


Dissolved in the yolk of an egg. 


Vitr. 


Vitrum, Vitreus 


Glass, Of glass, glazed. 


Vol. 


Volatilis, Volatile 


Volatile. 


Vom. urg. 


Vomitione urgente 


Vomiting being severe. 



For Dangerous Abbreviations, see ante, page 508, under the title PRESCRIPTIONS. 



NUMERALS. 



Cardi 


NALS. 


Ordinals. 


Unus 


One. 


Primus 


First. 


Duo 


Two. 


Secundus 


Second. 


Tres 


Three. 


Tertius 


Third. 


Quatuor 


Four. 


Quartus 


Fourth. 


Quinque 


Five. 


Quintus 


Fifth. 


Sex 


Six. 


Sextus 


Sixth. 


Septem 


Seven. 


Septimus 


Seventh. 


Octo 


Eight. 


Octavus 


Eighth. 


Novem 


Nine. 


Nonus 


Ninth. 


Decern 


Ten. 


Decimus 


Tenth. 


Undecim 


Eleven. 


Undecimus 


Eleventh. 


Duodecim 


Twelve. 


Duodecimus 


Twelfth. 


Tredecim 


Thirteen. 


Tertius decimus 


Thirteenth. 


Quatuordecim 


Fourteen . 


Quartus decimus 


Fourteenth. 


Quindecim 


Fifteen. 


Quintus decimus 


Fifteenth. 


Sexdecim 


Sixteen. 


Sextus decimus 


Sixteenth. 


Septemdecim 


Seventeen. 


Septimus decimus 


Seventeenth. 


Octodecim 


Eighteen. 


Octavus decimus 


Eighteenth. 


Novemdecim 


Nineteen. 


Nonus decimus 


Nineteenth. 


Viginti 


Twenty. 


Vicesimus 


Twentieth. 


Viginti unus, or\ 
Unus et viginti j 


Twenty-one. 


Vicesimus primus 


Twenty-first. 


Vicesimus secundus 


Twenty-second. 


Triginta 


Thirty. 


Tricesimus 


Thirtieth. 


Quadraginta 


Forty. 


Quadragesimus 


Fortieth. 


Quinquaginta 


Fifty. 


Quinquagesimus 


Fiftieth. 


Sexaginta 


Sixty. 


Sexagesimus 


Sixtieth. 


Septuaginta 


Seventy. 


Septuagesimus 


Seventieth. 


Octoginta 


Eighty. 


Octogesimus 


Eightieth. 


Nonaginta 


Ninety. 


Nonagesimus 


Ninetieth. 


Centum 


One hundred. 


Centesimus. 


Hundredth. 



GENITIVE CASE-ENDINGS VERBS. 



829 



GENITIVE CASE-ENDINGS. 



Nom. 


Gen. 


Exceptions. 


a 


se 


Cataplasma, Enema, Physostigma, Aspidosperma and Gargarysma, all have the 
genitive in -air's. Coca is unchanged, though the genitive Cocse is written by 
some authorities. Folia is plural, gen. Foliorum. 


us 
um 

OS 

on 


' 


Rhus, Rhois; Flos, Floris ; Bos, Bovis ; Limon, Limonis ; Erigeron, -ontis. 
Fructus, Cornus, Quercus, Spiritus, Haustus, Potus, do not change, being of 
4th declension. 


as 


atis 


Asclepias, -adis ; Mas, Maris. 


is 


idis 


Pulvis, -eris; Arsenis, -itis ; Phosphis, -itis ; Sulphis, -itis, and all salts ending 
in -is, have genitive in -itis. 





onis 


Mucilago, -inis ; Ustilago, -inis ; Solidago, -inis. 


i 


-lis 


Fel, Fellis ; Mell, Mellis ; Sumbul, Sumbuli. 


en 
ps 

rs 
r 

X 


inis 
pis 
rtis 
ris 
cis 


Words which do not change in the Genitive. 

* Amyl. * Coca. Haustus. Quercus. 
Azedarach. Cornus. Hydrastis. Sassafras. 
Berberis. Cundurango. Jaborandi. Sago. 
Buchu. Curare. Kino. Sinapis. 
Cannabis. Digitalis. Matico. Spiritus. 
Catechu. Fructus. Potus. 

* But some authorities give Amylis, Cocse. 



Pronunciation. 

Attention is particularly directed to the accentuation of words commonly mispronounced ; 
as, for example, acetas, angina, atropa, chimaphila {kimaphila), chldridum, codeia, co- 
nium, enema, iodidum, radicis, ricinus, sinapis, syrupus, eczema, umbilicus, abdomen, 
bromidum, paresis. 

Verbs. 

The Verbs used in prescription writing are nearly all in the imperative mood, giving 
directions to the compounder, and having their object in the accusative case. Such are — 



Adde, add. 
Cola, strain. 
Divide, divide. 
Fxtende, spread. 



Fac, make. 
Filtra, filter. 
Macera, macerate. 
Misce, mix. 



Recipe, take. 
Signa, write. 
Solve, dissolve. 
Tere, rub. 



A few verbs are found in the subjunctive mood, taking their subject or predicate in the 
nominative case. The most usual are — 



Fiat, let be made. 
Coletur, let be strained. 
Color etur, let be colored. 



Bulliat, let boil. 
Capiat, let take. 
Detitr, let be given. 



Dividatur, let be divided. 
Sit, let it be. 
Sumatur, let be taken. 



Participles. 

Participles or Verbal Adjectives are occasionally used, and should agree with their 
respective nouns in gender, number and case. Such are — 

Adhibendus, a, um, to be administered. Dividendus, a, um, to be divided. 

Sumendus, a, um, to be taken. 



8 3 o 



HYPODERMIC FORMULA. 



Prepositions. 

Those in the first column require the noun following to be in the accusative case, 
those in the second column require the ablative case. 

Ad, to, up to. Cum, with. 

In, into. Pro, for. 

Supra, upon. Sine, without. 

Ana, of each, — governs the genitive case. 



Sundry Words and Phrases, 
Bene, well. Non, not. 



Bis, twice. 
Dein, thereupon. 
Et, and. 

Gradatim, gradually. 
Guttatim, by drops. 
In dies, daily. 
Da, give. 



Numerus, number. 
Octarius, a. pint. 
Seme/, once. 
Simul, together. 
Statim, at once. 
Ter, thrice. 
Quater, four times. 



IN MOST FREQUENT USE. 

Ad saturandum, to saturation. 
Numero, to the number of. 
Quantum sujfficiat, as much as necessary. 
Pro re nata, according to need. 
In partes equates, into equal parts. 
Redactus in pulverem, let be pulverized. 
Secundum artem, according to art. 
Non Repetatur, let it not be repeated. 



HYPODERMIC FORMULAE. 



Apomorphine. 
R. Apomorphinae Hydrochlor., gr. j. 

Div. in pulv. xvj. One to four in TT^xx 
of water as required. 



Atropine. 

R . Atropinae Sulphatis, . . . . gr. j. 

Aquae Destillatae, ^j. 

Solve. Sig. — For hypodermic use, TT^vj 

= gr-sV» Tr l iv =g r -Tk- 



R. 



Caffeine. 

Caffeinae Citratis, gr. xxiv. 

Aquae Destillatae, . . . . ^j. 
Solve. Sig. — TT^xx contain gr. j. 



Carbolic Acid. 
R. Ac. Carbol. Purif., . . . . gr. x. 

Aquae Destil. , ^j. 

M. Sig. — rr^viij contain gr. )/(> of the 
acid, which may be given up to gr. ij or iij. 



Chloral. 



R. 



Chloralis Hydratis, . . 
Aquae Destil., .... 
M. Sig. — TT^xxx contain 
Chloral Hydrate. 



. ^iv. 

' 3J ' f 

gr. xv of 



Chloroform. 
R. Chloroformi Purif., . . . . !|ss. 

Sig. — TT^v-xv can be used as one deep 
injection. (See page 230.) The spirit is 
safer, in somewhat larger doses. 



R 



Coniine. 

Coniinae Hydrobromat., . 

Aquae Destillat., .... 

M. Sig. — rt^x contain gr. ^5. 



g r - J- 

3j. 



Cocaine. 
R . Cocainae Hydrochlorat., . . gr. v. 

Aquae Destillatae, ^ij. 

Solve. Sig. — n\xij contain gr. ss. 



Curare. 

R. Curare (Merck), gr. j. 

Acidi Acetici, rn^v. 

Aquae Destillatae, . q. s. ad n\c. 
M. et filtra. Sig. — n\x contain gr. T L. 



R. Curarinae Sulphat, . . . . gr. j. 

Aquae Destillat. , Jss. 

M. Sig. — mjv contain gr. J^. 



Daturine. 



R . Daturinae, gr. ss. 

Aquae Destil. , % j. 

Solve. Sig. — n\iv contain gr. ^lo- 
Dose, rryv-x. 



Digitalin. 
R. Digitalini, gr. ss. 

Alcoholis, 

Aquae Destil., aa gij. 

Solve. Sig. — n\,iv contain gr. t |q. 
Dose, Tr^iv— viij. 



HYPODERMIC FORMULA. 



831 



R 



B 



B 



Duboisine. 
Duboisinae Sulphat. , . . gr. j. 

Aquae Deslil., ^j. 

M. Sig. — n\iv contains gr. T2 ^. 



Ergot and Ergotin. 
Extr. Ergotae Fluid, . . . 
Filtra. Sig. — Dose, n\x. 



gss. 



. Extracti Ergotae (Squibb), 3 j. 
Aquae Destillat., .... % > ). 
Solve et filtra. Sig. — TT^x contain gr. j. 
Dose, n\x-xx. 



B. 



Hyoscine, Hyoscyamine. 

Hyoscinae Hydrobrom., vel 
Hyoscyaminae Hydrobrom., gr. j. 
Aquae Destillatae, .... ^j. 
M. Sig. — TT^v contain gr. g 1 ^. 



Mercury. 
R. Hydrarg. Chlor. Corr. , . . gr. j. 
Aquae Destillat., . . . . %\. 
M. Sig. 



iij. 



3jss. 



R . Hydrarg. Chlor. Corrosivi, 

Ammonii Chloridi, . . . aa gr. 

Misce et solve in — 
Aquae Destillatae, . . 

Dein adde — 

Albuminis Ovi, 3J SS - 

Aquae Destillatae, . . . . gv. 

Filtra, et adde — 

Aquae Destil., . . . q.s.c^^x. 

Sig. — rr\J contains gr. 2^q. Dose,nyij-x. 



R. Hydrarg. etSodii Iodidi, . gr. iij. 
Aquae Destillatae, .... 5 iijss. 
Solve. Sig. — n\x contain gr. ^ . Dose, 
Tn^x every second day. 



B 



Morphine. 

Morphinae Sulphatis, . . . gr. xvj. 
Acidi Carbolici, . ... n\uj. 
Aquae Destillat., .... ^j. 
Solve et filtra. Sig. — TT^vijss contain 
gr. %. [Atitiseptic Magendie's.) 



Morphine and Atropine. 
R . Morphinae Sulphatis, . . . gr. xvj. 
Atropinae Sulphatis, . . . gr. ss. 
Acidi Carbolici, ..... n\iij. 
Aquae Destillat., . . . . !|j. 
Solve et filtra Sig. — tt^vijss contain gr. 
^ of Morphine Sulph., and gr. T2 -q of 
Atropine Sulphate. 



R . Morphinae Sulphatis, . . . gr. xxiv. 

Atropinae Sulphatis, . . . gr. j. 

01. Amygdalae Amar. , . . gtt. j. 

Aquae Destillat., 1|ij. 

Solve. Sig. — TT\x contain gr. ^ of 
Morphine Sulphate, and gr. ^ of Atropine 
Sulphate. {Didayna 1 s Solution.') 



B 



B 



Physostigmine (Eserine). 
Physostigminae Sulph., . . gr. j. 
Aquae Destillatae, . . . . ^j. 
Solve. Sig. — TT\viij contain gr. gL. 



Pilocarpine. 

Pilocarpinae Hydrochlor. , . gr. xvj. 
Aquae Destillat., . . . . ^j. 
M. Sig. — H\v contain gr. */£. 



Potassium Iodide. 

R. Potassii Iodidi, v ) ). 

Aquae Fontanae, . . . . giv. 
Solve. Sig. — Dose, tt^vj-xx. 



R. 



Quinine. 

Quininae Disulph., . . . gr. 1(50). 
Ac. Sulphurici Dil. , . . . rr\c(ioo). 

Ac. Carbolici, ^1^(5)- 

Aquae Fontanae, ^j. 

Solve. Sig. — 5 j contains gr. vj. (Lente.) 
Is irritant (B.) 



R. Quininae Hydrobrom., . . gr. xlviij. 
Aquae Destillat., . . . . giv. 
Solve. Sig. — TT^xx contain gr. iv. 



B 



B 



Quininae Bimur. Carbamidat., 
Aquae Destillatae, . . . . aa ^ iv. 
Solve. Sig. — rr^x contain gr. v. 



Strychnine. 

Strychninae Sulphat., . . gr. j. 
Aquae Destillatae, .... ^j. 
Solve sine alcohol. Sig. — TT^x contain 



g r - ?V 



R. Strychninae Nitratis, . . . gr. iij. 

Aquae Fervid., Sjx. 

Solve. Sig. — tt\,x contain gr. ^V 

{Portugaloff.\ 



8 3 2 



CHLORODYNE. 



Acetanilid, in minute proportion, added to aqueous solutions for hypodermic use, is 
said to preserve them from decomposition more efficiently than any other agent hitherto 
employed for that purpose. Solutions for hypodermic injection should be neutral in 
reaction, neither acid nor alkaline, and freshly prepared, especially solutions of the 
alkaloids, which soon develop a penicillium, which grows at the expense of the alkaloid. 
Aqua Fontana, if filtered, is a better menstruum than Aqua Destillata which has been 
kept for a week, and frequently exposed to the atmosphere. 

To run the least risk of producing a sore at the point of injection, use very fine 
needles, and deliver the injection into the areolar tissue beneath the skin, instead of into 
the skin, as lay parties generally do for themselves. An exception to this rule is in the 
case of Cocaine, which is injected into the skin itself to produce local anaesthesia thereof 
(see page 247). After using the syringe force out all liquid, and wipe the needle-point 
dry between the fingers, before returning it to the case ; the sebaceous matter on the fingers 
will keep it free from rust. Avoid puncturing a vein ; if you do so, watch the patient and 
prepare an injection containing gr. ^ of Atropine Sulphate, to administer if dangerous 
symptoms arise. Never, except under special circumstances, administer the salts of 
Morphine or Atropine hypodermically to children less than 15 years of age. [Com- 
pare The Hypodermic Method, ante, page 25.] 



CHLORODYNE. 



A Comparison of Ten Formula therefor, the Quantities being calculated 
for each to a Four- Ounce Mixture, or nr. ip20. 



Articles. 




Quantity of each article in a Siv 


mixture, as per the formula 


of 


Oh' 

u 


W 


c 


d 

V. 

5 

CO 


d 


* 


U 

Q 


fef 






V 

a 

PQ 






•J 
in 


en 








£ 


Cu 


£ 




pa 


U 


Morphine Hydrochlorate, 


er. 


! 


16 


16 


32 


33^ 


14 


16 


i& 


4 


24 


Chloroform, 


Ill 


236 


192 


240 


372 


375 


207 


240 


247 


240 


240 






59 


96 










I20 


62 


60 




Cannabis Indica, Tincture, 




248 


250 


207 


20 








Cannabis Indica, Extract, 


gr. 






32 














24 


Hydrocyanic Acid, 2 p. c, 


Ill 


118 


192 




50 


50 


42 


90 


123 


120 


48 


Ol. Mentha? Piperita?, . . 


III 


2 


6 


16 


10 


8 


7 


7 


2 


2 




Capsicum, Fluid Extract, 


ril 






4 
















Capsicum, Tincture, . . . 


m 




290 






37 


7 


120 








Capsicum, Oleo-resin, . . 


ii| 








4 
















111 


236 




810 


994 
126 


ioio 
62 


690 


30 


247 


240 




Hydrochloric Acid, . . . 


Sugar, Burnt, 


gr. 














20 








Glycyrrhizse, Extract, . . 


gr. 


147 














154 


240 




Acacia, Mixture, .... 


Ml 




384 


. . 
















Tragacanth, Mucilage, . 


m 














9°3 








Theriaca, or Syr. Fusci, . 


in 


236 


760 










150 


247 


240 


1632 


Syrup, 


m 




760 












992 


q. s. 




Glycerin, 


m 


io33 




818 






-60 










Water, 


m 








126 


128 




240 








Morphine Hydroch. in 
























rrixv, 


gr. 


T2F 


H 


ft 


l A 


% 


T<X 


ft 


T*5 


3 1 * 


5 



Note. — See ante, page 227, for remarks on this preparation, and the number of formulae representing it. 

* Author of "A Companion to the Br. Pharmacopoeia." 

f See Hartshorne's " Essentials," 5th ed., p. 625. ** Parke, Davis & Co., Detroit. 

% Made by Eli Lilly & Co., Indianapolis. ffTinct. Chloroformi et Morphinae, B. P. 

f 2d ed., page 430. § As given by Stokes and Blyth in " Hygiene." 



PATENT MEDICINES. 



833 



PATENT MEDICINES. 

These formulae have been published from time to time in various journals and formu- 
laries, and are supposed to represent the preparations designated. The name of the 
author is appended in each case when known. 



Alcoholic Strength of Quack Bitters. 

Hostetter, 43-20 

Drake Plantation, 30.24 

Rush, 34- 20 

Peruvian, .... 22.40 

Hoofland, 20.85 

Oxygenated, !9- 2 3 

California Wine Bitters, 18.20 

Walker's Vinegar Bitters, .... 7.20 



Amick's Consumption Cure. 

The Amick advertisements appeared 
shortly after the publication of Dr. N. B. 
Shade's paper in this and other journals. 
Amick copied Shade's language, speaking 
of the " chemical " cure, etc., and, I believe, 
adopted Shade's methods of treatment. 
These were fully described by Shade, and 
consist in the use of Calomel, Iodoform, 
Guaiacol, etc. 

{Dr. Waugh,in Times and Register.} 



Ayer's Ague Cure. 

This, according to Churchill's analysis, is 
alleged to consist of a syrupy tincture of 
Peruvian Bark with Aromatics, each bottle 
holding six fluid ounces, and each fluid 
ounce containing 3.2 grains of amorphous 
Cinchona alkaloids, 3 grains Cinchonine, 
0.7 grain Cinchonidine, 0.8 grain Quinine, 
and one grain of Quinidine. 



Ayer's Cherry Pectoral. 

Morphina Acetat, . . . . gr. iij. 
Vini Antim. et Potass. Tartrat., 
Vini Ipecacuanha, . . . aaJpij. 
Tinct. Sanguinaria, . . . £ij. 
Syr. Pruni Virginian., . . Jiij. 



Ayer's Pills. 

Consist of Colocynth, Gamboge and 
Aloes, coated with Starch and Sugar. 

53 



Ayer's Sarsaparilla. 

Alcohol, 

Fl. Extr. of Sarsaparilla, 

Fl. Extr. of Stillingia, aa ^iij. 

Fl. Extr. of Yellow Dock, 

Fl. Extr. of Podophyllum ,aa ^ ij. 

Sugar, 'Jj. 

Potassium Iodide, . . . . 3Jss. 

Iodide of Iron, gr. x. 

Mix. 



Brandreth's Pills 

Podophylli Radicis, . . 
Extracti Podophylli, 
Extr. Phytolacca Baccse, 
Pulv. Caryophylli, . . . 

Cambogiae, 

01. Mentha Piperita, . 
Croci, 



gr. x. 
gr. x. 
gr. xxx. 
gr. x. 
gr. ij-v. 
nxiij. 



Misce, fiat massa, et div. in pil. xxiv. 

(Hager. ) 



Castoria. 



Senna, av.oz. 2. 

Pumpkin seed, dr. 6. 

Rochelle salts, dr. 4. 

Wormseed, Levant, . . . dr. 3. 

Sodium Bicarbonate, . . dr. 2. 

Anise Seed, dr. I. 

Oil of Gaultheria, . . . , dr. ^ 

Oil of Peppermint, . . . dr. ^ 

Sugar, av.oz. 8. 

Water, enough to make . . fl. oz. 

Exhaust the vegetable drugs by boiling 

with water, evaporate to the proper volume, 

and dissolve the sugar and other ingredients. 

( Western Druggist. ) 



6. 



Chlorodyne, Collis Browne's. 

Morphine Hydrochlorate, gr. 6. 

Chloroform dr. 6. 

Cannabis Indica, . . gr. 6. 

Prussic Acid (Scheele's), . TT\, 6. 

Treacle, to make, . . . . oz. I. 

Dose. — 10 to 30 minims. [Hygiene.) 



834 



PATENT MEDICINES. 



Clarke's Blood Mixture. 

Potassium Iodide, . . . . gr. 48. 

Chloric Ether, dr. 4. 

Liquor Potassae, rt^ 30. 

Water, colored with Burnt 

Sugar, oz. 7^. 

'Dose. — One tablespoonful four times a 
day. [Hygiene.) 



Ely's Cream Balm. 

consists of Vaselin, 1 ounce ; Thymol, 3 
grains ; Bismuth Carb., 15 grains ; Oil Win- 
tergreen, 2 minims. The directions are to 
dip the little finger into the balm and insert 
up the nostrils, giving two or three full 
inhalations. (Medical Record. ) 



Garfield Tea. 



consists chiefly of Senna leaves and Couch- 
grass (Triticum), with aromatics. 

{Prof. Lengfield.) 



Hamburg Tea. 

Sennae Foliorum, . . . . pt. viij. 

pt. iv. 

Pt- J- 



Mannae, 
Coriandri 



Hamlin's Wizard Oil. 

Spt. Camphorae, ]|j. 

Spt. Ammoniac, 

Olei Sassafras, . . . . aa ^ss. 

Olei Caryophylii, . . . . 5J ij. 

Chloroformi , 

Olei Terebinthinae, . . aa 3 ss. 

Alcoholis, . . . . q. s. ad £ v. 



Helmbold's Buchu. 

Said to resemble the genuine. 

Short Buchu, ...... oz. 9. 

Uva Ursi, oz. \)/ 2 . 

Licorice root, dr. 10. 

Macerate in 9 pints of boiling water, 
strain and add — 

Caramel, oz. 2. 

Molasses, oz. 8. 

Mix well and add — 

Cubeb (fluid extract), . . . oz. 5. 

Alcohol, pints 2. 

Peppermint Oil, oz. I. 

Water, sufficient to make . pints 12. 
(Lillard's Prac. Hints and Formula.) 



Holloway's Ointment. 

Has in 159 parts — 

Olive Oil, 62i parts. 



Lard, 

Resin, . . . 
White Wax, 
Yellow Wax, 
Turpentine, 



... 50 
.... 25 
. . . 12I 
.... 3 
... 3 
Spermaceti, . 3 



Holloway's Pills. 

Have in 144 Pills — 

Aloes, gr. 62. 

Rhubarb, ....... gr. 27. 

Saffron, gr. 3. 

Glauber's Salt, gr. 3. 

Pepper, gr. 7. 

{Dorvalt. 

Hostetter's Bitters. 

Sacchari Albi, 
Aurantii Corticis, 
Calami, 
Cinchonae, 

Gentianae, aalbj. 

Rhei Pulv. , 5 iv. 

Cinnamomi, Sij. 

Caryophylii, 3J. 

Alcoholis Diluti, .... Cij. 

{Med. Bulletin, 1884. 



The Keeley Gold Cure. 

The hypodermic injection, administered 
4 times daily for 3 weeks, contains Strych- 
nine (or Brucine) and Atropine (or Hyos- 
cine), with Codeine and Cocaine for the 
opium cases. The whiskey supplied to the 
victims contains about gr. J^ of Apomor- 
phine to each average drink. The " cross- 
shot " is an injection of Apomorphine. The 
" tonic "contains — 

Ammonium Chloride, . . gr. j. 

Aloin, gr. ij . 

Tinct. Cinchonae Comp. , . ^iij. 

Water, to make, ^ iv. 

{N. Y. Med. Record.) 



Laville's Gout Mixture. 

Calcium Chloride, Chinoi- 

din, of each, .... grm. 
Extract of Colocynth, . grm. 

Water, grm. 

Alcohol, grm. 

Spanish Wine, .... grm. 
Made into a solution. A pill of very 
complicated composition is used in connec- 
tion with the gout remedy. {Hager.) 
[See also page 251, ante. ] 



5- 

25 
85. 
100. 
800. 



PATENT MEDICINES. 



835 



Morrison's Pills. 

Powdered Colocynth, . . gr. 3. 

Powdered Gamboge, . . . gr. 6. 

Powdered Aloes, . . . . gr. 9. 

Cream of Tartar, . . . . gr. 12. 

Also syrup enough for 12 pills. Serious 
results are often produced by large doses of 
these pills. 



Orange Blossom. 

Zinc Sulphate, gr. 60. 

Alum, gr. 15. 

Expr. Oil of Almond, . gr. 90. 

Extract of Hyoscyamus, . gr. I. 

White Wax, gr. 30. 

Oil of Theobroma, . . . gr. 180. 
Made into oblong suppositories, one inch 
long, one and a half wide and half an inch 
thick, weighing 32 grains each. 



Perry Davis's Pain Killer. 

Tinct. Capsici, 5j. 

Spt. Camphorae, %i). 

Guaiaci Resinse, . . . . ^ss. 

Alcoholis, 3 u j- 

Tinct. Myrrhae, q. s. ad coloret. 



Pierce's Favorite Prescription. 

Sabinae, Cinchonae, 

Agarici Albi, a a 3 i j . 

Cinnamomi, gr. xv. 

Coq. in aq.suff.,ut ft. decoct, ^viij. 
Deinde cola, et adde — 

Sacchari Albi, ^ss. 

Acacise, ^j. 

Solve, et addantur — 

Tinct. Opii Deodorat., 

Tinct. Digitalis, . . . . aagss. 

01. Anisi, gtt. viij, in Alco- 
holis, ^j ss - 

Misce. (Hager. ) 

Pierce's Golden Discovery. 

Ext. Lactuci, £j. 

Mellis, 3j. 

Tinct. Opii Deodorat, . . ^ss. 
Alcoholis Diluti, 

Aquae, aa^ iij. 

\Hager) 

Radam's " Microbe-Killer." 

Oil of Vitriol (impure), . dr. 4. 
Muriatic Acid (impure), . dr. I. 

Red Wine, oz. I. 

Water, gall. I. 

{Eckels. ) 



Radway's Ready Relief. 

Tinct. Capsici, 

Aquae Ammoniae, 

Alcoholis, . . . . . . aa^j. 

Linimenti Saponis, . . . 3jiij. 

(Hager.} 

Radway's Resolvent. 
Vini Zingiberis, 
Vini Cardamomi, . . . aa ^iij. 

Sacchari Albi, q. s. 

(Hager.) 

Recamier Balm. 

Zinc Oxide, . . . 
Glycerin, .... 
Alcohol, . . 
Mercuric Chloride, 



Distilled Water, 



lbs. 5. 

dr. 2. 

oz. 2. 

oz. 4. 

qts. 64. 

(Boston Herald. ) 



Recamier Cream. 

Rice Flour, oz. 48. 

Zinc Oxide, oz. 60. 

Glycerin, oz. 640. 

Cacao Butter, oz. 48. 

Lard, oz. 48. 

Mercuric Chloride, . . . oz. 4. 
Make 32 pints. (Boston Herald.) 



Revalenta Arabica Food. 
Consists solely of Lentils ground up into 
a fine powder. (Stokes in " Hygiene.'''') 



Sage's Catarrh Remedy. 

Salis Culinaris (Sodii Chlor.), partes xx. 

Pulv. Camphorae, part. j. 

Acidi Carbolici, part. j. 

M. — To be dissolved in water and either 
injected or sniffed up the nose. 



Pulv. Hydrastis Canadensis, partes v. 

Pulv. Indigo, part. l / z . 

Pulv. Camphorae, 

Acidi Carbolici, . . . . aa partes ij. 

Sodii Chloridi, partes 1. 

(New Remedies. ) 

Sanford's Catarrh Cure. 
According to an analysis made by Prof. 
A. B. Lyons for the New Idea, this"prepa- 
ration is composed of distilled extract of 
Witch-hazel, containing a little Alcohol and 
Glycerin and some Morphine. The pro- 
portions of the constituents were not de- 
termined. (Nat. Druggist.) 

Seigel's (Mother) Syrup. 
Contains Aloes, gr. 30 to the oz. Also 
Borax, Capsicum, Liquorice, and Treacle. 
(Stokes in " Hygiene.") 



836 



PATENT MEDICINES. 



Sequah's Oil. 

A mixture of % Turpentine and )/$ Fish 
Oil, scented with a few drops of Oil of 
Camphor. {Stokes in * * Hygiene. ' ' ) 



Sequah's Prairie Flower. 
Has to the ounce — 

Aloes, gr. 52^. 

Carbonate of Soda, . . . gr. 17J4. 

Water, gr-362^. 

and a few drops of the Tinctures of Capsi- 
cum and Myrrh. {Stokes in " Hygiene.") 



St. Jacob's Oil. 

Gum Camphor, 

Chloral Hydrate, 

Chloroform, 

Sulphuric Ether, . of each, oz. I. 

Tinct. of Opium, 

Oil of Origanum, 

Oil of Sassafras, . of each, oz. y z . 

Alcohol, gal. y z . 

Dissolve the Gum Camphor in the Oils 

and Alcohol, then add the other ingredients. 

Squibb says that it is a weak Aconite 

Liniment, also containing Ether, Alcohol, 

Turpentines, red coloring matter, and water. 

{Ephemeris, p. 1 14.) 



Swift's Specific, " S. S. S." 
Fluid Extr. of Smilax Sarsaparilla, 16 parts. 
Fluid Extr. of Stillingia Sylvatica, 16 parts. 
Fluid Extr. of Lappa Minor, . . 16 parts. 
Fluid Extr. of Phytolacca, . . .16 parts. 
Tinct. of Xanthoxylum, .... 8 parts. 
{Registered Pharmacist.) 
Stearns' New Idea gives the following : 
Stillingia, Pokeroot, and Sarsaparilla, with 
Nitrate of Potash and a small quantity of 
Iron, and enough alcohol to preserve it. 



Thompson's Eye-Water. 

Copper Sulphate, . . . . gr. 



Tamar Indien. 



According to the Report de. Pharmacie, 
the formula for this preparation is as fol- 
lows : — 

Tamarind (pulp), 450, powd. Sugar, 
40; powd. Sugar-of-milk, 60; pure Gly- 
cerin, 50 (all parts). Mix and evaporate 
to the consistence of a soft extract, then 
add powd. Anise, 10 ; Ess. Lemon, 3 ; Tar- 
taric Acid, 3 (all parts). Mix and divide 
into 100 boluses. Roll in the following 
mixture : Cream of Tartar, 5 ; White Su- 
gar, 35 ; Sugar-of-milk, 35 ; Tragacanth, 2 ; 
Tartaric Acid, 2 ; powd. Red Sandal, 25 
(all parts). Dry and put up in tin foil. 

{American Druggist. ) 



Zinc Sulphate, 
Rose-water, .... 
Tincture of Saffron, . 
Tincture of Camphor, 
Mix and filter. 



IO. 

gr. 40. 
pints 2. 
drm. 4. 
drm. 4. 



Van Buskirk's Sozodont. 

Saponis Albi, % ss. 

Alcoholis, 3J. 

Aquae, 5Jvj. 

Glycerini, gij. 

Olei Gaultheriae, 
Olei Caryophylli, 
Olei Menthae Piperitae, 

aa q. s. ad saporem grat. 
Cocci Cacti, q. s. ad coloret. 



Calcis Praecipitat., 
Magnesii Carbonatis, 
Iridis Florent. Radicis, . aa p. aeq. 
M. et triturat. {Hoffmann.) 



Vita Nuova. 
Cocaine, gr. 8 

Pepsin (golden scale), . . gr. 48. 

Port Wine, gall. I. 

{Boston Herald.) 



Walker's Vegetable Vinegar Bitters. 

Aloes Socotrin, gij. 

Guaiaci Resinae, . . . . giv. 

Sassafras Mucil., .... ^j. 

Aceti, gij. 

Aquae, q. s. 

Coque, et ft. decoctum, ad ^xix, 

deinde cola, et addantur — 

Sodii Sulphatis, ijj. 

Acaciae, . . gij. 

Spt. Anisi, 10 p. c, . . . 3 ij- 

Alcoholis, 3J. 

M. Dose, gij. {Eberbach.) 



Warner's Safe Kidney and Liver Cure. 
In Germany each maker of patent medi- 
cines must furnish the government with 
the formula for the patent he makes, 
is the one furnished by Warner for 
Kidney and Liver Cure." Each 
contains : — 

Extr. Lycopus Virginiana, gr. 

Extr. Hepatica (herb), . . gr. 

Extr. Gaultheria, . 

Potassium Nitrate, 

Alcohol (90 ), . . 

Glycerin, .... 

Water sufficient to make one pint. 
{Formulary and Druggists'' Magazine. 



■ g r - 
• gr- 
. oz. 
. dr. 



This 
" Safe 
bottle 

308. 
322. 

39- 

*#■ 

10. 



DIFFERENTIAL DIAGNOSIS. 



%S7 



TABLES OF DIFFERENTIAL DIAGNOSIS. 



Forms of Bright's Disease. 

Compared with Acute Nephritis and with each other. 







^3 

V 

Z 

V 

3 
o 

< 


(i) Acute 

Bright's 

Disease. 

Acute 

Parenchy. 

Nephritis. 


Chronic Bright's Disease. 


Clinical Phenomena. 


(2) Chron. 
Parenchy. 
Nephritis. 
{Large 
White 
Kidney.) 


J 3) 
Fatty 

Kidney. 


(4) 
Amyloid 
or Waxy 
Kidney. 


(5) Chron. 
Interstitial 
Nephritis. 
( Cirrhotic 
Kidney.) 


M 
Z 

X 

S3 


Quantity, 


Normal 
or — 


- 


-or + 


Normal 
or — 


Normal 
or + 


Normal 
or + 


Reaction, 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 


Acid. 




Wine 
yellow. 


Dark 

smoky. 


Brown 
yellow. 


Pale. 


Pale. 


Clear. 




Sp. Gr., . 


Normal 
or — 


High. 


- 


1.015-1.030 


— , above 
1. 010 


I.OIO 




Urea, 


Normal. 


- 


- 


- 


Normal 
or — 


Normal. 


Chlorides, 


Normal. 


- 


- 


- 


- 


Normal. 


Albumen {per cent.), . . 


tV to 1 


i to 6 


yi to 2 


1 to 6 


of 
globulin. 


tV to % 


Casts, 


Hyaline 

and 
Epithel. 


Blood 
Epithel. 
Hyaline. 


Granular 
Hyaline. 
No blood. 


Fatty. 


Few and 
Hyaline. 


Very few. 


Sediment {macroscopical), 


Mucus. 
Blood. 


Brown 

cells. 

Urates. 


Kidney 
epithel'm. 

Blood. 
Lymph. 


Free oil. 


Seldom 
any. 


Seldom 
any. 


Dt 




Seldom. 


Great, 

especially 

of face. 


Never 
absent. 


Great. 


Trifling. 


In last 

stages. 






Uf 


.iEMIA, 




Often 
great. 


Not 
marked. 


Rare. 


Rare. 


Great. 








Other Symptoms, 


Stiff 

joints. 

Sacral 

pain. 

Lassitude. 


Fever. 


Tempera- 
ture low. 
No fever. 
Inflam. of 

serous 
membr's. 
Cardiac 

hyper. 


Face pale, 
puffy. 
Cardiac 
hyper. 


Emacia- 
tion, sal- 
low face, 
enlarged 
liver and 
spleen, 
thirst, 
diarrhoea. 


Retinitis. 

Tense, 

quick 

pulse. 
Hyper, of 

heart. 


Pf 


OGNOSIS, 


Favorable. 


Recovery 
or No. 2. 


Recovery 
(?jorNo.3. 


Always 
fatal. 


Depends 
on con- 
stitutional 
disease 

present. 


Unfavor- 
able, but 

course 
perhaps 

long. 







Note. — The signs 4- and — in the line entitled Sp. Gr., respectively denote a specific gravity greater 
than 1.024, or l es s than 1.018. 



8 3 8 



DIFFERENTIAL DIAGNOSIS. 



Cancer. 



Cancerous {Malignant) Tumors. 

Are of constitutional origin. 

Have no cyst, but invade and convert the 

surrounding tissues. 
Cancer material is short-lived from rapid 

deterioration, but is rapidly reproduced. 
Severe increasing pain. 
Extend to remote parts, reappearing chiefly 

in lymphatic glands. 
Cancerous cachexia of general health. 
Recur after extirpation, fatal in end. 



Non-malignant Tumors. 

Origin, some local error of growth. 
Limited by a cyst ; may compress, but do 

not invade adjacent tissues. 
Have uncertain period of increase, after 

which may remain stationary. 
Usually no pain. 
Are local, have no disposition to spread. 

Impare functions of parts pressed on. 
Do not recur. 



Scirrhus. 

Is hard. 

Appears mostly on female breast. 

Hard kernel, movable under skin. 

Becomes fixed to adjoining structures, which 

it puckers. 
Single and grows slowly. 
Course slow — 2 to 4 years. 
Never in the young. 



Encephaloma. 

Is soft and brain-like. 

Most frequently on the limbs. 

At first deeply seated, hard to recognize. 

Spreads through loose textures, which 

pushes aside and distends. 
Has numerous tumors, grows rapidly. 
Generally fatal in I to 2 years. 
Often in the young, even at birth. 



Carditis, Endo- and Peri-. 



Endocarditis. 

Blowing sound. Excited heart action. 
Slight if any increase of percussion dullness. 
Impulse strong. 

Sounds normal, or more distinct, except at 
site where murmur is heard. 



Pericarditis. 

Friction sound. Excited heart action. 
Marked increase in effusion stage. 
Wavy and feeble. 
Feeble and muffled; no blowing sounds. 



Cerebral. 



Concussion. 



Patient can be roused ; pupils act. 
Breathing seldom stertorous. 
Urinary action normal. 
Symptoms appear closely after accident. 



Compression. 



Complete insensibility ; motionless pupils. 
Breathing usually stertorous. 
May be either retention or incontinence. 
Frequently do not. 



Chancre and Chancroid, 



Chancre 



Commences about 3d week after coitus. 
First as a papule, abrasion, or crack. 

Generally indurated (rarely not). 

Develops slowly. 

Discharge slight, unless irritated. 

Is soon limited and seldom phagedenic. 

Edges sloping, not undermined. 

Scanty serous secretion. 

Sore remains solitary, and cannot be multi- 
plied. 

Followed by numerous buboes, rarely sup- 
purating, never furnish inoculable pus. 



Chancroid. 



In 24 hours to 3 days. 

First as a red spot, then a pustule, then a 
suppurating sore. 

Not on an indurated base. 

Develops rapidly. 

Suppurates profusely. 

Tends to invade surrounding tissues, or be- 
come phagedenic. 

Edges undermined. 

Discharge is pus and copious. 

May be transplanted at will, and is seldom 
single. 

A single bubo may appear and suppurate. 



DIFFERENTIAL DIAGNOSIS. 



839 



Cholera. 



Asiatic. 



Preceded by painless diarrhoea. 
Not directly from error in diet. 
First pain shooting down thighs. 
Prostration rapid and overwhelming, and 

out of ratio to evacuations. 
Rapid reduction of surface temperature ; 

high temperature in cavities. 
Evacuations like rice-water from first. 

Cramps commence in extremities. 
Veins congested ; tongue, lips, and extremi- 
ties livid purple. 
Urine albuminous. 



Simple. 

Seizure sudden. 

Generally is from error in diet. 

First pain is abdominal (colic). 

Prostration gradual, less marked than the 

vomiting and purging. 
Gradual reduction of surface temperature ; 

internal temperature normal. 
Discharges bilious, causing burning and 

smarting pain ; colorless only at very last. 
Cramps commence in abdomen. 
Not so. 

Not so. 



Croup and Diphtheria. 



Croup. 



Premonitory hoarse, metallic cough, with- 
out illness. 

A child's disease. 

Tenacious mucus covering the swollen 
membrane. 

A local disease. 



Diphtheria. 

Premonitory illness, marked by shivers, 

fever, and sore throat, without cough. 
Attacks adults as well. 
Distinguished by a false membrane. 

A blood poison ; great general depression. 



Epilepsy and Hysteria 

Epilepsy. 

Loss of consciousness is sudden, complete. 

Livid face, frothy saliva escapes, eyelids 
half open, eyeballs rolling, teeth grind- 
ing, tongue biting ; more or less insensi- 
bility of pupils to light. 

Countenance is distorted. 

Patient shows no feeling. 

Aura epileptica. 

Short paroxysm, followed by heavy coma- 
tose sleep and dull intellect. 

Frequently occurs at night. 

Not necessarily of uterine connection, 
though a paroxysm often occurs at the 
menstrual period. 



Hysteria. 

Gradual and partial or apparent. 

Face flushed, or complexion unaltered, no 
froth on lips, eyelids closed, eyeballs 
fixed, no grinding of teeth, or biting of 
tongue; pupils react readily. 

Is not. 

Sighs, or laughs, or sobs. 

Globus hystericus. 

Longer paroxysm ; patient not sleepy, usu- 
ally wakeful and depressed in spirits. 

Rarely occurs at night. 

Often connected with uterine or menstrual 
disorders. 



Gout and Rheumatism, 



Gout. 



Affects chiefly the small joints, especially 

the metatarsal joint of the great toe. 
Occurs from 35-50 years of age; rarely 

before puberty. 
Most frequent in men, and result of idle, 

intemperate and luxurious life. 
Is strongly hereditary. 
Chalk-stones (sodium urate) in external ear, 

on tops of fingers, or elsewhere. 
Uric Acid in the blood, absent from urine. 
A fit often affords temporary relief. 
Is confined to the temperate zone. 



Rheumatism. 
Large joints chiefly implicated. 

Occurs generally in young adults. 

Affects both sexes equally, and equally the 

poor and the rich. 
But slightly so. 
Not so. 

Lactic Acid in the blood. 

Quite the contrary. 

Is ubiquitous — prevails in all climates. 



840 



DIFFERENTIAL DIAGNOSIS. 



Hematemesis and Hemoptysis. 



Hematemesis. 
Blood is of a dark color, and is vomited. 

Often mixed with food, not froth. 
Preceded by nausea and stomachal dis- 
tress, and blood is passed with the stools. 



Hemoptysis. 

Blood is bright red, and generally coughed 

up. 
Generally frothy and mixed with sputa. 
Preceded by pain in the chest and dyspnoea. 
No blood in the stools. 



Phthisis. 



Tubercular. 
First symptom, a dry, short cough. 

No exciting cause apparent. 

Hereditary cases are of this class. 

Frequently preceded by enlarged or suppu- 
rating glands, or other evidence of the 
scrofulous diathesis. 

Voice changes, from tubercular deposit. 



Non- Tubercular. 



First stage follows catarrh, bronchitis, or 

some other acute disease. 
Is referable to some exciting cause, as cold, 

inflammation, or inhaling heavy dust. 
Not hereditary. 
No evidence of scrofula. 



No change of voice. 



Pleurisy and 

Pleurisy. 

Sharp pain, friction sound, dry cough, im- 
paired chest motion. 

In stage of effusion, obliteration of inter- 
costal spaces, enlargement of the side, 
viscera displaced. 

Dullness, with enfeebled or absent respira- 
tion, voice, and fremitus. 

Sputa frothy, rarely any rales. 
Febrile symptoms slight usually. 
Temperature irregular, rarely high. 



Pneumonia. 

Pneumonia. 

Dull pain, crepitant rale, cough followed 

by expectoration. 
In stage of hepatization none of these signs 

are present. 

Dullness, with marked bronchial respira- 
tion, distinct thoracic voice, increased 
vocal fremitus. 

Sputa rusty color, rales common. 

Febrile symptoms severe. 

Sudden elevations and falls, high tempera- 
ture not uncommon. 



Scarlet Fever, Measles and 



Scarlet Fever. 
Incubation, I day to weeks. 

Fever, great heat of skin, 
and frequent pulse, un- 
abated during eruption. 

Brilliant stare. 
Sore throat, rarely coryza 
or bronchitis. 

" Raspberry" tongue, red. 

Temperature may be 105 - 
106 to loth day, subsides 
gradually, falls on 5th, 
loth, and 15th days. 

No secondary fever. 



Measles. 
Incubation, 7 to 14 days. 

Same fever rather increased 
by eruption. 



Liquid, watery eye. 
Coryza and bronchitis very 

constant, sore throat 

rarely. 
Tongue coated, may be red 

at edges. 
io3°-io6° before eruption, 

remains high for I to 2 

days thereafter, then falls 

suddenly. 
No secondary fever. 



Smallpox. 

Smallpox. 

Incubation, 6 to 20 days, 
average, 10. 

Fever often violent, bound- 
ing pulse, pain in loins ; 
all are greatly relieved by 
eruption. 

Eyes injected, face red. 

Sore throat often, also a dry 
cough. 

Tongue coated, and swollen, 
may be red at edges. 

Before eruption often 106 , 
then rapidly sinks to ioo° 
in 36 hours ; rises during 
the secondary fever. 

Secondary fever always. 



DIFFERENTIAL DIAGNOSIS. 



8 4 : 



Scarlet Fever. 

Eruption on second day, not 
rough, first on neck and 
chest, spreads rapidly, 
white streak on pressure 
with nail. 

Eruption uniform, or in 
large patches, inter- 
spersed raised spots and 
some vesicles ; rash scar- 
let, on its seventh day 
very complete desquama- 
tion in large patches. 

Cerebral symptoms are fre- 
quent and grave. 

Pneumonia rare, pleurisy 
more frequent. 

Sequelae: Blight's disease, 
dropsy, deafness, conjunc- 
tivitis, phthisis, chronic 
diarrhoea ; glandular en- 
largements. 



Measles. 

Eruption on fourth day, on 
face, rough, spreads grad- 
ually, the streak lasts 
only a short time. 

Eruption in crescentic 
patches, lasts about 5 
days, then partial des- 
quamation, scales very 
fine. 



Not so. 

Pneumonia a frequent com- 
plication. 

Sequelae : chronic bronchi- 
tis, phthisis, conjunctivi- 
tis. 



Smallpox. 

Eruption usually on third 
day, at first on lips and 
forehead, spreads rapidly. 



Eruption is first papular, 
then vesicular, finally 
pustular ; pustules matur- 
ate on 8th day of erup- 
tion. 



Cerebral symptoms are fre- 
quently seen. 

Pneumonia not a very fre- 
quent complication. 

Sequelae : chronic diarrhoea, 
glandular enlargements, 
various eye diseases. 



Typhus and 

Typhus Fever. 
Attacks quickly, incubation 9 days. 

Occurs at any age. 

Rare among the higher classes, except 

those exposed. 
Mulberry Eruption on 4th or 5th day, on 

extremities, lasts till close. 



Brain chiefly affected ; bowels often but 
little so; abdomen natural, evacuations 
dark, but never bloody (these are occa- 
sionally reversed). 

Contracted pupils, dusky face. 

Pulse and temperature rise to 120 and 105 
till 3d day, high for 6 days, then fall. 

Lasts 2 to 3 weeks. 
Relapses rare. 

Death from coma, or congestion of the 
lungs, in 1st or 2d week. 

Arises from destitution, over-crowding, 
bad ventilation, is highly contagious, and 
generally epidemic. No microbe deter- 
mined. 

Post-mortem : changes not constant, the 
most frequent are dark blood, enlarged 
spleen, soft heart. 



Typhoid. 

Typhoid {Enteric) Fever. 

Commences slowly, incubation about 13 

days. 
Most common in youth and childhood, 

rarely after 40. 
As common among the rich as the poor. 

Rose Eruption on 7th to loth day, isolated, 
flattened papules, few, on abdomen and 
back, in successive crops, which fade 
and disappear. 

Bowels chiefly affected, evacuations ochre- 
color and watery, sometimes hemorrhage, 
or even ulceration, abdomen tumid. 

Dilated pupils, cheeks flushed. 

Pulse and temperature rise and fall inde- 
pendently, and without uniformity, but 
both are usually high to 15th day. 

Lasts 4 to 6 or more weeks. 

Relapses frequent. 

Death from asthenia, pneumonia, hemor- 
rhage, or perforation of intestine, in or 
after 3d week. 

From poisoned drinking water, putrid ani- 
mal matter, bad drainage ; is not conta- 
gious, often sporadic. Eberth's bacillus 
present in the intestinal lesions, the 
spleen, liver, blood, etc. 

Post-mortem : morbid Peyer's patches, en- 
larged mesenteric glands, ulcerated mu- 
cous coat of intestines ; enlarged and 
soft spleen, ulcerated pharynx. 



842 



TEMPERATURE IN DISEASE. 



Vomiting. 



Cerebral. 



Little or no nausea, vomiting continues 

after stomach is emptied. 
No tenderness on pressure over the liver or 

stomach. 
Pulse infrequent and hard. 
Tongue clean, breath sweet, conjunctivae 

normal or injected, and headache primary. 

Constipation generally obstinate. 
No salivation. 



Gastric or Hepatic. 

Nausea relieved by discharge, returns when 
food is taken. 

Liver and stomach are tender, pressure pro- 
duces inclination to vomit. 

Pulse frequent and weak. 

Tongue furred, breath offensive, conjunc- 
tivae often yellowish, and headache sec- 
ondary as to time. 

Griping abdominal pain, diarrhoea and 
clay-colored stools. 

Increased salivation. 



Yellow and Bilious Remittent Fevers. 



Yellow Fever. 

Duration short, ends in 3 to 7 days. 

Incubation 5 to 9 days. 

A disease of one paroxysm, terminating in 

recovery or collapse. 
Very severe nausea and vomiting, early 

epigastric tenderness. 
Black vomit, due to gastric hemorrhage. 
Hemorrhages from various parts. 
Tongue clean, or slightly coated. 
Pulse variable, slow at end. 
Eye injected and humid. 
Supra-orbital pain, pain in back and in 

calves of legs. 
Rarely delirious, mind clear generally. 
Urine albuminous, usually suppressed. 
Convalescence rapid, no sequelae. 
Muscular prostration slight. 
Mortality high, disease epidemic. 
Treatment unsatisfactory. 
Autopsy : inflamed or congested stomach, 

enlarged yellow liver, filled with oil 

globules, muscular fibres of heart are 

often disintegrated. 



Bilious Remittent. 

Lasts 9 days or more. 

Incubation may extend to months. 

A disease of several paroxysms, with inter- 
vening remissions. 

These symptoms are not so severe nor do 
they occur so early. 

Bilious vomiting. 

No hemorrhagic tendency. 

Tongue heavily coated. 

Pulse quick until convalescence. 

Eye natural. 

Headache, sense of fullness in head, often 
no loin or leg pains. 

Delirium frequent, mind dull. 

Not so. 

Convalescence slow, tedious sequelae. 

Muscular prostration greater. 

Mortality slight, disease endemic. 

Very amenable to treatment. 

Autopsy : stomach congested, rarely in- 
flamed, liver olive or bronze hue, not 
fatty. 



TEMPERATURE IN DISEASE. 

Average Normal Temperature, of adults, 98. 6° F.; of children, 99 ; of the 
aged, 98. 8°. Diurnal variation i° to 1.5 F., highest from 9 a.m. to 2 p.m. 
Above 108 F. is a fatal sign, which issue may be averted by cold baths, reduced 
by ice from 96 to about 6o° F. (A). The clinical thermometer placed in the 
mouth, axilla or rectum, and retained in situ for five minutes, should go hand 
in hand with Aconite in the treatment of inflammations (R). [For Antipyretics 
see the articles Fever, Inflammation, in part III, also the list of these agents 
on page 51.] 

Clinical Thermometry is one of the principal means of positive diagnosis. 
The thermometer should be self-registering, certified, and accurately marked 
according to the Fahrenheit scale. The most reliable temperature is that in 
the rectum or vagina ; less so in the axilla and folds of skin, and still less re- 



TEMPERATURE IN DISEASE. 843 

liable in the mouth. A correct reading of the thermometer cannot be obtained 
in less time than five to seven minutes (Da Costa). 

The Average Normal Temperature of the body is 98. 6°; which, like the pulse, 
will vary somewhat in individual cases ; as a general practical result, it is agreed 
that in temperate regions the normal temperature at completely shelteredparts 
of the surface of the human body amounts to 98. 4 Fahr., or a few tenths more 
or less; and a rising above 99. 5 , or a depression below 97. 3 F., are sure in- 
dications of some kind of disease, if the increase or depression is persistent. 
The temperature is increased at the prime of life, is raised and depressed 
temporarily by the influence of diet, stimulants, exercise, etc. The minimum 
diurnal temperature is observed at 2 A. m., the maximum at 4 to 6 p. m. The 
greatest recorded range of temperature in disease is 50.4 ; the minimum is 
71. 6° in a case of sclerema neonatorum (Ouain's Diet.), the maximum 122 . 
In severe and fatal cases it rarely exceeds 107 , and rarely falls below 92 , even 
in fatal collapse. It may rise 3 to 4 after death, as observed in a case of typhoid 
fever in which death occurred with a temperature of 107 , which increased 
shortly afterward to 110.5 . A temperature of 107 indicates malignancy, and 
when met with for two consecutive days in typhus, scarlatina, measles, pneu- 
monia, pyaemia, meningitis or rheumatism, death may be expected shortly. 
In relapsing, remittent and intermittent fevers, and in the initial chill of an 
abortion, the temperature may reach 107 without indicating great danger. 
During the last hours of life, in many diseases, the temperature rises to 109 - 
111 ; for example, in tetanus, sunstroke, typhus, etc. With a temperature of 
96 collapse is imminent. 

Abnormally High Temperatures reported in the British Medical Journal, by 
Dr. Donkin, include those of eight cases, all but one in females, and none 
proved fatal. Pain was a prominent symptom in all. (1) 111.6 ; convalescing 
from enteric fever. (2) 108 ; no organic lesions; ovarian pain. (3) 115 8°; 
great abdominal pain and excitement. (4) in ; convalescing from enteric 
fever. (5) 113 ; enteric fever and double pneumonia. (6) 112 ; synovitis; 
this was the only male. (7) 112 ; painful stump, with necrosis. (8) 117 ; pyo- 
nephrosis. 

High Average Temperature (above 104 ), is found in severe pneumonia, 
scarlatina, remittent, typhus, typhoid and relapsing fevers, pyaemia, etc. Mod- 
erate High Temperature (102 and above), is seen in peritonitis, acute rheu- 
matism, pericarditis, pleurisy, dysentery, cerebro-spinal meningitis, catarrhs, 
etc. A temperature of ioo° and above is found in chronic affections, incipient 
inflammations and mild fevers. When, in effervescence, the heat increases 
rapidly, it will, in defervescence, decline proportionately fast, and vice versa. 
Beware of a grave affection when the temperature is of a continuous type. A 
distinct interval between morning and evening temperature is a favorable sign. 
A slow and gradual increase indicates typhoid fever; in rheumatism and 
anomalous fevers the increase is more rapid, and still more so in acute inflam- 
matory disease, as pneumonia, angina, pleurisy, typhus, scarlatina, rubeola, 
etc. The rise is usually very rapid in intermittent fever, febricula, and 
ephemeral fevers. A rapid effervescence and slow defervescence indicates 
some complication of disease ; the reverse order indicates great danger. When 
the temperature begins to fall from the evening to the morning, it is an indica- 
tion of improvement ; while a rise of temperature from the evening to the 
morning is a sure indication that the patient is worse. Stability of temperature 
from morning to evening is a good sign, but from evening to the morning is 
unfavorable. 

Decrease of Temperature below the normal point is rare. It occurs some- 
times transitorily, announcing thereby a favorable crisis, by preceding return 
to the normal temperature. It is also met with occasionally during the morning 
remission of remittent fever; also during the apyrexia of intermittents ; in acute 
collapse, preceded or not by fever ; in chronic wasting diseases ; and some- 
times, also, on the approach of death, especially in typhus fever. 



844 CLINICAL EXAMINATION OF THE URINE. 

In Phthisis, the temperature is higher in the evening than in the morning 
later, higher at early bedtime than at noon, and high again at dusk. This is a 
valuable and delicate test of the progress of tuberculization. 

In Typhoid Fever, the accession is by a rise of one degree each day, with the 
diurnal variation. If the evening temperature does not exceed 103. 5 , the dis- 
ease will probably be mild ; but a temperature of 105 in the evening indicates 
a severe type and much danger. A sudden reduction to 95 in the third week 
denotes intestinal hemorrhage; a lingering temperature of ioi°-io2° in the 
fourth and fifth weeks indicates non-cicatrization of the intestinal ulceration. 

In Scarlatina, the rise of temperature is rapid, 104.7 may be reached in a few 
hours. It seldom rises above 105 and almost never above 106 ; is continuous 
until the eruption begins to fade, when remissions take place, unless complica- 
tions arise. 

In Measles, 103 is the usual temperature, with daily variations, increasing 
with the eruption and catarrhal symptoms. A high temperature lasting beyond 
the tenth day denotes complications. 

In Diphtheria, the temperature by the end of the third day will, in uncom- 
plicated cases, not exceed io3°-io4°. It falls temporarily with the exudation. 
Defervescence in the severe, favorable cases, is from the twelfth to the four- 
teenth day; in the milder cases not before the sixth. In some fatal cases it 
occurs early, from the third to the fourth day. In asthenic cases the tempera- 
ture of the surface falls, while that of the interior remains high, ioo° in the 
axilla, and 103 in the rectum. During convalescence, the temperature is low, 
and readily depressed, but may be raised by intercurrent maladies. Any in- 
crease after the first five days, or a continuous high temperature after the first 
ten days is unfavorable. A sudden rise may indicate complications. 

Co-Relation of Pulse and Temperature. — As a general rule the co-relation 
of pulse and temperature may be stated as follows, namely : — an increase of 
temperature of one degree above 98 F. corresponds with an increase of ten 
beats of the pulse per minute. 



CLINICAL EXAMINATION OF THE URINE. 

Urine for Examination should be that passed in the morning, or a sample of 
all passed during the 24 hours. 

Quantity. Normal quantity is about 50 fl. oz. in 24 hours, from which there 
may be considerable variation either way according to the quantity of sweat, 
the fluidity of food used, etc. 

Specific Gravity. If possible, take the mixed urine. Normal sp. gr. is about 
1. 018, i.e., 18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; 
if low, suspect albumen. 

Color and Specific Gravity. Urine pale and copious, of sp. gr. 1.030 and 
above, indicates the presence of sugar. Pale and copious, sp. gr. below 1.018, 
is seen in hysteria, convulsions, nervous diseases. Color high, urine scanty, 
sp. gr. above normal, — in fevers and the uric acid diathesis. Color high, urine 
scanty, sp. gr. below normal, — in Bright's disease. Urine is colored very yel- 
low or greenish-yellow, by Bile and by Rhubarb : dark, with odor of violets, 
by Turpentine : dark, muddy, smoky, by blood and strong coffee : black, by 
disintegrated blood, putridity of the urine, Tar, Creosote : olive-green or smoky, 
by Carbolic Acid : brown, by Arbutin : green, by Indigo and by Salicylic Acid : 
dark-green, by Kairin and by Thymol : dark-blue, by Methylene Blue : bluish- 
violet, by Resorcin : violet, by Juniper : greenish-yellow, reaction acid, by San- 
tonin : reddish purple, reaction alkaline, by Santonin: blood-red, by Hsema- 
toxylon : magenta, by Fuchsin : reddish-brown, by Sulphonal. 



CLINICAL EXAMINATION OF THE URINE. 845 

Smell, — fragrant, indicates Cystine or Sugar: a fetid smell indicates alka- 
linity : the smell of violets indicates Turpentine. 

Reaction, — of 24 hours' urine in health is always acid, but it may be alkaline 
shortly after a meal. It is often alkaline from medicine or disease. If exces- 
sively acid, examine for crystals of uric acid. If alkaline, let the test-paper 
dry, so as to ascertain whether the alkali be fixed or volatile. 

Albumen by Heat and Nitric Acid. With Acetic Acid, or dilute Ammonia, 
make the urine slightly acid, if alkaline or neutral. If a precipitate appear on 
boiling, it may be Albumen or Phosphates. Add a drop or two of Nitric Acid ; 
if the precipitate dissolve, it is Phosphates ; if not, it is Albumen. If a deposit 
or turbidity disappears on heating, it consists of Urates ; if not, add a drop of 
Nitric Acid ; if now dissolved, we have Phosphates ; if not, Cystine. Other 
Tests are Potassio-Mercuric Iodide, Sodium Tungstate, Potassium Ferro-cy- 
anide, and Picric Acid ; but the above described one, if carefully done, will 
give as good results as any. 

Tests for Albumen are interfered with by the presence in the urine of Alka- 
loids, Analgen, Antipyrin, Benzoic Acid (contained in Benzoin, Benzoates, 
Balsams of Peru and Tolu, Cranberries, Plums, Styrax), Benzosol, Chloroform, 
Copaiba, Hypnone, Oil of Santal, Piperazin. 

Bile Pigment and Bile Acids, if necessary. Vogel's color-table. Marechal's 
Test, as follows : Put £j of urine in a test-tube, and pour one or two drops of 
Tinct. Iodi to trickle down along the side of the tube, held horizontally nearly, 
so that the two fluids may touch, but not mix. If bile pigment be present, a 
fine green color will at once be developed below the red Iodine layer. Noel's 
Test, Pettenkofer's Test, Nitric Acid Test, Oxide of Silver Test. 

Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a pre- 
cipitate ceases to form. Thus estimate the amount of Chlorides. 

Sugar, if necessary. Urine containing sugar is usually light-colored, froths 
readily when poured from one vessel to another, and has a high specific gravity. 
Fehling's Test, as follows: Add to the boiling urine a few drops of freshly- 
prepared Alkaline Cupric Tartrate Volumetric Solution (Fehling's Solution). 
If sugar be present, a yellow, orange or red precipitate of Cuprous Oxide will 
form, 10 Cc. of the solution being reduced by gramme 0.05 of diabetic sugar 
(anhydrous glucose). For the preparation of Fehling's solution, see page 261. 
Much more convenient is Dr. Piffard's Cupro-Potassic Paste, or Dr. Pavy's 
Cupric Test Pellets (see Tyson on Urine, page 57), or Wyeth's Compressed 
Tablets for preparing Fehling's Solution ; a box of the latter costing only 50 
cents, and obtainable in any good drug-store. The writer has used these tab- 
lets for several years with great satisfaction. 

Pavfs Solution is a modification of Fehling's ; is equally good for qualitative 
and volumetric testing, and is intended for those who prefer the apothecaries' 
weights and measures to the metric system. It is made in the same manner 
as Fehling's, 100 minims corresponding to yi grain of diabetic sugar, and con- 
sists of Copper Sulphate, gr. 320 ; Potassium Tartrate (neutral), gr. 640 ; Caus- 
tic Potash, gr. 1280; and Distilled Water, f^ 20. Other Tests for sugar are 
Bottcher's Bismuth Test, the Fermentation Test, Moore's, Trommer's, the Picric 
Acid and the Indigo-Carmine. They are all useful, but will not be detailed 
here, as one good method is all that the average practitioner wants. 

Tests for Sugar are interfered with by the presence in the urine of Acetani- 
lid, Antipyrin, Ammonium salts, Arbutin (contained in Epigea, Kalmia, Uva 
Ursi, etc.), Benzoates, Betol, Bromides, Camphor, some Carbohydrates (e. g. 
animal gum), Chloral, Chloroform, Copaiba, Creatinine, Cubebs, Glycerin, 
Glycosuric Acid, Iodides, Morphine, Phenacetin, Pyrocatechin, Rhubarb, 
Rumex, Salicylic Acid (contained in Salicylates, Oil of Wintergreen, Oil of 
Betula and Salol), Senna, Serum-globulin, Sulphonal, Turpentine, Urethan, 
Uric Acid and Urates. Of the foregoing, those which actually reduce the 
Fehling's solution are Acetanilid, Antipyrin, Chloral, Chloroform, Copaiba, 
Morphine, Rhubarb and Salicylic Acid. 



846 



CLINICAL EXAMINATION OF THE URINE. 



Temporary Glycosuria may be produced by poisoning with Alcohol, Amyl 
Nitrite, Carbonic Oxide, Chloral, Hydrocyanic Acid, Morphine, Sulphuric Acid. 

Acetone. Add to the urine a drop of an aqueous solution of Magenta 
decolorized by Sulphurous Acid. If Acetone is present a violet color is pro- 
duced, the intensity of which is proportional to the amount of acetone. In 
dilute solutions the coloration does not appear until after four or five minutes. 
If the amount of acetone be very minute the urine may be distilled, the first 
portion coming over being examined. In this way a very minute proportion 
of acetone may be detected (Chautard). 

Urea. Place a drop of urine on platinum-foil, and to it add a drop of Nitric 
Acid, and leave undisturbed in a cool place for a minute or two. If the urea 
is in excess, crystals of Uric Nitrate form immediately. To ascertain the per- 
centage of urea present, use the Ureameter of Doremus, or that of Mayhew, 
manufactured by Mayer and Meltzer of London, or the Ureometer sold by 
Parke, Davis and Co. If the latter is used the Sodium Hypobromite solution 
should be employed rather than the Chlorinated Soda solution, as the former 
gives the best results. These instruments are simple and accurate enough for 
clinical purposes. 

Mucus and Pus resemble each other so closely under the microscope, that it 
is almost impossible for any one, except an expert, to distinguish between them 
thereby. Mucus is more cloudy and flocculent to the naked eye than Pus, 
which latter is generally of a stringy consistence and thickish yellow appear- 
ance at the bottom of the vessel. The supernatant liquid being poured off, 
and an equal bulk of Liquor Potassas added, the deposit, if containing much 
pus, becomes gelatinized, and so tough that it cannot be poured out. If Mucus, 
Acetic Acid added coagulates it, forming delicate molecular fibres. 

Other Deposits are best examined with the microscope, and compared with 
good plates, rather than with printed descriptions. The plates in Hoffmann 
and Ultzmann on Analysis of the Urine, will answer the wants of most general 
practitioners, but the text follows the metric system. The urinary deposits 
may be classified thus : — 



In Alkaline Urine 
only. 


In Alkaline or Acid 
Urine. 


Organized Deposits. 


Calcium Phosphate 
Ammonium Urate 
Ammoniaco- 
magnesian, or 
Triple Phosphates. 


Uric Acid 

Urates 

Phosphates 

Oxalates 

Cystine. 


Mucus Torulae 
Pus Sarcinse 
Blood Vibriones 
Tube-casts Bacteria 
Spermatozoids, etc. 



Necessary Apparatus. A dozen Test-tubes. Alcohol lamp. A small porce- 
lain dish. 2 watch-glasses. A sheet of platinum foil, ^ inch square. 3 pipettes 
of different sizes, to be used only for urine. A 2-oz. graduate. Urinometer 
(Squibb's). Ureameter (one of the 3 above-mentioned). Litmus-paper, blue 
and red. The reagents mentioned above. A little Grape-sugar, for use in 
testing the Fehling's solution. A Physician s Pocket Reagent Case, intended for 
urinalysis at the bedside, is put up by Parke, Davis & Co., and sold at the low 
price of $1.50. It contains a set of Dr. Oliver's Test Papers or Pellets (pre- 
ferably the latter), a color scale, specific gravity beads, two test-tubes, a pipette, 
and full directions for the use of the reagents. 

The foregoing directions comprise all that the average practitioner will usu- 
ally perform in the matter of urinary analysis. For fuller directions, the 
reader is referred to one of the numerous manuals on the subject, among 
which may be mentioned Da Costa on Medical Diagnosis, Chapter vii, — 
Tyson on the Practical Examination of Urine, — and Sir Henry Thompson's 
Clinical Lectures on Diseases of the Urinary Organs, Lecture xxiv. 



THE TREATMENT OF POISONING. 



The most energetic poisons are Hydrocyanic Acid, some reptile poisons, 
Strychnine and Nicotine. (See pages 87, 353, 463.) Those usually selected for 
criminal purposes are Arsenic, Colchicum, and Tartarized Antimony, the symp- 
toms of which resemble those of natural disease. 

General Principles of Treatment. In the treatment of poisoning, whether 
by mineral or vegetable substances, if the poison is known, the first indication 
is to administer the proper chemical Antidote, so as to render it harmless or 
comparatively so. Next, the stomach should be emptied and washed out, lest 
the newly-formed compound be absorbed after a time, and also in order to 
remove any of the poison which may have escaped the action of the antidote. 
Next, the appropriate Antagonist should be administered, to counteract the 
effects of such portion of the poison as may have been absorbed. Lastly, such 
Antagonistic Measures should be employed as may sustain the action of any 
organic function showing signs of failure. In most cases of alkaloidal poison- 
ing absorption has proceeded so far before professional assistance is obtained, 
that antidotes are of no value, and reliance can only be placed upon the 
physiological antagonist and such supporting measures as will tend to main- 
tain vitality until the poison can be eliminated by the natural channels. 



Antidotes and Antidotal Measures. 

Antidotes affect a poison, either physically or chemically or both, so as to 
remove it from the body or alter its character before absorption, and thereby 
prevent its toxic action upon the organism. They do their work in the ali- 
mentary canal or in the respiratory passages, and are applicable to vegetable 
as well as mineral poisons, but are not available against poisons administered 
hypodermically. (See ante, page 61.) Among them are Emetics, Cathartics, 
Washes, Injections, Ligatures, Poultices, the use of the Stomach-pump, of tour- 
niquets, etc., which are termed Mechanical Antidotes ; and the Chemical or 
True Antidotes, which include Albumen, Milk, Charcoal, Soap, Starch, Oils, 
Tannin, Turpentine, Acids, Alkalies, Potassium Permanganate, Carbonates, 
Hydrates, Sulphates, Sodium Chloride, Iodine, Iron preparations, etc. 

Emetics, when employed, should be used without delay. They are often 
rendered needless by vomiting induced by the poison itself, or by the free use 
of diluent drinks; and are contraindicated when there is severe corrosion of 
the alimentary canal or when abdominal inflammation exists. The best emetics 
are: — Zinc Sulphate, for stomachal administration, being non-nauseating, 20 
to 30 grains in water, 5 grains for children. Apomorphine, gr. 1 3 g— \, hypoder- 
mically, when narcosis prevents the use of emetics by the mouth. It should 

847 



TREATMENT OF POISONING. 

be administered hypodermically, as it is very uncertain in action when given 
otherwise. The following may be used : — Copper Sulphate, I to 5 grains in 
water; Ipecac, in powder ; Emetine, gr. x^to^; Tartar Emetic, 1% grains, acts 
slowly and is depressant ; Turpeth mineral ; Cadmium Sulphate ; Sodium 
Chloride (common salt), 2 teaspoonsful in a pint of water ; Mustard, 2 tea- 
spoonsful in a cup of warm water ; also Olive Oil, Soap-suds, Snuff, melted 
Fats, and tickling the fauces with the finger or a feather. Sodium Chloride, as 
an emetic, is contraindicated in poisoning by Tartar Emetic or Corrosive 
Sublimate, and so also are Oils and Fats and substances containing them, in 
poisoning by Phosphorus, Cantharis, Carbolic Acid or Copper salts. 

Cathartics are generally employed after the use of a chemical antidote, to 
remove the compounds formed thereby from the intestinal canal. The best 
are Castor Oil, Croton Oil, Senna, and Magnesium Sulphate (Epsom salt). 
Castor Oil protects the mucous membrane and obstructs absorption, but is 
contraindicated in poisoning by phosphorus, carbolic acid, copper salts, or 
cantharis, the absorption of which is aided by oils and fats. Croton Oil is rapid 
and powerful in the dose of from 1 to 5 minims, on a bread pill. Magnesium 
Sulphate, in the dose of from 1 to 4 oz., well diluted, is of special service in 
chronic lead poisoning and to remove antidotal compounds from the intestines. 
Senna, Gamboge, and other drastics are the best cathartics in narcotic poisoning. 

The Stomach Pump and Stomach Siphon are efficient, and do not weaken 
the patient as emetics do, but are not always available, and cannot be used 
when there is corrosion of the stomach or oesophagus, for fear of perforation. 
They are useless when the poison is in solid form and in large pieces (such as 
meat, sausage, fish, cheese, etc.). 

Albumen is an ideal chemical antidote, being harmless, easily procured, and 
forming compounds (which are more or less insoluble) with most of the metallic 
salts, corrosive alkalies and mineral acids, as also with Iodine, Bromine, Chlor- 
ine, Creosote, Anilin, and alcoholic solutions of most of the Alkaloids. It is 
especially suitable against inorganic poisons, and was recommended by Orfila 
for invariable use, even on the mere suspicion of poisoning. It should be well 
diluted, the whites of four eggs to a quart of lukewarm water ; and should be 
followed by emetics and cathartics, as many of its compounds are soluble in 
an excess of itself. 

Milk is a good substitute for Albumen, its antidotal action being nearly the 
same in range and due to its casein, albumin and free alkali. It is particularly 
valuable against metallic salts, corrosive acids and alkalies (especially Am- 
monia) and the alkaline earths, but it is contraindicated when fatty antidotes 
are to be avoided, by reason of its richness in fat. 

Gelatin is of especial value against Iodine, Bromine and the Alums, but 
requires too much time for its preparation, as it should be broken up, soaked in 
water for half an hour and reduced to the consistence of honey. 

Gluten is of value against Corrosive Sublimate, but is less so than albumen 
and is not easily obtained. 

Tannin (Tannic Acid), precipitates the Alkaloids and their salts, with which 
it forms compounds (tannates), which, though comparatively insoluble, are not 
entirely inactive, and should be removed at once from the alimentary canal 
by emetics and drastic purgatives. It acts well against many metallic salts, 
though inferior to albumen for these, except against Tartar Emetic, which 
albumen does not affect, but Tannin renders harmless. It is given in doses of 
gr. xv to xlv, in a 2 per cent, solution, every % hour ; and if it is combined with 
about 10 per cent, of its weight of Iodine its antidotal effect on vegetable poi- 
sons is greatly increased. If it is not itself obtainable, decoctions or infusions 
of substances containing it may be used, as tea and coffee, nut-galls, kino, 
rhatany, catechu, and the barks of oak, willow and cinchona. 

Oils and Fats are efficient against the corrosive acids and alkalies, metallic 
oxides and salts ; but are contraindicated in poisoning by Phosphorus, Canth- 



TREATMENT OF POISONING. 849 

aris, Carbolic Acid, or Copper salts, the absorption of which they promote. 
With the caustic alkalies they unite to form soaps, liberating glycerin ; they are 
inferior to albumen against the metallic salts, and as their action is slow they 
are less efficient than acids against alkalies. Those used are olive, cotton- 
seed, linseed and almond oils, also melted butter and lard. 

Starch, in paste (1 part to 15 of water), is the antidote for Iodine and Bro- 
mine, with which it forms compounds which are almost harmless. It has 
some value against Corrosive Acids, Corrosive Sublimate, and Zinc and Cop- 
per Sulphates, but is not so efficient as albumen, which is preferred for these 
poisons as well as for Iodine, since it has a greater affinity therefor than starch 
has. 

Soap, as Castile Soap, dissolved in 4 times its bulk of hot water, to make 
"suds," and given by the cupful, is one of the most efficient antidotes against 
corrosive acids and metallic salts, especially Corrosive Sublimate, Potassium 
Bichromate, and salts of Tin and Zinc. It is inferior to albumen against 
these, but is preferred to caustic alkalies against acids, as of itself it has no 
corrosive action. It should not be used against alkalies. 

Gum Arabic, in the form of mucilage, is chiefly used as a protective against 
corrosive poisons, and has been recommended in copious draughts against 
poisoning with the Bismuth salts. 

Charcoal has some antidotal value against many alkaloids, the metallic salts, 
and Phosphorus, slowing their toxic action and postponing their effects, prob- 
ably by a protective action upon the gastric walls. It has the valuable prop- 
erty of absorbing gases, but enters into no fixed compound with any mineral 
or vegetable poison. Fresh animal charcoal is the best, though wood charcoal 
is efficient, but in less degree. 

Oil of Turpentine, after long exposure to the air, and therefore containing 
much oxygen, is one of the antidotes against Phosphorus, and should be ad- 
ministered immediately after the ingestion of that poison, alone or in hot water, 
and in the quantity of 100 times the amount of the phosphorus supposed to be 
present. 

Organic Acids, such as Acetic (vinegar), Citric (lemon-juice), and Tartaric, 
are employed against the Alkalies and alkaline Carbonates. 

Inorganic Acids. — Diluted Sulphuric Acid, in water, is used against the solu- 
ble salts of Barium and Lead, with which it forms insoluble sulphates ; also as 
a prophylactic against the colic of lead poisoning. 

Ammonia, diluted, used by inhalation, is an efficient antidote against the 
vapors of corrosive acids and Nitrobenzol, also Chlorine, Bromine, and Hydro- 
cyanic Acid. 

Magnesium Hydrate and Carbonate are the most efficient antidotes against 
Acids and the acid salts, and even against Oxalic Acid and the acid Oxalates, 
in the absence of the calcium antidotes therefor. They are also valuable in 
poisoning by Arsenic, Phosphorus, Mercury, Corrosive Sublimate, and other 
metallic salts, forming with arsenic compounds which are almost insoluble, and 
with metallic salts in solution precipitating the corresponding oxides or basic 
salts. 

Magnesia is a compound of the Hydrate and Carbonate with water, or a 
basic Magnesium Carbonate. When heated at a low temperature it becomes 
calcined, losing C0 2 and H 2 ; and then mixed with 25 times its weight of warm 
water it becomes gelatinized, in which condition it is best for antidotal purposes, 
in doses of from \}4, to 2 oz., at short intervals for a few doses, then at longer 
intervals. An excess does no harm, but rather benefits the patient by its ca- 
thartic action. 

Carbonates and Bicarbonates of Sodium and Potassium are employed against 
most of the poisonous metallic salts, especially those of Zinc, which they imme- 
diately decompose, forming insoluble basic compounds ; also against Iodine, 

54 



85O TREATMENT OF POISONING. 

Bromine, and Potassium Bichromate, forming the neutral chromate with the 
latter and harmless salts with the former. They are useful in dilute solution 
against Acids, but are less easily tolerated than magnesium sulphate. They 
are contraindicated in poisoning by Oxalic Acid, with which they form danger- 
ous compounds. 

Calcium Hydrate and Carbonate, in the form of lime-water, chalk, eggshells, 
or powdered oyster-shells, are used against Acids, both mineral and organic, 
and especially against Oxalic Acid and the acid Oxalates, which they neutral- 
ize and convert into the insoluble calcium oxalate. 

Sulphates of Magnesium and Sodium (Epsom and Glauber's salts), the solu- 
ble sulphates, are particularly efficient against Carbolic Acid and the salts of 
Barium and Lead. 

Sodium Chloride (common salt), in dilute solution, is the best antidote against 
the Silver salts, converting them into the insoluble chloride of silver. It may 
be given with albumen, which is also a very efficient antidote in this form of 
poisoning. 

Potassium Ferrocyanide, given in doses of from 30 to 60 grains in water, is 
of special value against the Copper salts, but albumen is equally efficient and 
more easily obtained. 

Potassium Permanganate is the best antidote against all organic poisons, if 
used promptly, before absorption has taken place, as it rapidly destroys them 
by oxidation. It has been used successfully against Morphine and Strychnine 
salts and Phosphorus in the stomach, and locally for snake-poison. (See ante, 
Page 339.) 

Iron. — The Hydrated Sesquioxide is the best antidote to Arsenic in solution 
or in a soluble form, as it combines with it to form a ferrous arsenate, and also 
protects the gastro-intestinal mucous membrane against the local action of the 
poison. In the proportion of 10 parts to one of arsenic the union is very com- 
plete, but its union with the salts of arsenic is limited even when it is in great 
excess, though much more effectual if there is added to it a small amount of 
ammonia or other caustic alkali, or if the basic ferric acetate is mixed with it. 
For the preparation of the official arsenic antidote see Ferri Oxidum Hydratum 
cum Magnesia, under the title Iron. Dialyzed Iron, Saccharated Iron {Ferrum 
Oxy datum Saccharatutri), and the basic Ferric Acetate have all been used with 
more or less success in arsenic poisoning. 

Copper Carbonate, in the dose of from 3 to 6 grains, with sugar and water, 
preceded and followed by an emetic, is recommended in Phosphorus poisoning, 
being supposed to coat the particles of phosphorus first with a layer of copper 
phosphide and then with one of copper itself, thus preventing their solution in 
the fluids of the stomach. 

Sodium Hyposulphite, in doses of 15 grains, in very dilute solution and fre- 
quently repeated, is a valuable antidote against Bleaching Powder (Calcium 
Hypochlorite), Labarraque's solution (Sodium Hypochlorite), and Javelle Water 
(Potassium Hypochlorite), which it reduces to chlorides, itself undergoing oxi- 
dation to the sulphate. 

Chlorine, in the form of Chlorine Water, Labarraque's solution, or Javelle 
Water (see above), is employed externally as an antidotal wash for snake-bites 
and other poisoned wounds ; also, well diluted, internally against alkaloids and 
other vegetable and animal poisons ; and as a spray for antidotal inhalation 
against coal gas (Carbonic Oxide), Ammonia, Phosphoretted and Sulphuretted 
Hydrogen and Hydrocyanic Acid. 

Iodine, in very dilute solution, is used as an antidote against alkaloids and 
their salts, also other vegetable poisons, and snake-venom. All its compounds 
are more or less soluble and toxic, and must therefore be removed from the 
system as soon as possible. Bouchardaf s Antidote for vegetable poisons con- 
sists of 3 grains of Iodine, 30 grains of Potassium Iodide, and 11 oz. of distilled 
water. The dose, which is from \)& to 3 oz., should be repeated frequently. 



TREATMENT OF POISONING. 85 I 

Ammonium Carbonate, in the dose of 5 grains, administered hypodermically in 
the vicinity of wounds caused by poisoned arrows, was repeatedly used by Dr. 
Parke, the surgeon of Stanley's last expedition in Africa, with entire success in 
saving life when it was employed immediately after the injury. Persons so 
wounded, if they were at too great a distance to receive this treatment, invari- 
ably died within a short time. 

Antidote Bag, designed by Martindale, of London, contains the following- 
named articles, labeled with directions for use, viz. — 

Dialyzed Iron. Spt. Ammonise Aromat. Amyl Nitrite. 

Syrup of Chloral. Oil of Turpentine. Zinc Sulphate. 

Chloroform. Acetic Acid. Ipecacuanha. 

Spt. Chloroformi. Tinct. Digitalis. Potassium Bromide. 

Calcined Magnesia. Tannic Acid. Potassium Permanganate. 

Also a Hypodermic Syringe and Solutions or Pellets therefor of — 
Morphine Sulphate. Apomorphine Hydro- Pilocarpine Nitrate. 

Atropine Sulphate. chlorate. Strychnine Nitrate. 

General Antidotes have been devised for use when the nature of a poison is 
unknown, with the object of a " shot-gun prescription," intended to hit some- 
thing. One of the best is Jeaunel's, composed as follows, — Liquor Ferri Sul- 
phatis (sp. gr. 1.45) ^ijss, Magnesia Calcinat. ^ij, Carbo Animalis ^j, Aqua 
%xx. These ingredients should be kept separate — the solution of the sulphate 
in one vessel, the others together. When needed, the former should be added 
to the latter and violently agitated. Dose, |;jss to §iij. This is a perfect anti- 
dote to Arsenic, Zinc, Digitalin, etc. It delays the action of salts of Copper, 
Morphine and Strychnine, and slightly influences compounds of Mercury. It 
is valueless for Cyanide of Mercury, Tartar Emetic, Hydrocyanic Acid, Phos- 
phorus, or the caustic Alkalies. 

Bellini, of Florence, considers the Iodide of Starch a valuable antidote to 
alkaline Sulphides, earthy Sulphides, vegetable and caustic Alkalies, and 
Ammonia. In the first two cases he considers it superior to all other antidotes. 

Bouchardat's Antidote for vegetable poisons consists of Iodine, gr. iij, Potas- 
sium Iodide, gr. xxx, Aqua Destillata ^xj ; the dose of which is ^jss-iij fre- 
quently repeated. 

A fresh mixture of the Sulphides of Iron and Sodium with Magnesia, is said 
to be a perfect antidote for Copper salts, Corrosive Sublimate and Mercuric 
Cyanide. If the nature of the poison is entirely unknown, a harmless yet 
effectual antidote in most cases is one composed of equal parts of Magnesia, 
Wood Charcoal, and the Hydrated Ferric Oxide, given freely in plenty of 
water. 

Antagonists and Antagonistic Measures. 

Antagonists in toxicology are agents which oppose each other in their 
physiological action, and may be employed against each other as counter- 
poisons, to neutralize their effects upon the organism. They do their work in 
the blood and tissues, after absorption, and are especially available against 
poisons administered hypodermically, in both which cases antidotes are use- 
less. Substances so employed are generally the active principles of plants, a 
few being chemicals, as Oxygen and Chloral. Antagonistic Measures include 
such proceedings as tend to neutralize the remote effects of poisons, as arti- 
ficial respiration, faradism of the respiratory muscles, hot and cold applica- 
tions, douching, constant motion or absolute repose, etc. (See ante, page 62.) 

Poisons, their Antidotes and Antagonists. 

Acetanilid. Antagonists, — Belladonna or Atropine, to maintain the blood- 
pressure ; Strychnine, for the respiration ; Oxygen inhalations, to overcome 
cyanosis ; Heal, externally applied ; stimulants and supporting measures. 



852 TREATMENT OF POISONING. 

Acids. Antidotes, — Alkalies for the least irritant acids, Magnesia, Mag- 
nesium Oxide, slaked Lime, Chalk ; plaster from wall with water, milk, oil, 
white of egg", bland mucilaginous drinks and poultices (R). Antagonists, — 
See under Acids, Mineral, below. 

Acid, Acetic. Antidotes, — Magnesia or Magnesium Carbonate, freely ; Soap 
and water, Lime-water, Chalk, White-wash ; also milk, oils and thick gruel 
may be given. Antagonists, — Morphine, gr. X hypodermically, to ward off 
shock. 

Acid, Carbolic. Antidotes, — Any soluble Sulphate is the best, to form a 
sulpho-carbolate, as Magnesium or Sodium Sulphate (Epsom or Glauber's 
salts). In a case where l / z oz. of 95 per cent, acid had been taken, nearly 
3 ozs. of Magnesium Sulphate were used, resulting in full recovery from an 
apparently hopeless condition. Liquor Calcis Saccharatus, or the official 
Syrupus Calcis, given freely. Soap, in strong watery mixture (suds), is said to 
be almost a perfect antidote. Cider Vinegar may prove antidotal, as it removes 
the effects of the strong carbolic acid applied locally. Vegetable Demulcents 
(but no oils or glycerin), to protect the mucous surface. Sodium Carbonate, in 
strong solution locally, for the effects of its local use in excess : this also as a 
wash for the mouth, if necessary. Antagonists, — Atropine is a very complete 
antagonist to the systemic symptoms, maintaining the heart and respiration 
until elimination occurs: gr. -^ hypodermically. Amyl Nitrite, by inhalation. 
Alcoholic stimulants freely. Heat to the extremities, also Faradism and fric- 
tion thereof. Venesection in desperate cases (Murrell). 

Acid, Carbonic. See ante, page 81, also under Coal-gas, below, for the treat- 
ment of poisoning by Carbonic Acid and Carbonic Oxide gases. 

Acid, Hydrocyanic (Prussic). Forty minims of the official diluted acid have 
proved a fatal dose. Antidotes, — if time to do anything, Cobalt Nitrate, has 
proved a perfect antidote in over 40 cases (Johann). Ainmonia, diluted, by in- 
halation, or Chlorine Water by spray, for the vapor. Per- and Proto-salts of 
Iron with Magnesia. Calcium or Sodium Chloride, gr. xxx-xl, in water. 
Emetics or stomach-pump. Antagonists, — Stimulants, as Brandy, Chloric 
Ether, Ammonia, ad libitum. Alternate hot and cold Douche, from a height. 
Artificial Respiratio7i. Faradic current (mild) to chest walls and over cardiac 
region. Atropine has antagonistic action, but is too slowly diffused to be of 
any value. Ammonia by inhalation, by the stomach, and by intra-venous 
injection, with cold affusion to the spine, and artificial respiration, are the 
measures most likely to avail in cases where there is time to do anything. 

Acids, Mineral. Antidotes, — Alkalies, as Sodium Carbonate, or Bicarbonate, 
Magnesia, or Chalk, Soap, Whiting, Wall-plaster, in water. Albumen, Flour, 
Milk, Starch, Olive Oil, to protect the mucous membrane. Avoid water in 
Sulphuric Acid cases. Antagonists, — Opium, Ammonia (intra-venously), Al- 
cohol, as stimulants, to combat the depression of the vital powers. 

Acid, Oxalic, also the Acid Oxalates, as Potassium Oxalate, known as " Salts 
of Lemon " or of" Sorrel," used for removing ink-stains. Antidotes, — Calcium 
Carbonate or Hydrate (as lime-water, chalk, whiting, wall-plaster, in water), or 
Magnesia. Avoid Potassium and Sodium Carbonates and Bicarbonates. Bland 
mucilaginous drinks and poultices to the abdomen. 

Aconite. Antidotes, — Tannic Acid, or Animal Charcoal, powdered, in water. 
Emetics or the stomach-pump. Castor Oil, or other purgatives. Bland fluids, 
and poultices for abdominal irritation. Antagonists, — Atropine, Caffeine, 
Morphine, Ether, Ammonia, Amyl Nitrite, antagonize its effects on the heart 
and respiration. Digitalis antagonizes its action on the heart and its relax- 
ation of cardiac inhibition (Fothergill). In Aconite-poisoning the stomach 
should be evacuated, warmth applied to the extremities, stimulants adminis- 
tered, artificial respiration if necessary, and the recumbent posture strictly 
maintained. Caffeine may be administered hypodermically, and strong Coffee 
by the mouth. 



TREATMENT OF POISONING. 853 

Alcohol. Antidotes, — Emetics or the stomach-pump, if much alcohol re- 
cently swallowed. Antagonists, — Ammonia by inhalation cautiously. Cold 
affusion to the head. Warmth to the extremities. Faradism of the muscles of 
respiration. Artificial Respiration. Chloral, gr. xx-xxx every 4 hours to 
secure sleep. Bromides for the same purpose, or Capsicum in doses of 
gr. xx-xxx. Ammonium Chloride, about 3ss in half a pint of water at one 
draught, has a marvellous effect in generallv straightening up the victim, an- 
tagonizing stupor and restoring faculties. Hyoscine or Dubnisine, as hypnotic, 
gr. .^fl -^ hypodermically. [Compare Alcoholism and Delirium Tremens in 
Part III, also page 114, ante.] 

Alkalies. Antidotes, — Acids, diluted, especially the vegetable acids, as 
Vinegar, Lemon-juice, etc. Albumen, Milk, Gelatin. Oils to protect the mucous 
surfaces. [Compare Ammonia below.] Antagonists, — Opium for the shock 
and vital depression, also Caffeine, Alcohol, and other stimulants. 

Alkaloids. Antidotes, — Tannin holds high rank, forming tannates, which 
are comparatively insoluble. Potassium Permanganate (see ante, page 339). 
Albumen. Iodine. Charcoal. Emetics and cathartics afterwards. Antago- 
nists, — differ for each. [See their several titles below.] 

Alum. Antidotes, — Carbonates of Ammonium, Potassium, etc. Other 
treatment as for corrosive salts. [See Metallic Salts below.] 

Ammonia. Sources of Danger, the use of Smelling Salts or Spirit of Harts- 
horn in excess, and the strong solution of Ammonia kept by housekeepers 
for laundry purposes. Antidotes, — Vinegar, Lemon- or Orange-juice, any 
Vegetable Acid, followed by demulcents to protect the mucous surfaces. When 
inhaled, give vapor of Acetic or Hydrochloric Acids or Chlorine-water by in- 
halation, the two latter forming the chloride. Antagonists, — Aconite, Vera- 
trum, Digitalis, as cardiac sedatives. 

Amyl Nitrite. Antagonists, — Ergotin, Atropine, Strychnine, also Brucine, 
Digitalis, Picrotoxin, and all other agents which increase the functional activity 
of the spinal cord and sympathetic, are antagonistic, though not always avail- 
able by reason of their slower rate of diffusion. Stimulants, artificial respira- 
tion, the alternate cold and hot douche, with cold to the head, and Ergotin or 
Atropine hypodermically, are the best measures to be used in cases of poison- 
ing by the Nitrites. 

Anaesthetics (Ether, Chloroform, etc., by inhalation). Antagonists, — Atro- 
pine, hypodermically, is of great value in combating the cardiac and respira- 
tory failure of Ether (Amidon); and is equally efficient in Chloroform poison- 
ing, as I have found by experience (Potter). Strychnine, hypodermically, has 
done good service in chloroform narcosis and has many advocates. Amyl 
Nitrite, by inhalation. Oxygen, by inhalation. Venesection, to relieve the 
engorged right heart, supplemented by Galvanism to stimulate the cardiac 
action (Spooner). Artificial Pespiration, Fresh Air, Coffee. Faradism of the 
respiratory muscles. Heat applied to the body and limbs. Ice in the rectum. 
Ammonia, 10 minims of the Liquor in 40 of water, intravenously, — unsuccess- 
ful (Bartholow). Invert the patient, draw the tongue well forward with forceps, 
compress and relax the chest, maintain the inverted position until the pulse and 
respiration are good (Nelaton). 

Antimony (as Tartar Emetic, etc.). Antidotes, — Tannin, or any substance 
containing it, is the antidote, forming the insoluble tannate. Albumen or Milk. 
Carbojiates of Magnesium and Sodium. Magnesia, in milk, especially for the 
Chloride of Antimony. Alkalies and Salts of Lead decompose Tartar Emetic. 
Emesis by tickling the fauces. Demulcent drinks freely, to protect the mucous 
membranes. Water, warm, in large draughts; or lavage of stomach with 
water first, then with solution of Tannin. Antagonists, — Opiu?n, Alcohol, 
Ether, and other antispasmodics. 

Antipyrin. See above, under Acetanilid, for the treatment of poisoning by 
Antipyrin, Phenacetin, Kairin, and similar compounds. 



854 TREATMENT OF POISONING. 

Arsenic (Arsenous Acid). Two grains have been fatal. Common Sources of 
Danger: arsenical wall-papers, Arsenic mistaken for " salts " or for " magnesia," 
adulterated confectionery, also Paris Green (Cupric Aceto-Arsenite) taken with 
suicidal intent. Antidotes, — Hydrated Ferric Oxide, freshly precipitated by 
precipitating a solution of Ferric Chloride with Sodium Carbonate or Ammo- 
nia, — or as the official Ferri Oxidum Hydratum cum Magnesia (see ante, page 
282), in the proportion of gr. viij for each grain of the poison ingested. Dia- 
lyzed Iron, is quite efficient as an antidote, is more easily obtained than the 
hydrated oxide, and has rendered good service in many cases of poisoning 
from inhaling arsenical fumes. Ferri Subcarbonas is equally good, ^ij followed 
by Castor Oil (Leale) ; or Hydrated Magnesia, or Magnesia and Sugar (Carl). 
Magnesium Bicarbonate or other alkalies (R). Charcoal, ^ss or more (R). 
Saccharated Ferric Oxide. Basic Ferric Acetate. Apomorphi?ie, hypoder- 
mically, or Zinc Sulphate, as emetic (avoid Tartar Emetic). Emesis by 
feather-tickling. Oil and Lime-water mixed, before and after emesis (Taylor). 
Milk or other bland fluids to wash stomach. Castor Oil after emesis. Mag- 
nesia and Linseed tea. Poultices and fomentations over abdomen. Potassium 
Iodide afterwards to promote elimination. Antagonists, — None. 

Barium Salts. Antidotes, — Sulphates of Magnesium, Sodium (Epsom and 
Glauber's salts), Calcium, or Potassium. Diluted Sulphuric Acid. 

Bee and Insect Venom. Antidotes, — Aqua Ammonia, Sodium Bicarbonate 
or Chloride, or Carbolic Acid, applied to the wound ; or tr^xv of a 2 per cent, 
solution of the first hypodermically, with Liquor Ammonii Acetatis internally. 
[Compare the article on Stings in part III.] 

Belladonna and Atropine. Caustic Alkalies decompose Atropine and are 
therefore incompatible with the preparations of Belladonna. Antidotes, — 
Ta7inin, Zinc Sulphate or Apomorphine, as emetics, or the Stomach-pump. 
Purgation. Magnesium Bicarbonate, and other alkalies (R). Charcoal, ^ss 
or more is necessary (R). Antagonists, — Morphine is the physiological an- 
tagonist to the effects of Atropine on the cerebrum, pupils, heart, respiration, 
arterial tension and kidneys; Aconite, Physostigmine, Pilocarpine and Quinine 
are each antagonistic to some of its effects, Muscarine to most of them. 
Brandy or strong Coffee. Capsicum. Faradism of respiratory muscles. Flagel- 
lation. Cold to the head. Ammonia, breathed into air-passages (R). 

Bromides. Antidotes, — Nitrous Ether is incompatible with Ammonium 
Bromide, Acids and Metallic Salts are so with all the Bromides. Poisoning 
thereby is always chronic, never acute, hence no antidotes can be employed. 
Antagonists, — Morphine is the most efficient, especially for the mental symp- 
toms. Digitalis, Ergot, Belladonna, and other vaso-motor stimulants, antag- 
onize many of the effects of the bromides. Cocaine is useful in chronic depres- 
sant poisoning thereby, and Alcohol with Opium as a nervous stimulant. 

Bromine. Antidotes, — Albu?nen, Starch, Gelatin, Sodium and Potassium 
Carbonates and Bicarbonates. Against the irritant vapor, Ammonia vapor by 
inhalation, or steam inhalations. Antagonists, — Opium and Alcohol as stimu- 
lants, if much depression ensues. 

Calcium Chloride. Antidotes, — Albumen, Mucilaginous drinks, or Oils, 
Milk, Flour and water. Avoid acids. Antagonists, — Opiiun, Alcohol, for 
vital depression. 

Camphor. Antidotes, — Water to precipitate it from the alcoholic solution. 
Alkalies and earthy salts precipitate even the small quantity which is soluble 
in water. Emetics to remove as much as possible. Antagonists,^^4<t<7/zz/<? 
and other arterial sedatives. Coffee. Cold. Alcoholic stimulants. Opium 
and Bromides for the convulsions. 

Cannabis Indica. Antidotes, — Emetics to remove as much as possible. 
Caustic Alkalies are incompatible. Antagonists, — Alcohol, as stimulant. 
Strychnine as respiratory stimulant. Faradism of muscles of respiration. 
Lemon-juice is said to antagonize its effects, which last over 24 hours from a 
large dose. 



TREATMENT OF POISONING. 855 

Cantharis. Avoid Oils, also fats and milk, which promote its absorption. 
Antidotes, — Emetics. Demulcents (as linseed tea, gruel, barley-water), freely. 
Water in large quantity, to flush the kidneys. Oleaginous injections into the 
bladder to allay irritation. There is no chemical antidote. Antagonists, — 
None, but Opium may be given for the gastro-enteritis. 

Carbonic Oxide. See below, under Coal-gas, for the treatment of poisoning 
by Carbonic Oxide and Carbonic Acid gases. 

Chloral .Hydrate. All Alkalies are incompatible as they decompose it. Anti- 
dotes, — Liquor Potasses, in hourly doses of Z\) well diluted, which amount will 
decompose 20 grains of chloral each time in the blood (Dougall). Emetics or 
the stomach-pump, if patient is seen shortly after ingestion of a toxic dose. 
Reliance must be placed on the antagonism of the following. Antagonists, — 
Strychnine, but only to a limited extent ; though Chloral is the most perfect 
antagonist to strychnine, opposing its spinal action (but see page 223). Heat 
to the body and limbs, by hot blankets, hot water bottles, etc., is the most effi- 
cient antagonist. Atropine antagonizes its cardiac, respiratory and spinal de- 
pression, and should be used hypodermically, in small doses (gr. ^-^), fre- 
quently repeated, until its effects are apparent. Morphine administered with 
Chloral antagonizes its tendency to produce cardiac failure, while synergistic to 
the hypnotic action of the drug. Cocaine is of value for the cardiac and respira- 
tory depression. Alcoholic stimulation. Amyl Nitrite by inhalation. Frictions. 
Coffee, black, a pint injected into rectum, as for narcotic poisoning. Artificial 
Respiration. 

Chlorine. Antidotes, — Albumen for Chlorine preparations in the stomach, 
also Aqua Ammonias in small quantity, well diluted. A?nmonia vapor in- 
haled against Chlorine inhalations, forming Ammonium Chloride. Am- 
monium Sulphide has similar reaction, but should* be used in great modera- 
tion. Fresh air. Steam inhalations. Emesis with warm water, then white of 
egg or milk, flour, or lime-water. Antagonists, — Chloroform by inhalation to 
ease the cough. 

Chloroform (swallowed). Recovery has occurred after the ingestion of one, 
two and even three ounces of chloroform (H. C. Wood). Antidotes, — Sodium 
Carbonate in plenty of water. Emetics. Treatment as for irritant poisoning. 
Antagonists, — Atropine or Strychnine, hypodermically. Amyl Nitrite, by in- 
halation. Coffee, black, a pint into the rectum. Heat to the body and espe- 
cially to the cardiac region. Rouse by slapping with wet towel. Mustard to 
calves of legs and over the heart. Relapse may occur, hence the patient should 
not be left for some time after apparent restoration. 

Coal-gas. Antidotes, — Chlorine -water as spray, inhaled. Antagonists, — 
Oxygen by inhalation, 4 or 5 quarts. Ammonia vapor inhaled. Galvanism, 
by interrupted current to extremities. Artificial Respiration, to be maintained 
steadily for hours. Rhythmic traction of the tongue. Fresh air, in plenty ; 
open all doors and windows. Coffee, black, a pint as enema. Ve7iesection may 
be of service. Douche, alternately cold and warm, to head and chest. Hori- 
zontal position, clothing removed. Alcohol moderately by mouth or rectum. 
Catheter may be required in prolonged cases. Subsequently, a warm bed, 
heat applied to the body and limbs, open windows, perfect quiet, Condy's fluid 
about the room, stimulants sparingly, cold acid drinks freely. 

Cocaine. Antidotes, — See Alkaloids, above. Antagonists, — Chloral is 
the most direct antagonist, so also are Chloroform and Ether. Morphine is 
directly antagonistic at almost all points of action. Amyl Nitrite combats the 
earliest symptoms of cardiac depression, then Alcohol and Opium as cardiac 
stimulants. Artificial Respiration may be required. 

Colchicum. Antidotes, — Tannic or Gallic Acid, followed by emetics and 
cathartics. Demulcent drinks, warm. Antagonists, — Alcoholic stimulants. 
Morphine, hypodermically for the cardiac depression. Treatment is the same 
as that for Aconite poisoning. 



856 TREATMENT OF POISONING. 

Conium. Antidotes, — Tannic or Gallic Acid y followed by emetics and 
cathartics. Antagonists, — Nux Vomica and its alkaloids, also Picrotoxin and 
other tetanizers. Alcohol. Muscular Movement. Heat applied externally, as 
soon as the stomach has been evacuated. 

Copper Salts. Antidotes, — Albumen, Soap, Gluten, Milk, Sugar, Mag- 
nesia. Potassium Ferrocyanide, is the most efficient chemical antidote, but 
Magnesia or Albumen may be used. In the absence of eggs, give a thin paste 
of flour and water. Any antidote should be followed by prompt evacuation of 
the stomach, and Potassium Iodide to saturation of the system. Antagonists, 
— Opium and Demulcents for the gastro-enteritis. 

Corrosive Sublimate (Corrosive Mercuric Chloride). Antidotes, — Albumen, 
Gluten, Magnesia, Milk, Lime-water. Albumen, in some form, is the most 
efficient ; the white of one egg to each 4 grains of the poison, forms the albu- 
minate, which must be at once evacuated by emesis or the stomach-pump, it 
being soluble in an excess of albumen, also in the alkaline contents of the in- 
testines. Potassium Iodide for after-treatment, converts the poison into solu- 
ble combinations and promotes their elimination. Charcoal, ^ss or more neces- 
sary (R). Hydrated Protosulphide of Iron, if given within 20 minutes, is said 
to be an efficient antidote. Antagonists, — See under Mercury, below. Fatal 
Dose, — gr. iij have proved fatal. 

Creosote. Antidotes, — Mucilage, Oils, are the most easily obtained. An- 
tagonists, — Ammojiia, for depression. Treatment is the same as for Acid, 
Carbolic, which see. 

Curare. Antidotes, — Ligate above the wound, if any; incise the part freely 
and suck it strongly. Evacuation of the bladder repeatedly, to prevent reab- 
sorption. Caustic Alkalies destroy the poison. Antagonists, — Artificial Re- 
spiration is the most efficient antagonist, maintaining life until elimination 
occurs. Strychnine, though from a member of the same family of plants, is an- 
tagonistic as to the action upon the heart and respiration. So also is Atropine. 

Cyanide of Potassium. Antidote, — Ferrous Sulphate to form Prussian 
Blue (Ferric Ferrocyanide), followed by evacuation of the stomach. Cobalt 
Nitrate, is a perfect antidote (Johann). Antagonists, — Ajnmonia, intraven- 
ously. Digitalin, Strychnine, Alcohol. Artificial Respiration, general friction, 
and galvanism. [Compare Acid, Hydrocyanic, above.] 

Digitalis. Antidote, — Tannic Acid, to form the tannate, which, however, 
is not inert, so that the stomach should be immediately evacuated. Antag- 
onists, — Aconite for the effects of large doses, Opiwn for those due to its con- 
tinued use. Saponin and Senegin are its most complete physiological antag- 
onists. Alcohol, Galvanism, Horizontal posture. The treatment is similar to 
that for Aconite. 

Ergot. Antidote, — Tannic Acid, followed by an emetic. Antagonists, — 
Amy I Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia, antagonize its 
action on the circulation. 

Fish-poison. Antidotes, — Emetics and Cathartics. Antagonists, — Potas- 
sium Chlorate freely, Liquor Ammonii Acetatis, Opium, Capsicum, Chloroform. 

Fungi, Poisonous. Antagonist, — Atropine, is practically specific as an 
antagonist in many cases of fungi poisoning. [Compare Muscarine, below.] 

Gamboge. Antidotes, — Potassium or Sodium Carbonates. Magnesia in 
milk. Emetics. Mucilaginous drinks. Antagonists, — Opium for the depres- 
sion. Alcoholic stimulants. 

Gases and Vapors. See Ammonia, Acid Hydrocyanic, Chlorine, Coal-gas, 
Nitrous Oxide Gas, Sulphur. 

Gelsemium. Antidote, — Tannic Acid, followed by an emetic or the 
stomach-pump, if recent. Antagonists, — Morphine is the most complete. 
Ligitalis, Ammonia, Alcohol, Atropine, and to some extent the tincture of 
Xanthoxylum, are also antagonistic. Heat externally, Faradization of the 



TREATMENT OF POISONING. 857 

respiratory muscles, and Artificial Respiration are measures of prime import- 
ance. Brandy and Capsicum are useful. 

Glass (coarse or powdered). Antidotes, — Bread-crumbs freely to envelope 
it, then emetics. 

Gold Salts. Antidotes, — Ferrous Sulphate. Albumen, as eggs or flour. 
Mucilage. Emetics. Treatment as for Corrosive Sublimate. 

Hyoscyamus. See Belladonna, above. 

Hypochlorites, as Javelle Water (Potassium Hypochlorite), Labarraque's 
Solution (Sodium Hypochlorite), and Bleaching Powder (Calcium Hypo- 
chlorite). Antidote, — Sodium Hyposulphite, in dose of gr. xv, well diluted 
and frequently repeated, reducing them to chlorides, itself undergoing oxidation 
to the sulphate. 

Iodine. Antidotes, — Starch, Albumen, Flour, Gelatin, Sodium and 
Potassium Carbonates and Bicarbonates. Starch is the antidote to free Iodine, 
but the stomach must be evacuated, as the Iodide of Starch is not inactive. 
In chronic poisoning by the Iodides, a free salivary flow induced by chewing 
Pyrethrum-root will hasten elimination of the drug. Antagonists, — Quinine, 
Digitalis, and other restorative agents and vaso-motor tonics. Amyl Nitrite. 
Morphine, for pain. 

Ipecacuanha. Antidotes, — Vegetable Acids and Astringents are incom- 
patible with Ipecac, and may be used as antidotes. Antagonists, — Bismuth, 
Carbolic and Hydrocyanic Acids, also Narcotics, antagonize the emetic action. 

Iron. Antidotes, — Ammonium and Sodium Carbonates, Magnesia, Mucil- 
aginous drinks. 

Lead Salts. Antidotes, — Sodium or Magnesium Sulphate, Sodium Phos- 
phate, Diluted Sulphuric Acid, Magnesium Bicarbonate, Ferrous Sulphate, 
freshly precipitated. Albumen, Milk. Emetics or the stomach-pump. Potas- 
sium Iodide, gr. xv-xxx, 3 or 4 times daily, in cases of chronic poisoning, as 
eliminative (R). The cachexia is much relieved by a combination of Quinine 
Sulphate, Ferrous Sulphate and Diluted Sulphuric Acid (B). Baths of Potassa 
Sulphurata (%j or more in the necessary water), are also very useful in chronic 
poisoning by Lead (R). Antagonists, — Opiuin, to allay irritation. Belladonna, 
the extract, gr. y%, with Pulv. Rhei, gr. ij, in pill twice daily, for the great pain 
at defecation (Da C). Alum, is the most efficient remedy for the colic; to a 
pint of boiling milk add 90 grains of powdered Alum, separate the curd and 
sweeten with sugar ; give a wineglassful every hour or two (B). Strychnine, 
for the paralysis, gives good results; also Atropine, gr. y^, with Potassium 
Iodide, gr. v. Electricity, a slowly interrupted current until it causes reaction, 
for the paralysis of extensors (dropped wrist) ; cure to be completed by the 
faradic current (B). Marked Diagnostic Signs of chronic poisoning by 
Lead are — the dropped wrist, due to paralysis of extensor muscles and a dark, 
blue line around margin of gums. 

Lime. See Alkalies, above. 

Lobelia. Antidotes, — Tannic Acid, to form the insoluble tannate. Char- 
coal, powdered in water. [See Aconite, above.] Antagonists, — Alcohol, 
Digitalis, Belladonna, Ergot, the vaso-motor excitants, antagonize its effects on 
the circulation ; Strychnine, Picrotoxin, and Thebaine, those on the nervous 
system. 

Mercury. [See Corrosive Sublimate above, also Metallic Salts below.] 
Antidotes, — Albumen, Gluten, Flour, Milk. Vegetable astringents. Hy- 
drated Protosulphide of Iron. Charcoal. Alkalies, especially Magnesium Bi- 
carbonate (R). Potassium Iodide, to saturation of the system, as after-treat- 
ment; converts the metal into soluble combinations (B). Baths, simple or 
sulphurous (R). Antagonists, — Bismuth, Tannin, Sodium Sulphite, Diluted 
Nitric Acid in water, as gargles and mouth- washes for salivation. Belladonna, 
tt^v-x of tincture every 4 to 6 hours, to lessen secretion in ptyalism (B). Hyos- 
cya?nine, for the tremor, gr. -^ gradually increased to gr. -^ (Oulmont). 



858 TREATMENT OF POISONING. 

Metallic Salts. Antidotes, — Albumen, Milk, Magnesia, Starch, Soap. 
Oils and other demulcents. Sodium or Potassium Carbonate and Bicarbonate. 
Lavage of stomach. Emetics and cathartics. Antagonists, — Opium, Alcohol, 
Cocaine, and other stimulants, when shock and vital depression. 

Mezereum. Antidotes, — Albumen, Milk, Oils and fats, Mucilaginous 
drinks. Antagonists, — Opium, as stimulant against shock and depression. 
Poultices, cool, to abdomen. 

Morphine. See Opium, below. 

Muscarine. Antidotes, — [See Alkaloids, above.] Antagonists, — Atro- 
pine exactly opposes Muscarine, and vice versa. Digitalis is antagonistic to 
some extent, so also is Physostigmine. There is no example of physiological 
antagonism so complete in all particulars as that between Atropine and Mus- 
carine. [See ante, page 105.] 

Mushrooms. Antidotes, — Emetics, if poisoning very recent; Cathartics, 
especially Castor Oil, if some time has elapsed. Tannic Acid, has been recom- 
mended. Antagonists, — Atropine. Alcoholic stimulants. Poultices, warm, 
to abdomen. [Compare Muscarine, above.] 

Narcotics. See Alkaloids above, also Opium, Belladonna, Alcohol, Chloral 
Hydrate, Cannabis Indica, Carbolic Acid, Chloroform, Coal-gas, Hydrocyanic 
Acid, etc. Vegetable Acids antagonize their after-effects to some extent. 

Nitrobenzol. Antidotes, — Ammonia, diluted, by inhalation. Emetics. 
Antagonists, — Alcohol, Liq. Ammonias (3ss in water), or Chloric Ether (3j in 
water), frequently repeated, as stimulants, given internally, by enema or hypo- 
dermically (brandy). Atropine. Artificial Respiration. Galvanic current, in- 
terrupted, to chest-walls, and over cardiac region. Fatal Dose, — Death has 
resulted from merely tasting it. 

Nitroglycerine. See Amyl Nitrite, above. 

Nitrous Oxide Gas. Antagonists, — Artificial Respiration, to be commenced 
at once and kept up for two hours if necessary, not faster than 18 per minute. 
Fresh air, open all doors and windows, and fan the patient. Oxygen by in- 
halation, 3 or 4 pints. Douche to chest, alternately hot and cold. The tongue 
should be pulled well forward, and the mouth cleared of any obstruction to 
respiration, as artificial teeth. In apparently hopeless cases, two or three 
violent blows on the chest, delivered in quick succession, may restore the 
cardiac action (Murrell). 

Nux Vomica and Strychnine. Antidotes, — Tannic Acid, forms the very 
insoluble tannate. Iodine in dilute solution, or a soluble salt thereof. Animal 
Charcoal, largely. Potassium Permanganate , has been taken in large dose by 
Dr. Fahr, of Milford, N. J., after having ingested gr. ^ of Strychnine, resulting 
in the entire absence of any symptoms of strychnine poisoning. Emetics or the 
stomach-pump should follow the administration of any antidote. The bladder 
must be frequently evacuated to prevent reabsorption. Antagonists, — Quiet, as 
perfect as possible, is very important. Chloral is the antagonist, gr. xxx as soon 
as possible, repeated in 20-grain doses at hourly intervals, as long as reflex exal- 
tation continues. Butyl-chloral Hydrate, is a very energetic antagonist (Gri- 
gorescu). Potassium Bromide, is almost too slow of action to be of much prac- 
tical service. Chloroform or Ether inhalation, to procure muscular relaxation. 
Physostigma, is antagonistic (R). Chamomile Oil, remarkably subdues reflex 
excitability in frogs after poisoning by Strychnine or Brucine (P). Amyl Nitrite, 
by inhalation (R). Veratrum Viride, cured a bad case ; 3j wa s given at once, 
then gtt. ij every ten minutes (R). Urethan. Methyl and Ethyl compounds 
of Strychnine, Brucine, and Thebaine. Monobromated Camphor. Ice to spine. 
Tobacco, by enema. Valerian mitigates the spasms (P). Curare, gr. % hypo- 
dermically ; is warmly recommended, but its claims are doubtful (P). Apo- 
morphine, hypodermically, is very effective in dogs (Wills). Nicotine, many 
cases prove its curative power (P). Hydras tinine Hydrochlorate, in doses of 
gr. j hypodermically, has been successfully employed. Artificial Respiration, 
if possible. Fatal Dose of Strychnine, — gr. \ for an adult, gr. -^ for a child. 



TREATMENT OF POISONING. 859 

Opium and Morphine. Antidotes, — Tannic Acid, or vegetable astringents, 
followed by evacuation of the stomach, if the poison has been taken by the 
mouth. Charcoal, ^ss or more (R). Apomorphine, as emetic, gr. tV to tV nv " 
podermically ; must be administered before narcosis sets in (B). Stomach- 
pump better than emetics, which by the mouth are generally useless in these 
cases. Potassium Permanganate, an efficient antidote if given soon after inges- 
tion of the poison (see pages 339, 366). Compound Tincture of Iodine. An- 
tagonists, — Atropine, hypodermically, gr. y^ every 15 minutes for three doses 
(B) ; antagonizes the cerebral action, also that on the respiration, heart, and 
arterial tension ; but, if given too freely, will endanger the case by deepening 
the narcosis (see page 366). No one is warranted in omitting it (P). Caffeine, 
is antagonistic and may be given hypodermically, though generally used in the 
form of strong coffee, frequently administered by mouth or rectum. Cocaine, 
is of especial value against the cardiac and respiratory depression. Strychnine, 
efficiently antagonizes the respiratory paralysis, and may be used in lieu of 
Atropine, or in conjunction therewith. A?nyl Nitrite, by inhalation, or Ammonia 
by intravenous injection, when the heart shows signs of failure ; the former 
proved eminently successful in a case wherein Atropine proved useless to 
restore the patient. Capsicum, the tincture, ^ss-j by rectal injection, is said to 
antagonize the stupor almost instantaneously. Vegetable Acids, as Vinegar and 
water, Lemon-juice, Cream of Tartar in water, etc., every 10 minutes (R); to 
antagonize the narcotism. Douche, alternately cold and hot, or hot water and 
ice alternately to nape of neck, for the narcosis. Artificial Respiration, should 
be kept up for at least two hours (Murrell). Oxygen, by inhalation, is of great 
value (Macalister). Venesection, has proved effective after all other measures 
failed ; is especially beneficial when death is impending from failure of respira- 
tory action due to distention of the right heart with backward pressure (Marshall). 
Potassium Bromide removes some of the cerebral effects of Opium, as the vertigo 
and mental confusion ; others are antagonized by Quinine, and the general 
intracranial effects of the drug are to some extent opposed by Digitalis and 
Tartar Emetic. The Important Measures indicated in Opium or Morphine 
poisoning are — (1) the removal of the poison, (2) the maintenance of respira- 
tion, (3) the keeping up of the circulation. The stomach should be evacuated 
at once, and then washed out repeatedly at short intervals, in order to recover 
the morphine which is constantly excreted into that viscus. Faradization of 
the chest muscles, cold affusion and artificial respiration are of great value, and 
evacuation of the bladder frequently is important, to prevent reabsorption. 
Flagellation is a very dangerous procedure, from the exhaustion which may be 
thereby induced, — strong faradic currents are much more efficient. The anode 
should be placed over the lowest conjoined root of the phrenic nerve, the ca- 
thode three inches below the ensiform cartilage and a little to the left of the 
median line. Common Sources of Danger, — Overdosing with cough mix- 
tures, or Paregoric, or the Soothing Syrups so much used for quieting children, 
all of which contain Opium (see page 362). The American Journal of Pharm- 
acy estimates the loss of life from the latter cause at 150,000 yearly. Fatal 
Doses, — see page 366. 

Phenacetin. See above under Acetanilid, for the treatment of poisoning by 
Phenacetin, Antipyrin and similar compounds. 

Phosphorus. Antidotes, — Potassium Permanganate, is probably the most 
reliable. Copper Sulphate, as an emetic and a chemical antidote, doses of 3 
grains in dilute solution every 5 minutes, until emesis occurs ; is recommended 
by authority but does more harm than good. Turpentine, old and acid, con- 
taining oxygen, given rapidly in a gum emulsion, is said by some to be the best 
antidote ; it is generally unattainable and has proved useless in many cases. 
Lime-water or Charcoal, to prevent action on the tissues. Hydrated Magnesia, 
as a quickly acting purgative ; may be given in Linseed tea. Copper Car- 
bonate, with sugar and water. Avoid Oils, Fats and Milk, as they dissolve the 
poison and promote its absorption. Antagonists, — Opium, to counteract the 
cardiac and systemic depression. Transfusion, to repair the blood. 



860 TREATMENT OF POISONING. 

Physostigma. Antidotes, — Emetics or the stomach-pump. Tannic Acid 
or vegetable astringents. Antagonists, — Atropine, as to the effects on the 
respiration, heart and pupil; gr. -^ to -^ hypodermically, repeated until effects 
are evident. The one nine-thousandth of a grain of Atropine, injected 5 minutes 
before giving a minimum fatal dose of Physostigma, prevents its fatal result (R). 
Chloral, is also antagonistic, and over a greater field of action, but to be effec- 
tive must be administered very early in the case (R) ; gr. x by mouth or rectum 
every y 2 hour. Strychnine, gr. ^y of the sulphate or gr. ^ of the nitrate, hypo- 
dermically ; or the tincture of Nux Vomica, tt^xx by mouth or rectum, in very 
bad cases (Murrell). Stimulants, freely. Artificial Respiration. Fatal Dose, — 
gr. 1^ is given as the minimum fatal dose. 

Picrotoxin. Antidotes, — Emetics or stomach-pump. Acetic Acid gives 
relief in overdosing, and may have some antidotal power. Antagonists, — 
Chloral, is antagonistic to its cerebral and spinal action, but synergistic to its 
depressant power over the heart and respiration. Anesthetics, against its 
spasm-producing action. Potassium Bromide, in addition to Chloral, if 
tetanus (Murrell). 

Pilocarpine (Jaborandi). Antidotes, — Persalts of Iron and salts of the 
metals generally, are chemically incompatible. Antagonists, — Atropine, gr. 
y-^ for gr. \ of the poison, is a complete antagonist, the most so known to 
physiological experimentation. Conversely, Pilocarpine is exactly antagonistic 
to Atropine, but Jaborine acts similarly to the latter. Morphine controls the 
nausea and vomiting. 

Potash. See Alkalies, above. 

Potassium Bichromate. Antidotes, — Sodium and Potassium Carbonates 
and Bicarbonates. Soap. Antagonists, — Opiu7n or Alcohol, for the nervous 
and muscular depression. 

Potassium Nitrate (Saltpetre). Antidotes, — No chemical antidote. Emetics 
or stomach-pump. Demulcent drinks and emollient enemata. Milk. An- 
tagonists, — Opium, for the subsequent depression. Aromatics. Brandy. 

Pulsatilla. Antidotes, — Ta7i?iic Acid, followed by emetics. Antagonists, — 
Alcohol, Opium, Digitalis. 

Quinine. Antidotes, — Emetics and cathartics, also diuretics and sudorifics 
to promote elimination. Antagonists, — Alcohol, Opium, Coffee. Morphine 
antagonizes its cerebral action, Atropine that on the nervous system and heart, 
also its antipyretic power. 

Rat-pastes, — contain Phosphorus or Arsenic. Ratsbane is Arsenous Acid 
(Arsenic). Rough-on-Rats contains Arsenic (which see). 

Resorcin. Antidotes, — Albumen. Soda or Saccharated Lime, in plenty of 
tepid water, as wash for stomach. Emetics or the stomach-pump. Antago- 
nists, — Stimulants freely. Heat to the extremities. A?nyl Nitrite, inhaled. 
Atropine and other cardiac and respiratory stimulants, cerebral excitants, and 
agents which raise the arterial tension, are physiologically antagonistic. Fric- 
tion with warm hand. Galvanism, the interrupted current. Fatal Dose, — 
Z'\] nearly proved fatal (Murrell). 

Rhus (Poison Oak or Ivy). Antagonists, — Cocaine, a 5 per cent, aqueous 
solution, or a 10 per cent, oleate, locally, is by far the most efficient application, 
promptly relieving the burning and itching. Grindelia Robusta, the fluid ex- 
tract, 1 to 10 of water, or undiluted, is a very serviceable lotion. Other appli- 
cations found useful are : — Carbolic Acid, 5 per cent, solution ; Lobelia, as infu- 
sion, ^j to the pint; solutions of Corrosive Sublimate, Lead Acetate, Chlorin- 
ated Soda, Lime-water with Linseed Oil, Alum-curd. R. Plumbi Acetatis, £ij ; 
Ammonii Chloridi (crude), ^ss; Aquae, ^viij ; as lotion on cloths constantly 
wetted therewith, is used with uniform success (Burns). Soap-suds and Hot 
Water, frequent washing therewith the surest, speediest and best treatment 
(Couch), Aristol, freely dusted over the part, gives magical relief (Levick). 
Hydrogen Dioxide, a solution washed over the face and hands, as a preventive 



TREATMENT OF POISONING. 86 1 

(Behringer). Sassafras, an infusion of the bark, taken internally and applied 
locally, is almost specific for the rash (Hinton). Sodiiwi Sulphite, granular, 
3j ; Glycerin, £ss ; Camphor-water, q. s. ad ^iv, is preferred as a topical appli- 
cation (Behringer). Opium, or Coffee, to relieve the nervous irritability. Rest, 
low diet, and laxatives are appropriate measures. 

Sanguinaria. Antidotes, — Tannin, Alkalies, and most of the metallic salts 
are incompatible. Antagonists, — Opium, Atropine, Amyl Nitrite, etc., to an- 
tagonize the depression of the circulation and the local irritant action. 

Savine. Antidotes, — Epsom salt. Demulcents. Emetics and purgatives, 
especially Castor Oil. Antagonists, — Morphine, gr. X hypodermically. Poul- 
tices of linseed meal to abdomen. 

Serpent- venom. Antidotes, — Potassium Permanganate, hypodermically 
into the vicinity of the wound, after ligating the part above it (Weir Mitchell). 
Chloride of Lime (Chlorinated Lime) in solution, i in 60, injected in doses of 
20 minims, produced recovery (Hodgson) ; after ligature applied above the 
wound a solution, 1 in 12, was injected in doses of 30 minims, 25 injections in 
all in different parts of the body, brought about recovery after severe symptoms 
from the bite of a tiger snake (Mackenzie). Hypochlorites of Lime or Sodium, 
Chloride of Lime, and Gold Chloride, are absolute antidotes against serpent- 
venom (Calmette). Antivenene (see ante, page 155). Carbolic Acid, strong, or 
a Mineral Acid, as caustic, after forcible sucking of wound by a person with 
perfect mucous surface of lips and mouth, and thorough cleansing. Ammonia, 
Tr^xij of Liq. Ammoniae, diluted with 3 volumes of water, hypodermically into 
the radial vein, for snake-poison (Halford) ; is shown to be unavailing by 
Brunton and Fayrer (B). Antagonists, — Strychni?ie, hypodermically, has 
proved eminently efficient in numerous cases (Baron von Muller). Alcohol, 
as brandy or whiskey freely. Arsenic, for the rapid prostration (R). Potassium 
Iodide, R. Potassii Iodidi, gr. iv ; Hydrarg. Chlor. Corr., gr. ij ; Bromi, 3v ; 
Aquas, 3j ; of which gtt. x in gij of Brandy, repeated if necessary (Hammond). 
Viola Cucullata, the common Violet, is used in Pennsylvania against rattlesnake 
venom. [See ante, page 487.] Agave Virginica, is known in South Carolina 
by the name of " rattlesnake's master." 

Silver Salts. Antidotes, — Sodium Chloride (common salt), dissolved in 
water, largely diluted and freely used ; precipitates the silver as the insoluble 
and harmless chloride, and acts as an emetic (R). Alkalies, especially Mag- 
nesium Bicarbonate (R). Albume7i. Antagonists, — Milk, to allay the result- 
ing irritation ; it may serve as food until the stomach is restored. Opium, against 
results of irritation. [See also Metallic Salts, above.] For the treatment of 
chronic poisoning, and regulation of a course of silver medication, see ante, 
page 162. 

Soda and Sodium Salts. See Alkalies and Potassium Nitrate, also Metallic 
Salts, above. 

Stramonium. See Belladonna, above. 

Strychnine. See Nux Vomica, above. 

Sulphonal. Antagonists, — Stimulants. Diuretics. 

Sulphur and Sulphides. Antidotes, — Chlorine-water. Sodium Chloride 
(common salt). Potassium Chloride. Ferrous Sulphate. Chlorine Gas or Cal- 
cium Hypochlorite, for Sulphuretted Hydrogen ; the former should be well 
diluted with common air. Antagonists, — Artificial Respiration is the best 
treatment for poisoning by Sulphuretted Hydrogen. 

Tartar Emetic. See Antimony, above. 

Tin. Antidotes, — Albumen, Ammonium and Sodium Carbonates, Milk. 
[See also Metallic Salts, above.] 

Tobacco. Antidotes, — Tannin, followed by emetics, or the stomach-pump. 
Iodides. Antagonists, — Strychnine is the true physiological antagonist to 
Nicotine (or Tobacco) and vice versa.. Alcohol, Ammonia, Ergot, Digitalis, 
Belladonna, antagonize its action on the circulation ; Brandy is efficient, also 



862 



SPECIFIC GRAVITIES AND VOLUMES. 



strong Coffee. Warmth applied to the surface, also friction. Artificial Respi- 
ration. Recumbent position should be strictly maintained. 

Turpentine. Antidotes, — Magnesium Sulphate (Epsom salt), ^j in water. 
Emetics or the stomach-pump. Demulcent drinks, as milk, barley-water, etc. 
Antagonists, — Opium or Morphine, if much pain, and for shock. 

Tyrotoxicon (in milk, cheese, ice-cream, etc.). Antidotes, — Emetics, if 
vomiting is not free ; also the stomach-pump or siphon to rinse out the stomach 
with water. Thymol, Salol, Naphtalin, or other antiseptics. Antagonists, — 
Opium, or other sedatives, to allay irritation. Stimulants, when prostration. 

Veratrum and Veratrine. Antidotes, — Emetics or the stomach-pump. An- 
tagonists, — Alcohol, Opium, Ammonia, Digitalis, and Belladonna counteract 
the cardiac depression. Morphine with Atropine hypodermically, or Lauda- 
num internally, with alcoholic stimulants. Heat, dry, applied to the body. 
Recumbent posture strictly maintained. Coffee^ strong, as enema. [See also 
Aconite, above.] 

Wounds, Poisoned. Antidotes, — Ammonium Carbonate, gr. v hypodermi- 
cally in the vicinity of wounds caused by poisoned arrows, was repeatedly used 
with entire success by Dr. Parke, surgeon to Stanley's last African expedition. 
[See ante, page 124; also Serpent-venom above, and the article on Wounds, 
in Part III.] 

Zinc Salts. Antidotes, — Sodium or Potassium Carbonate dissolved in warm 
water, largely diluted, used freely. Albumen, as eggs and milk, with tepid 
water, freely. Tannic Acid, or vegetable astringents, or strong tea. Lime- 
water. Soap-suds, freely. Mucilaginous drinks. Antagonists, — Opiu7n, or 
Morphine hypodermically. Linseed-meal as poultices to abdomen. Enemata 
of gruel or starch-and-water, if much abdominal pain. 



TABLE OF SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 

(Temperature at 59 F., except when otherwise stated. Where the sp. gr. is variable, 





the mean specific 


gravity is stated.) 






Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Liquid. 


Specific 
Gravity. 


Specific 
Volume. 


Acid, Acetic, 

Acid, Acetic Dil., . . . 
Acid, Hydrobromic (34 

per cent), 

Ac. Hydrobrom. Dil , 
Ac. Hydrochloric, . . 
Ac. Hydrochlor. Dil , . 

Acid, Lactic, 

Acid, Nitric, 

Acid, Nitric, Dil., . . . 

Acid, Oleic, 

Acid, Fhosphoric, . . . 
Ac. Phosphoric, Dil., . 
Acid. Sulphuric, . . . 
Ac. Sulphuric. Dil., . . 
^ther, 


1.048 
i.co8 

1-303 

1.077 

1.163 

1.059 

1. 213 

i-4i4 

1.057 

.900 

1.710 

1 057 

1.835 

1.070 

.725 

.820 

.812 

■937 

.930 

1. 000 

.960 

.901 

.670 

1.268 

1.490 

1.470 

1.250 

1.160 

1.387 


•954 
.992 

.767 

.928 

.860 

.952 

.824 

.709 

.946 

1. in 

.584 

.946 

• 545 

■934 

J -379 

1. 219 

1. 231 

1 c66 

1075 

1. 000 

1.042 

1. 109 

1-493 

.788 

.671 

.680 

.800 

.862 

.721 


Liq. Ferri Tersulph., . 
Liq. Potassae, .... 

Liq. Sodae, 

Mel (Honey), 

Ol. Adipis 

Ol. Amyg. Expres., . . 
Ol. Aurant. Cort., . . . 
Ol. Bergamottae, . . . 
Ol. CaryophyUi, . . . 

Ol. Copaibas, 

01. Cubebae 

Ol. Eucalypti, .... 
Ol. Gaultheriae, .... 
Ol. Gossyp. Sem., . . . 
01. Lavandulae, .... 

Ol. Limonis, 

Ol. Lini, 

Ol. Menthae Pip., . . . 

Ol. Morrhuae, 

Ol. Olivae, 

Ol. Ricini, 

Ol. Rosmarini, .... 

j Ol. Sassafras, 

01. Scsami, 

01. Terebinthinae, . . . 
Spt. ^Etheris Nitrosi, . 

Spt. Frumenti 

Spt. Vini Gallici, . . . 

Syrupus, 

Vinum Album, .... 


1.320 

1.036 

1-059 

1-375 

•9*5 

.917 

.850 

.883 

1.065 

.900 

.920 

.920 

1.180 

•9 2 5 

.886 

.858 

-93 6 
.910 

■9 2 3 
.9.6 
.960 
•9°5 
1.080 
.921 
.862 

•839 
.920 

•933 
i 317 
1. 000 


•757 
•965 
•944 
•727 
1.092 

1. 132 

939 
1. in 

1.086 
1.086 

.838 
1.081 
1. 128 
1. 165 
1.068 
1.098 
1.083 
1.092 
1.042 
1. 104 

•925 
1. 194 
1.160 
1. 191 
1.086 
1.071 

•759 
1 000 


Alcohol, at 6o° F., . . 
Alcohol, at 77 F., . . 
Alcohol, Dil., at 6o° F., 
Alcohol, Dil., at 77 K., 
Aqua Destil., at 59 F., 
Aq. Ammoniae, .... 
Aq. Ammon., Fort., . . 

Benzin, 

Carbon Disulphide, . . 
Chloroform, .... 
Chloroform, Venale . . 

Glycerin, 

Liq. Ferri Acet., . . . 
Liq. Ferri Chlor., . . . 



DROPS IN A FLUIDRACHM. 



86 3 



TABLE SHOWING THE 
NUMBER OF DROPS IN A FLUIDRACHM 



OF VARIOUS LIQUIDS, ALSO THE WEIGHT OF ONE FLUIDRACHM IN GRAINS. 

(Compare page 497.) 



Liquid. 



Acetum Opii, 

Acetum Scillae, . . . . 

Acid, Acetic, 

Ac. Acetic, Dil., . . . 
Acid, Carbolic, . . . . 
Ac. Hydrochloric, . . 
Ac. Hydrocyanic, . . . 

Acid, Lactic, 

Acid, Nitric, 

Ac. Nitro-hydrochloric, 
Ac. Phosphoric Dil., 
Ac. Sulphuric, . . . . 
Ac. Sulph. Aromat., . . 
Ac. Sulph. Dil., . . 
Ac. Sulphurosum, . . . 

^Ether, 

Alcohol, 

Aqua, 

Aqua Destillata, . . . 
Balsam Peruvian, . . . 

Bromine, 

Chloroform, 

Copaiba, 

Creosote, 

Ext. Belladon., Fl., . 

Ext. Buchu Fl 

Ext. Digitalis Fl., . . . 
Ext. Ergotae Fl., . . . 
Ext. Ipecac. Fl., . 
Ext. Rhei Fl., . . . . 
Ext. Senegas Fl., . . . 
Ext. Valerianae Fl., . . 
Ext. Zingib. Fl., . . . 

Glycerin, 

Hydrargyrum, . . . . 
Liq. Acidi Arsenosi, 
Liq. Ferri Chloridi, . . 



Drops 
in f 5j. 

(mix.) 



108 

68 



76 
59 
128 
146 

60 

59 
176 
i 4 6 
60 
60 
101 
250 
250 



137 

150 

142 

67 

150 

57 

7 1 



Weight 
of f 3j in 
grains. 



61 
57 
58 
55 
59 
65 
54 
66 

77 
66 
57 
101 

53 
58^ 
55 
39 
44 
55 

53^2 
60 
165 
80 
5i 

56^ 
57 

47^ 
62 
60 
60 
61 
62 
49 



760 

55 
72 



Liquid. 



Liq. Iodi Compos., . . 

Liq. Potassae, 

Liq. Zinci Chloridi, . . 
Oleores. Aspidii, . . . 
Oleores. Capsici, . . 
Oleores. Cubebae, . . . 

Oleum Anisi, 

Oleum Bergamottae, . . 

Oleum Cari, 

Oleum Juniperi, . . . 
Oleum Limonis, . . . 
Oleum Ricini, . . . . 

Oleum Rosae, 

Oleum Terebinthinse, . 

Oleum Tiglii, 

Spt. Athens Comp., . 
Spt. ^Etheris Nitrosi, . 
Spt. Camphorae, . . . 

Syrupus, 

Syrupus Acaciae, . . . 
Syrupus Ferri Iodidi, . 
Syrupus Scillae, . . . . 
Syr. Scillae Comp., . . 
Syrupus Senegae, . . . 
Tinctura Aconiti, . . . 
Tinctura Belladonnae, . 
Tinct. Benzoini Comp., 
Tinct. Cantharidis, . . 
Tinct. Digitalis, . . . 
Tinct. Ferri Chlor., . . 

Tinct. Iodi, 

Tinct. Opii 

Tinct. Opii Camph., 
Tinct. Opii Deodor., . 
Vin. Colchici Rad., . . 
Vin. Colchici Sem., . . 
Vinum Opii, 



Drops 
in f 5j 

(mix.) 



123 

119 

130 

132 

148 

129 

77 

132 

136 

104 

148 

146 

'43 

65 

44 

65 

75 

102 

106 

146 

J 37 

148 

131 
128 
150 
148 

>3° 
130 

no 



Weight 

of f 3j in 

grains. 



59 
58 

88 
52 
51 
52 
54 
46 
50 
49 
47 
V% 

47 i/ 

50 
45 
47 
47 
72 

73 
77 
74 
70 
70 
46 



WEIGHTS AND MEASURES. 



Pound 



apothecaries' or 


TROY WEIGHT. 


. Ounces. Drachms. 


Scruples. Grains 


5 5 

= 12 = 96 
1 = 8 

1 


= 


3 gr. 
288 = 5760 
24 = 480 
3 = 60 



METRIC WEIGHTS. 

igramme, .... o.ooi = gr. B x 5 



1 M 

1 Centigramme, 
1 Decigramme 
1 Gramme, . 

1 Kilogramme 



o.oi 
0.1 



: gr- 15 

= gr. 15.432 

( lb 2.7 Troy. 

1 ft> 2.2 Av. 



APOTHECARIES OR WINE MEASURE. 

Gallon. Pints. PI' ounces. Fl'dr'ms. Minims. 

C. O. fS f5 m 

1 = 8= 128 = 1024 = 61440 

1 = j6 = 128 = 7680 

1 = 8 = 480 

1 = 60 



APPROXIMATE EQUIVALENTS. 



ITIJ orgr. j, . . 
i 5j or 3j , . . 

fSj, 

3j 

f Sj of Glycerin, 
f 3j of Syrups, . 



.06 gramme, 
grammes. 



864 



METRIC CONVERSIONS. 



TABLE FOR CONVERTING 
APOTHECARIES' WEIGHTS AND MEASURES INTO METRIC. 

(Adapted from Maisch.) 

[Multiply all grains, or fractions of a grain, by 6479 ( or 648) for the metric equivalent 

in milligrammes. — Potter.] 



Troy Weight. 


Metric. 




Fluid Grammes or Cubic Centimeters. 






Apothecaries' 








Grains. 


Grammes. 


Measure. 


Liquids 

Lighter than 

Water.* 


Liquids of 
Specific 

Gravity of 
Water.f 


Liquids 

Heavier than 

Water.J 




Milligramme. 


"1 I 


•055 


.06 


.08 


1 
6? 


.OOI 


2 


.IO 


.12 


•15 


1 
40 


.OOI5 


3 


.16 


.18 


.24 


1 
30 


.002 


4 


.22 


.24 


•32 


T5 


.OO3 


5 


.28 


•30 


.40 


1 
TF 


.OO4 


6 


•32 


•36 


.48 


T2" 


.005 


7 


•38 


.42 


•55 


1 
TO 


.006 


8 


•45 


•50 


.65 


j 


.O08 


9 


•50 


•55 


•73 


1 


Centigramme. 


10 


•55 


.60 


.80 


6 
1 


.OI 

.Ol6 

.02 


12 


.65 


.72 


.96 


! 


15 


.80 


.90 


1.20 


1 


16 


.90 


1. 00 


1.32 


2 


•°3 


20 


1. 12 


1-25 


1.60 


I 
I 


•°5 
.065 

Decigramme. 


25 
30 


1.40 
1.70 


i-55 
1.90 


2.00 
2.50 


2 


•13 

.20 


35 


2.00 


2.20 


2.90 


3 
4 


40 


2.25 


2.50 


3-3o 


.26 


48 


2.70 


3.00 


4.00 


5 
6 


•32 

•39 

•45 


5o 


2.80 


3.12 


4-15 


60 (f sj) 


3-4o 


3-75 


5.00 


7 


65 


3.60 


4.00 


5-30 


8 


•52 
•59 
•65 


72 


4.00 


4-5o 


6.00 


9 
10 


80 


4-5° 


5.00 


6.65 


90 (f 3jss) 


5.10 


5.60 


7-5o 




Gramme. 


96 


5-4o 


6.00 


8.00 


15 


I. OO 


100 


5.60 


6.25 


8.30 


20 (Bj) 


I.30 


I20(fgij) 


6.75 


7-5o 


10.00 


24 


I.50 


150 (fsijss) 


8.50 


9-5o 


12.50 


26 


I.62 


160 


9.00 


10.00 


i3-3o 


30 (3ss) 


i-95 


180 (f^iij) 


10.10 


11.25 


15.00 


40 


2.60 


210 (f^iijss) 


11.80 


13.00 


17-50 


50 


3.20 


240 (f^iv) 


i3-5o 


15.00 


20.00 


&>(3J) 


3-9o 


300 (f 3 v) 


16.90 


i8.75 


25.00 


100 


6.48 


330(f^vss) , 


18.60 


20.75 


27.50 


120 (^ij) 


7.80 


3 6o(f.5vj) 


20.25 


22.50 


30.00 


180 


11.65 


420 (f^vij) 


23.60 


26.25 


35- 00 


240 ( g ss) 


i5-5o 


48o (f gj) 


27.00 


30.00 


40.00 


300 


19.40 


540 (f Six) 


30.40 


33-75 


45.00 


360 


23-50 


600 (f^ x) 


33-75 


37-5o 


50.00 


420 


27.20 


7 20(f 3 xij) 


40.50 


45.00 


60.00 


480 (§j) 


31.10 


840 (f zxiv) 


47-25 


52.50 


70.00 


960 (Jij) 


62.20 


960 (f-fij) 


54.00 


60.00 


80.00 


1000 


64.79 


1000 


56.00 


62.50 


83.00 



* Lighter than water are tinctures, spirits, compound spirit of ether, sweet spirit of nitre, fixed and 
volatile oils. iEther, f5j = grammes 2.80. 

t Same as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinctures made with 
dilute alcohol. 

% Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter f3j = 
grammes 5.50. 



INDEX. 

The salts of the metals are usually described in the text under the titles of their metal- 
lic constituents; some few (as the Arsenates, Phosphates, etc.), also the salts of the 
alkaloids and those of active elementary substances (as the Bromides, Iodides, etc.) 
are placed under the titles of their most active constituents. Salts are therefore not 
mentioned individually in the Index except when their places in the text are exceptional 
and do not come within either of the above rules. 



Abbreviations, their use, 508 

Table of, 508, 816 
Abdominal Plethora, 567 
Abasia and Astasia, 567 
Abies, 392 
Abies balsamea, 465 

canadensis, 393 

excelsa, 392 
Abietic Anhydride, 410 
Abortion, 567 
Abrin, 65, 147 
Abrus, 65 
Abscess, 568 

of the Liver, 692 

Mammary, 568 
Absinthe, 66 
Absinthium, 66 
Acacia, 66 

Catechu, 216 
Accommodation, Agents affecting, 37 
Aceta, 528 
Acetanilid, 66 

Compound, 67 

Antidotes and Antagonists, 851 
Acetates, — See their basic titles. 
Acetone, 455 

in Urine, Test for, 846 
Acetous Preparations, 527 
Acetum, 70 
Acid, Abietic, 410 

Abric, 65 

Acetic, 69, 107 

Antidotes, etc., 852 

Aconitic, 96 

Agaricic, 104 

Aloetic, 118 

Anemonic, 405 

Angelic, 461 

Arabic, 66 

Arsenous, 165 

Antidotes and Antagonists, 854 

Artanthic, 340 

Benzoic, 183, 239 

Boracic, 70 

55 



Acid, Boric, 70 
Brassic, 443 
Butyric, 345 
Calumbic, 203 
Camphoric, 204, 206, 466 
Camphretic, 204 
Capronic, 163 
Caprylic, 163 
Carbazotic, 92 
Carbolic, 72, 238 

Antidotes and Antagonists, 852 

Gauze, 73 

Solution, 73 
Carbonic, 80 

Antidotes and Antagonists, 852 
Carminic, 248 
Caryophyllic, 214 
Caryophyllinic, 215 
Catechuic, 216 
Catechu-tannic, 216 
Cathartic, 440 
Cathartogenic, 440 
Cerotic, 217 
Cetraric, 218 
Cevadic, 484 
Chelidonic, 218, 430 
Chromic, 82 
Chrysammic, 1 18 
Chrysophanic, 234, 413, 421 
Cinnamic, 177, 183, 454 
Citric, 330 
Coca-tannic, 243 
Copaibic, 254 
Cresylic, 73, 256 
Cubebic, 260 
Digallic, 94 
Ergotic, 274 
Ergotinic, 275 
Erucic, 443 
Eugenic, 347 
Euonic, 279 
Euphrastic, 280 
Filicic, 170 
Fluoric, S3 



865 



866 



INDEX. 



Acid, Formic, 345 
Gallic, 288 
Gallo-tannic, 94 
Gambogic, 204 
Gelsemic, 289 
Gentesic, 291 
Gentianic, 291 
Glycyrrhizic, 293 
Guaiac, 297 
Guaiaconic, 297 
Guaiarec, 297 
Gurjunic, 298 
Gynocardic, 218 
Hydriodic, 316 
Hydrobromic, 85 
Hydrochloric, 85 
Hydrocyanic, 87, 404 

Antidotes and Antagonists, 852 
Hypophosphorous, 380 
Hypopicrotoxic, 386 
Igasuric, 351 
Ipecacuanhic, 321 
Juglandic, 325 
Kinic, 236 - 
Kinotannic, 236, 326 
Kinovic, 236 
Kinovo-tannic, 236 
Lactic, 89, 359 
Lactucic, 328 
Laricic, 104 
Linoleic, 331 
Lobelic, 333 
Lupulinic, 301 
Maizenic, 488 
Malic, 179 
Mastichic, 340 
Meconic, 359 
Melassic, 424 
Methyl-salicylic, 289 
Mezereinic, 344 
Mineral, 85 

Antidotes and Antagonists, 852 
Morrhuic, 345 
Muriatic, 85 
Myristic, 347 
Nitric, 90 

Nitro-hydrochloric, 85, 90 
Nitro-muriatic, 85, 90 
Nucleinic, 133 
Oleic, 91,358 
Ophelic, 220 

Ortho-phenol-sulphonic, 74 
Ortho-phosphoric, 91 
Oxalic, 56, 575 

Antidotes and Antagonists, 852 
Palmaric, 410 
Palmitic, 358 
Phenic, 72 
Phosphoric, 91, 345 
Phytolaccic, 385 
Picric, 92 
Picrotoxic, 386 
Pinic, 410 



Acid, Piperonylic, 256 

Podophyllinic, 398 

Polygonic, 398 

Protocatechuic, 398, 483 

Prussic, 87 

Punico-tannic, 295 

Pyrogallic, 84, 238 

Pyroligneous, 392 

Quercitannic, 409 

Rhatania-tannic, 326 

Rheotannic, 413 

Rheumic, 413 

Ricinoleic, 417 

Robustic, 296 

Rosolic, 73 

Sabadillic, 484 

Salicylic, 239, 425 

Salicylous, 427 

Salicyluric, 427 

Sanguinarinic, 430 

Scheele's, 87 

Sclerotic, 275 

Sclerotinic, 275 

Silvic, 410 

Sozolic, 74 

Sphacelinic, 275 

Stearic, 99 

Strychnic, 351 

Sulphuric, 92 

Sulphuric, Aromatic, 92 

Sulphurous, 93 

Succinic, 1 19 

Tannic, 94, 288 

as an Antidote, 848 

Tartaric, 95 

Thebolactic, 359 

Tiglinic, 471 

Toxicodendric, 415 

Tropic, 180, 311 

Valerianic, 461, 482 

Vanillic, 483 

Vegetable, 70 

Veratric, 484 

Viburnic, 486 

Xylic, 73 
Acids, — their action, 44, 70, 85 

as Antidotes, 849 

Antidotes and Antagonists, 852 
Acidity, 569 
Acipenser Huso, 314 
Acne, 569 

Rosacea, 570 
Acocanthera Ouabaio, 454 
Aconine, 96 
Aconite, 95 

Antidotes and Antagonists, 852 
Aconitine, 96 
Aconitum, 95 
Acorin, 199 
Acorus Calamus, 199 
Acrinyl, Sulpho-cyanate, 443 
Acrolein, 292 
Actinomycosis, 571 



INDEX. 



867 



Adeps, 98 

Benzoinatus, 98 

Lanae Hydrosus, 98 
Addison's Disease, 571 
Adenitis, — See Glandular Affections, 669 
Administration of Medicines, 23 
Adrenal Extract, 138 
Adynamia, 571 
/Ether, 99 

Acetic, 99 
After-pains, 572 
Agalactia, 572 
Agaricin, 104 
Agaricus, 104 
Agathin, 67 
Agave Americana, 1 18 
Agents acting on each other, 61 
Agropyrum repens, 480 
Ague, — See Intermittent Fever, 703 
Ailanthus, 105 
Alabastrine, 349 
Albau, 273 
Albumen, as an Antidote, 848 

in Urine, Test for, 845 
Albumin, 487 

Phosphorized, 136 
Albuminuria, 572 
Alcohol, 106 

Amyl, 107 

Antidotes and Antagonists, 853 

Caustic, 445 

Ethyl, 106 

Methyl, 107 

Phenic, 72 
Alcoholic Preparations, 527 

strength of Bitters, 833 
Alcoholism, 112, 115, 573, 853 
Aldehyde, 107 

Acetic, 107 

Ethyl, 107, 373 

Formic, 107, 287 

Proto-catechuic, 483 
Alder Bark, 84, 1 18 

Black, 404 

Buckthorn, 288 
Ale, 108 
Aletris, 1 17 
Alexins, 147 
Alkalies, their action, 44 

Antidotes and Antagonists, 853 
Alkaline Mineral Waters, 157 
Alkaloids, 21 

Antidotes and Antagonists, 853 

Liquid, 21, 462 
Allium, 117 
Allspice, 390 
Allyl Sulphide, 117, 168 

Sulpho-cyanide, 443 
Almond, 87, 125 
Alnus, 84, 118 
Aloe Socotrina, 118 
Aloes, 118 
Aloin, 118 



Alopecia, 574 

Areata, 792 
Alstonia scholaris, 271 
Alteratives, 50 

Uterine, 57 
Althaea, 119 
Alum, 120 

Ammonio-ferric, 283 
Antidotes and Antagonists, 853 
Alum-root, 84 
Alumen, 120 

Exsiccatum, 120 
Aluminum, 120 
Alumnol, 121 
Amanita Muscaria, 104 
Amaurosis, 574 
Amber, 455 
Amblyopia, 38, 574 
Amenorrhcea, 575 
Amick's Consumption-cure, 8^^ 
Amido-benzene, 238 
Ammonia, 121 

as an Antidote, 849 
Antidotes and Antagonists, 853 
Ammonia-alum, 120 
Ammoniated Copper, 261 
Glycyrrhizin, 293 
Mercury, 303 
Ammoniacum, 121 
Ammonio-ferric Alum, 283 

Tartrate, 283 
Ammonium, 121 
Benzoate, 183 
Carbonate, as Antidote, 85 1 
Picrate, 92 

Sulpho-ichthyolate, 458 
Ammonol, 67 
Amorphous Bodies, 520 
Amygdala, 125 
Amygdalin, 87, 125, 404 
Amyl Alcohol, 107 
Chloride, 102 
Hydrate, 107 
Hydride, 102 
Nitrite, 126 

Antidotes and Antagonists, 853 
Amylamine, 345 
Amylene, 102 

Hydrate, 221 
Amylum, 128, 424 

Iodatum, as Antidote, 851 
Anacyclus Pyrethrum, 408 
Analgen, 67 
Analgesics, 35 
Analgesine, 67 
Anamirta paniculata, 386 
Ananassa Sativa, 376 
Anaphrodisiacs, 56, 554 
Anarcotine, 365 
Anasarca, — See Dropsy, 637 
Andira Araroba, 234 
Anaemia, 576 

Cerebral, 605 



868 



INDEX. 



Anaesthesia, ioi, 228, 577 

Local, 33, 245, 258 

Therapeutics of, 577 
Anaesthetics, 33, 35, 100, 102, 228 

Antidotes and Antagonists, 853 

Local, S3, 2 45> 258 

Mixtures, 100 

Modes of using, 230 
Anemone, 405 
Anemonin, 405 
Aneurism, 577 
Angelate of Butyl, 140 
Angina, — See Croup, Laryngitis, Pharyn- 
gitis, Throat, Tonsillitis, etc. 
Angina Pectoris, 578 
Anhidrotics, 55 
Anilin, 238 

Red, 288 
Animal Extracts, 129 
Anise, 139 

t Star, 315 
Anisum, 139 
Anodynes, 33, 35 

Local, ss 
Ant-acids, 44 
Antagonism of Drugs, 62 
Antagonists, 62, 851 

List of, 64, 851 

Table of, 64 
Anthelmintics, 48, 432 
Anthemis, 140 
Anthrax, 578 
Antiabrin, 147 
Antibilious Pills, 554 
Antidote, Arsenic, 282 

Bouchardat's, 850, 851 

Jeaunel's, 851 
Antidote-bag, 851 
Antidotes, 61, 847 

General, 851 
Anti-emetics, 45 
Anti-fat, 288, 386 
Antifebrin, 66 
Antigalactagogues, 57 
Antikamnia, 67 
Antiko], 67 
Antilithics, 54 
Antimonial Powder, 140 
Antimony, 140 

Antidotes and Antagonists, 853 

Sulphurated, 140 
Antinervin, 67, 69 
Antiperiodics, 51 
Antiphlogistics, 51 
Antiphthisin, 154, 476 
Antipyretics, 50, 259 
Antipyrin, 142 

Antidotes and Antagonists, 853 

Salicylate, 143, 426 
Antiricin, 147 
Antiseptic Fluid, 470 
Injection, 309 
Solution, 309, 709 



Antiseptics, 60, 470 
Antisialics, 43 
Antispasmodics, 36 
Antitoxin, 147 

Diphtheria, 149 

Streptococcus, 154 

Syphilis, 155 

Tetanus, 152 

Tuberculosis, 153 

Typhoid, 156 

Vaccinia, 156 
Antitoxins, 146 
Antivenene, 155 
Antizymotics, 59 
Antrum, Disease of, 578 
Anus, Fissured, 579 

Prolapse of, 761 
; Aperients, 46, 554 
: Aphonia, 579 

Aphrodisiacs, 55 
i Aphthae, 580 
Apiin, 156 
Apiol, 156 

Apis mellifica, 217, 341 
Apncea, 583 
Apocynin, 156 
Apocynum, 156 

Apomorphine, 359, 362, 365, 367 
Apoplexy, 580 
j Apotheme, 535 
Apparatus for testing urine, 846 
Appetite, 581 
Approximate Measures, 497, 863 

Weights, 863 
Aqua, 157 

Carbonata, So 

Regia, 90 
Aquse, 528 
Arabin, 66, 480 
Arbor Vitse, 469 
Arbutin, 219, 289, 481 
Arctium Lappa, 328 
Arctostaphylos glauca, 481 

Uva-ursi, 481 
j Argentum, 161 

Antidotes and Antagonists, 861 

I Argo 1 , 399 
Argyria, 162 
Aristol, 320 
Aristolochia, 441 
Aristolochine, 441 
Arnica, 163 
Arnicin, 163 
Aromatic Fluid Extract, 243 

Powder, 243 

Sulphuric Acid. 92 
Arsenate, Iron, 283 

Sodium, 165 
Arsenates and Arsenites, 165 
Arsenauro, 173, 176 
Arsenic, 165 

Antidote, 282 

Antidotes and Antagonists, 854 



INDEX. 



Arsenite, Copper, 165 

Potassium, 165 

Strychnine, 352, 357 
Arsenum, 165 
Artemisia Absinthium, 66 

pauciflora, 432 
Arterial Transfusion, 25 
Arthritis, Rheumatoid, 581 
Asafoetida, 168 
Asagraea officinalis, 484 
Ascarides, — See Worms, 296, 812 
Ascites, 582 
Asclepias, 169 
Aselline, 345 
Aseptol, 74 
Aseptolin, 74 
Ash, Flowering, 340 

Prickly, 487 
Asparagin, 119, 279, 293 
Asphyxia, 583 
Aspidium, 169 
Aspidosperma, 170 
Aspidospermine, 1 70 
Assay, 525 
Astasia, 567 

Asthenia, — See Adynamia, Convalescence. 
Asthenopia, 584 
Asthma, 584 
Astigmatism, 586 
Astragalus gummifer, 480 
Astringents, 50, 58 

Intestinal, 47 

Pill, 554 

Powder, 556 

Urinary, 53 

Vegetable, 84, 94 
Atheroma, 586 
Atropa Belladonna, 179 
Atrophy, 586 
Atropine, 179, 180 

and Morphine, 369, 831 

Antidotes and Antagonists, 854 
Atrosin, 179 
Aurantiin, 171 
Aurantium, 171 
Aurin, 73 
Aurum, 172 

Authorities, List of, 566 
Ava-kava, 326 
Avena Sativa, 177 
Ayer's Ague Cure, 833 

Cherry Pectoral, 833 

Pills, 833 

Recamier Balm, 835 
Cream, 835 

Sarsaparilla, 833 

Vita Nuova, 836 
Azedarach, 177 

Azoturia, — See Urinary Disorders, 803 
Azulen, 341 



Balanitis, 587 

Baldness, — See Alopecia, 574, 792 

Balm, 342 

Cream, 834 

of Gilead, 465 

Recamier, 835 
Balnea, 157, 528 
Balsam of Copaiba, 254 

of Fir, 465 

Friar's, 183 

Gurjun, 298 

of Peru, 177 

of Tolu, 178 
Balsamum Dipterocarpi, 298 

Peruvianum, 177 

Tolutanum, 178 
Bandoline, 264 
Banting Dietary, 736 
Baptisia, 178 
Baptisin, 178 
Barbaloin, 118 
Barberry, 184 
Bark, Blackberry, 420 

Casca, 215 

Chittem, 412 

Cramp, 486 

Cuprea, 236 

Elm, 481 

Honduras, 215 

Huxham's Tincture of, 237 

Oak, 409 

Ordeal, 215 

Peruvian, 235 

Sacred, 412 

Sassy, 215 

Soap, 410 

Willow, 427 
Barley, 337 
Barium Dioxide, 179 
Barium Salts, Antidotes, etc., 854 
Barosma, 191 
Barosmin, 192 
Basham's Mixture, 282 
Basilicon Ointment, 410 
Bassorin, 480 
Baths, 528 

Formulae, 528 
Battley's Sedative, 361 
Bay, Sweet, 336 
Bay-berry, 347 
Bay Rum, 347 
Bear-berry, 481 
Bed-sores, 587 

Bee-venom, Antidotes, etc., 854 
: Beer, 108 

Ginger, 492 
Behring's Law, 147 
Belladonna, 179 

Antidotes and Antagonists, 854 
Belladonnine, 179 
Benne Oil, 442 
Benzene, 102, 182, 238 



870 



INDEX. 



Benzin, 182 
Benzoates, 183 
Benzoin, 183 
Benzoinated Lard, 98 
Benzol, 102, 182, 238 
Benzosol, 256, 259 
Benzoyl Guaiacol, 256 

Sulphonic-imide, 423 
Benzyl Cinnamate, 177 
Berberine, 184, 203, 309, 342, 374, 397, 
488 

Hydrochl orate, 184 
Berberis, 184 
Bergamot, Oil of, 185 
Bergaptene, 185 
Beta-naphtol, 349 
Beta vulgaris, 423 
Betula lenta, 425 
Bhang, 207 

Bibliography and References, 566 
Bichlorinated Methyl Chloride, 226 
Bichromate of Potassium, 83 

Antidotes and Antagonists, 860 
Bile, Agents affecting the, 48 
Bile Pigment in Urine, Test, 845 
Biliary Solvents, 54 
Biliousness, 308, 587 
Bilious Remittent Fever, 842 
Bind-weed, 301 
Birch, Sweet, 425 
Bird-lime, 487 
Bismuth, 185 

Mixture for Children, 546 

Subgallate, 186, 321 

Subiodide, 186, 321 
Bitartrate, Potassium, 400 

Nicotine, 462 
Bites and Stings, 784 
Bitters, Action of, 203 

Alcoholic Strength of, 833 

Hostetter's, 834 

Vinegar, 836 
Bittersweet, 272 
Blackberry, 84, 420 
Black Draught, 440 

Drop, 360 

Haw, 486 

Paste, 673 
Bladder, Inflammation of, 625 

Irritable, 588 

Paralysis of, 588 
Bladder-wrack, 288 
Blancard's Pills, 281 
Blaud's Pills, 281 
Bleaching Powder, Antidotes, 857 
Blende, 489 
Blepharitis, 588 
Blistering Cerate, 209 

Collodion, 209 
Blisters, 58 
Blood-root, 430 
Blood-stains, 783 
Blue Cohosh, 216 



Blue Flag, 323 

Mass, 302 

Methylene, 343 

Ointment, 302 

Pill, 302 
Boiling, 527 
Boils, 589 
Boldine, 187 
Boldo, 187 
Boldus, 187 
Bolus, 548 
Bone Diseases, 589 

Marrow Extract, 133 
Boneset, 279 
Borax, 71 
Borine, 7 1 
Borneol, 466 
Boro-glyceride, 71, 72 
Bos Taurus, 280 
Botkin's Cholera Drops, 609 
Bots, 177 

Bouchardat's Antidote, 850, 851 
Bougies, 558 
Boxwood, 374 

Brain Disorders, — See Cerebral Anaemia, 
Cerebral Concussion, etc. 

Extract, 137 

Fever, — See Meningitis, Cerebro- 
spinal Meningitis, Typhoid Fever, 
Typhus. 
Brandreth's Pills, 8^3 
Brandy, 107 
Brassica, 443 
Brayera, 264 
Breasts, — See under Abscess, Lactation, 

Mastitis, Nipples. 
Breath, Fetid, 590 
Bright's Disease, Acute, 590 

Chronic, 591 

Diagnosis, 837 
Bromelin, 376 
Bromides, 187 

Antidotes and Antagonists, 854 

Formulae for, 654, 740 
Bromidrosis, — See Feet, 660 
Bromine and Bromides, 187, 189 

Antidotes and Antagonists, 854 
Bromism, 188 
Bromoform, 187, 190 
Bronchiectasis, 592 
Bronchitis, Acute, 592 

Capillary, 593 

Chronic, 594 
Bronchocele, — See Goitre, 671 
Bronchorrhcea, 595 
Broom, 437 
Brown Mixture, 293 
Brucine, 301, 314, 352, 357 
Bruises, 596 
Bryonia, 190 
Bryonin, 190, 191 
Bubo, 596 
Buchu, 191 



INDEX. 



8 7 I 



Buchu, Helmbold's, 834 

Buckthorn, 288, 412 

Bulimia, 581 

Bunion, 596 

Burdock, 328 

Burnett's Disinfectant, 60, 490 

Burns, 597 

Bursitis, 597 

Butternut, 324 

Butyl Angelate, 140 

Chloral Hydrate, 225 

Chloride, 102 

Hydride, 102 

Valerianate, 140 
Butylamine, 345 
Buxine, 374 
Buxus sempervirens, 374 



Cacao-butter, 468 
Cachets, 555 
Cachexia?, 597 
Cactine, 192 
Cactus Grandiflora, 192 
Cadmium, 192 
Caffea, 193 
Caffeine, 193 

Citrated, 193 
Caffenol, 67 
Caffeol, 193 
Caffeone, 193 
Cajuput, Oil of, 199 
Cajuputene Bihydrate, 199 
Cajuputol, 199 
Calabar Bean, 383 
Calabarine, 383 
Calamine, 489 

Ointment, 491 
Calamus, 199 
Calcauro, 173 
Calcination, 522 
Calcium, 199 

Chloride, Antidotes, etc. , 854 

Hydrate, as an Antidote, 850 

Sulphide, 458 
Calculi, Biliary, 598 

Renal, 598 

Solvents of, 54 

Vesical, 598 
Calendula, 203 
Calomel, 303 
Calumba, 203 
Calx, 200 

Chlorata, 232 

Sulphurata, 458 
Cambogia, 204 

Camp Fever, — See Typhus, 800 
Camphene, 466 
Camphor, 204, 466 

Antidotes and Antagonists, 854 

Baldrian, 482 

Bergamot, 185 

Carbolated, 205 



Camphor- Chloral, 205 

-Cymol, 204 

Monobromated, 205 

Naphtol, 350 

Peppermint, — See Menthol, 342 

Pulsatilla, 405 

Salicylated, 205 
Camphylene, 349 
Canadian Hemp, 156 

Moonseed, 342 
Cancer, 599 

Diagnosis of, 838 

of Uterus, 804 
Cancrum Oris, 600 
Cannabene, 207 
Cannabin, 207 
Cannabis, 207 

Antidotes and Antagonists, 854 
Cantharides, 209 
Cantharidin, 209 
Cantharis, 209 

Antidotes and Antagonists, 855 
Caoutchouc, 273 
Capsicin, 21 1 
Capsicum, 211 
Capsules, 528 
Caraway, 214 
Carbinol, 107 
Carbo, 212 

Animalis, 212 

Ligni, 212 
Carbon, 212 

Disulphide, 102, 212 

Dioxide, 102, 212 

Antidotes and Antagonists, 855 

Monoxide, 102, 212 

Tetrachloride, 102, 228 
Carbonei Disulphidum, 102, 212 
Carbonated Mineral Waters, 158 
Carbonates, as Antidotes, 849 
Carbonization, 519 
Carbuncle, 600 
Carcinoma, — See Cancer, 599 
Cardamom, 213 
Cardiac Disorders, — See Heart, 679, 680 

Sedatives, 42 

Stimulants, 41 

Tonics, 41 
Cardialgia, — See Pyrosis, 768 
Cardine, 137 

Carditis, Diagnosis of, 838 
Carduus, 214 
Carica Papaya, 376 
Caries, 601 
Carminative, Dalby's, 362 

Dewees', 168, 335 
Carminatives, 46 
Carmine, 248 
Caroval, 263 
Carragheen, 234 
Carron Oil, 200, 331 
Carthamus tinctorius, 260 
Caruen, 214 



872 



INDEX. 



Carum, 214 
Caruol, 214 
Caryophyllin, 214 
Caryophyllus, 214 
Casca Bark, 215 
Cascara Amarga, 215 

Sagrada, 412 
Carcarilla, 215 
Cascarillin, 215 
Cassia acutifolia, 440 

angusti folia, 440 

Cinnamon, 242 

Fistula, 216 

Purging, 216 
Castanea, 84, 216 
Castor Oil, 417 

Emulsion ; Formula, 619 
Castoria, 833 
Catalepsy, 602 
Cataplasmata, 529 
Cataract, 602 
Catarrh, Acute Nasal, 602 

Broncho-pulmonary, — See Bronchitis, 
Bronchorrhcea. 

Chronic Nasal, 604 

Duodenal, 638 

Epidemic, — See Influenza, 700 

Gastric, — See Gastritis, Chronic, 666 

Genito-urinary, — See Bladder, Catarrh 
of, Cystitis, Endometritis, Gonor- 
rhoea, Leucorrhcea, etc. 

Intestinal, — See Dysentery, Jaundice. 

Sage's Remedy, 835 

Sanford's Cure, 835 

Summer, — See Hay Fever, 675 
Catechol, 239 
Catechu, 84, 216 
Cathartics, 46 

in Poisoning, 848 
Catharto-mannite, 440 
Caulophyllin, 217 
Caulophyllum, 216 
Caustic, Lunar, 161 

Mitigated, 161 

Potash, 399 

Soda, 444 
Caustics, 58 
Cedar, Oil of, 432 

Red, 422 

White, 469 
Celandine, 218 
Celerina, 244 
Cellulose, 294, 424 
Centaurea benedicta, 214 
Century-plant, 1 18 
Cephaelis Ipecacuanha;, 321 
Cephalalgia, — See Headache, 676 
Cera, 217 
Cerata, 529 
Cerate, 217 

Blistering, 209 

Cantharides, 209 

Cetaceum, 217 



Cerate, Goulard's, 395 

Lead, Subacetate, 395 

Resin, 410 

Savine, 422 

Theobroma, 468 
Cerates, 529 

Compounding of, 564 
Ceratum, 217 

Cerebellum, Agents affecting, 36 
Cerebral Anaemia, 605 

Compression, Diagnosis, 838 

Concussion, 606 
Diagnosis, 838 

Congestion, 606 

Depressants, 34 

Excitants, 33 

Softening, 606 

Vomiting, — Diagnosis, 842 
Cerebrine, 137 
Cerebrinin, 137 
Cerebro-spinal Fever, 722 
Cereus, Night-blooming, 192 
Cerium Oxalate, 217 
Cerolein, 217 
Cetaceum, 217 
Cetin, 218 
Cetraria, 218 
Cetyl Palmitate, 218 
Cevadilla, 484 
Cevadilline, 484 
Cevadine, 483 
Chalk, 200 

Chalybeate Waters, 158 
Chamomile, 140 

German, 341 
Chamomilla, 140, 341 
Chancre, 606 

Diagnosis of, 838 
Chancroid, 607 

Diagnosis of, 838 
Change of Life, — See Climacteric, 613 
Chapped Hands and Lips, 607 
Charcoal, 212 

as an Antidote, 849 
Chartse (Papers), 529 
Chartuke, 555 
Chaulmoogra Oil, 218 
Chekan, 349 
Chekanine, 349 
Chelerythrine, 218 
Chelidonine, 218 
Chelidonium, 218 
Chelidoxanthin, 218 
Chelsea Pensioner, 530 
Chemical Incompatibility, 511 
Chenopodium, 218 
Cherry-laurel, 87, 89 
Cherry Pectoral, 8^ 
Cherry, Wild, 404 
Chestnut, 216 
Chestnut-leaves, 84 
Chest-pains, 607 
Chian Turpentine, 465 



INDEX. 



873 



Chicken-pox, — See Varicella, 807 

Chilblains, 607 

Children, Dosage for, 28, 362 

Chimaphila, 219 

Chimaphilin, 219 

China, Pride of, 177 

Chinicin, 239 

Chininum Amorphum Boricum, 237 

Chinoidin, 238 

Chinolin, 219, 239 

Chirata, 220 

Chiratin, 220 

Chiretta, 220 

Chittem Bark, 412 

Chloral, 220 

Analogues, 221 

Antidotes and Antagonists, 855 

Butylic, 225 

Formidate, 225 

Hydrate, 220 
Chloralamid, 225 
Chloral-habit, 223 
Chlorates, — See their metallic titles. 
Chlorides, — See their metallic titles. 

as Antidotes, 850 

in Urine, Test, 845 
Chlorinated Waters, 158 
Chlorine, 231 

as an Antidote, 850 

Antidotes and Antagonists, 855 
Chlorine-water, 232 
Chlorodyne, 227 

Collis Browne's, 833 

Formulae for, compared, 832 
Chloroform, 226 

Antidotes and Antagonists, 855 

Sayre's method of using, 231 
Chlorosis, 608 
Chlorum, 231 
Chocolate, 195, 468 
Choking, 608 
Cholagogues, 47 

Pills, 554 

Purgatives, 46 
Cholera Asiatica, 609 

Diagnosis of, 839 

Infantum, 609 

Mixture (Squibb), 361, 609 

Simplex, 610 

Toxin, 478 
Cholesterin, 487 

Chondodendron tomentosum, 374 
Chondrus, 234 
Chordee, 611 
Chorea, 61 1 
Choroiditis, 612 
Chromic Trioxide, 82 
Chrysarobin, 234 
Chrysophan, 413 
Churrus, 207 
Chyluria, 61 2 

Cigarettes, Formulae for, 586 
Ciliary Excitants, 41 



Cimicifuga, 234 
Cimicifugin, 234 
Cinchona, 235 

Rubra, 236 
Cinchona Red, 236 
Cinchonamine, 236 
Cinchonidine, 236 
Cinchonine, 236, 238 
Cinchonism, 240 
Cineol, 348 
Cinnamein, 177 
Cinnamomum, 242 

Camphora, 204 
Cinnamon, 242 
Cinquefoil, 749 

Circulation, Agents affecting, 41 
Cissampeline, 374 
Cissampelos Pareira, 374 
Citrates, — See their basic titles, also 330 
Citrine Ointment, 303, 304 
Citron, 330 

Citrullus Colocynthis, 250 
Citrus acris, 330 

Aurantium, 1 71 

Bergamia, 185 

Limonum, 330 

medica, 330 

vulgaris, 1 7 1, 330 
Clarification, 519 
Clarke's Blood Mixture, 834 
Classification of Medicines, 30 
Claviceps purpurea, 274 
Clavus, — See Headache, 676 
Clemens' Solution, 165 
Climacteric Disorders, 613 
Cloves, 214 
Club-moss, 334 
Clysters, 539 
Cnicin, 214 
Cnicus benedictus, 214 
Coal-gas, Antidotes and Antagonists, 855 
Coca, 195, 243 
Cocaine, 195, 244 

Antidotes and Antagonists, 855 
Cocaine-habit, 246 
Cocculus Indicus, 386 
Coccus, 248 
Coccyodynia, 613 
Cochineal, 248 
Cocoa, 195 
Codamine, 359 
Codfish, 344 

Codeine, 359, 362, 365, 368 
Cod-liver Oil, 344 

Emulsion, 344, 534 
Coffee, 193 
Cohosh, Black, 234 

Blue, 216 
Cola acuminata, 196 
Colation, 519 
Colchiceine, 249 
Colchicine, 249 
Colchicum, 249 



8/4 



INDEX. 



Colchicum, Antidotes and Antagonists, 855 
Coldness, 613 
Colic, Hepatic, 614 

Intestinal, 613 

Lead, 614 

Renal, 614 
Colic-root, 117, 271 
Collapse, 615 
Collodia, 530 
Collodion, 294, 530 

Blistering, 294 

Cantharidal, 209, 294 

Flexible, 294 

Styptic, 94, 294 
Colloids, 521 
Colloxylin, 294 
Collunarium, 539 
Collyrium, 541 

Formulae for, 542 
Colocynth, 250 
Colocynthein, 250 
Colocynthin, 250 
Colocynthis, 250 
Colocynthitin, 250 
Cologne-water, 108 
Colophony, 410, 466 
Columbo, 203 
Coma, 615 

Alcoholic, 114 

Opium, 363 
Combination, Principles of, 505 
Combustibles, 513 
Comminution, 519 
Commiphora Myrrha, 348 
Compounding Medicines, 517 

a Mixture, 545 
Compounds, Explosive, 512 

Poisonous, 513 
Condylomata, 615 
Condy's Fluid, 60, 338 
Confectio Damocratis, 530 
Confections, 530 

Formulae for, 530 
Conhydrine, 251 
Conime, 251 
Conium, 251 

Antidotes and Antagonists, 856 
Conjunctivitis, Catarrhal, 616 

Diphtheritic, 617 

Gonorrhceal, 617 

Granular, 617 

Phlyctenular, 617 

Purulent, 618 
Conspergatives, 549, 550 
Constipation, 618 

Constituents of Vegetable Drugs, 20 
Contractions, List of, 508, 816 
Convalescence, 620 
Convallamarin, 253 
Convallaria, 253 
Convallarin, 253 
Convolvulin, 323, 436 
Convolvulus Scammonia, 435 



Convulsions, 620 

Infantile, 620 

Puerperal, 765 
Copaiba, 254 

Emulsion, 254, 534 
Copaifera Langsdorffii, 254 
Copper, 261 

Carbonate, as Antidote, 850 

Salts, Antidotes, etc., 856 
Coral, 201 
Cordial, Cascara, 413 

Godfrey's, 362 
Coriander, 255 
Coriandrum, 255 
Corn, Indian, 488 
Corn-silk, 488 
Corn-smut, 488 
Corneal Opacities, 621 
Corneitis, — See Keratitis, 70S 
Cornin, 255 
Corns, 621 
Cornus, 255 
Cornutine, 275 

Corpulence, — See Obesity, 736 
Corrosive Sublimate, 302 

Antidotes and Antagonists, 856 
Coryza, — See Catarrh, Acute, 602 
Coto Bark, 255 
Cotoin, 256 
Cosmoline, 378 
Cotton, 294 

Gun, 424 

Iodized, Formulae for, 683 
Cotton-seed Oil, 294 
Couch-grass, 480 
Cough, 368, 621 

Mixtures, Formulae for, 623, 721, 751, 
756 
Counter-irritants, 57 
Court Plaster, 314 
Coxalgia, 623 

Coxe's Hive Mixture, 140, 436 
Crab Lice, — See Pediculi, 747 
Crabs' -eyes, 201 
Cramp Bark, 486 

Cramps, See Trismus, Spasmodic Affec'ns. 
Cranesbill, 84, 291 
Cream, Cold, 218, 419 

Recamier, 835 

of Tartar, 400 
Creosote, 74, 256, 258 

Antidotes and Antagonists, 856 
Creolin, 74, 79 
Creosol, 256 
Cresol, 73 
Creta, 200 

Crocq's Solution, 383 
Crocus, 260 
Cro ton-chloral, 225 
Croton Eleuteria, 215 

Oil, 471 

Tiglium, 471 
Croup, Catarrhal, 624 



INDEX. 



«75 



Croup, Membranous, 624 

Diagnosis, 839 
Cryptopine, 359, 366 
Crystallization, 520 
Cubeb, 260 
Cubeben, 260 
Cubebene, 260 
Cubebin, 260 
Cuca, 243 

Cucumber, Squirting, 274 
Cucumber Tree, 336 
Cucurbita Pepo, 374 
Cucurbitine, 374 
Culver's Root, 329 
Cuprea Bark, 236 
Cuprum, 261 

Ammoniatum, 261 
Curare, 263 

Antidotes and Antagonists, 856 
Curarine, 263 
Cusso, 264 

Cutaneous Irritants, 57 
Cuttle-fish Bone, 201 
Cyanides, — See their metallic titles. 
Cyanosis, 625 
Cydonin, 264 
Cydonium, 264 
Cymene, 278, 466, 470 
Cynips Gallae tinctorite, 288 
Cypripedin, 265 
Cypripedium, 265 
Cystitis, Acute, 625 

Chronic, 626 
Cysts, 627 
Cytisus Scoparius, 437 



Dalby's Carminative, 362 

Damiana, 265 

Dandelion, 464 

Dangers of Incompatibility, 514 

Dandruff, — See Pityriasis, 756 

Daphne Mezereum, 344 

Daphnin, 344 

Datura Stramonium, 450 

Tatula, 265 
Daturine, 265, 450 
Deafness, 627 

Death, Signs of, — See Asphyxia, 584 
Debility, — See Adynamia, Anaemia, Con- 
valescence. 
Decantation, 520 
Decimal Weights, etc., 496 
Decocta (Decoctions), 531 
Decoloration, 521 
Deer, Musk, 346 
Deflagration, 521 
Deliquescence, 520 
Deliquescent Salts, List of, 552 
Deliriants, ^^ 
Delirium, 628 

Tremens, 1 12, 115, 628 
Delphinine, 449 



Delphinium Staphisagria, 449 
Dementia, 701 

Paralytica, 629 
Demulcents, 59 
Dengue, 629 
Dentition, 629 
Dentifrices, 42 
Deodorants, 61 
Deposits in Urine, 846 
Depressants, Cerebral, 34 

Hepatic, 48 

Renal, 52 

Respiratory, 39 

Uterine, 57 
Dermatol, 185, 187, 321 
Desiccation, 521 
Destructive Metamorphosis, 50 
Dew-berry, 420 
Dewees' Carminative, 168, 335 
Dextrin, 424 
Dextrose, 341, 424 
Diabetes Insipidus, 630 

Mellitus, 630 
Diabetin, 425 
Diacetyl-tannin, 95 
Diachylon Ointment, 395 

Plaster, 395 
Diagnosis, Differential, 837 
Dialysis, 521 
Dialysed Iron, 283 
Diaphoretics, 54 
Diarrhoea, 632 
Diastase, 337 

Pancreatic, 376 
Dichlor-methyl Chloride, 226 
Dichloro-methane, 227 
Didymin, 135 

Diethylsulphon-diethylmethane, 457 
Diethylsulphon-dimethylmethane, 455 
Diethylsulphon-methylethylmethane, 456 
Diffusate, 521 

Digestive System, Agents affecting, 42 
Digitalein, 266 
Digitalin, 266 
Digitalis, 265 

Antidotes and Antagonists, 856 
Digitin, 266 
Digitonin, 266, 439 
Digitoxin, 266 
Dihydrotoluidine, 345 
Diluents, 54, 544 
Dimethyl-ethylcarbinol, 221 
Dimethyl-piperazin Tartrate, 392 
Dimethyl-xanthin, 195 
Dioscorea, 271 
Dioscorein, 271 
Diospyros, 84 
Dipentene, 466 
Diphtheria, 150, 634 

Diagnosis of, 839 

Temperature in, 844 
Dipsomania, — See Alcoholism, Delirium 
Tremens. 



8?6 



INDEX. 



Discutients, 50 
Disinfectants, 60 

Burnett's, 60 

Condy's, 60 

Labarraque's, 60 
Disinfecting Fluid, 490 

Oil, 75 
Dislocations, 664 
Dispensatories, 494 
Dispensing, 517 

by Physicians, 516 
Displacement, 523 
Distillation, 522 
Dita Bark, 271 
Ditaine, 271 
Ditamine, 271 
Dithymol-Iodide, 320 
Diuretics, 52 

Formula? for, 638, 803 
Diuretin, 198 

Dizziness, — See Vertigo, 809 
Dobell's Nasal Wash, 540 
Dock, Yellow, 420 
Dog-wood, 255 

Jamaica, 392 
Domestic Measures, 497 
Donovan's Solution, 165 
Dorema Ammoniacum, 121 
Dosage of Medicines, 28 

Official Preparations, 29 
Doses, Average, 29 

Table of, — See inside of cover. 
Dover's Powder, 321, 360 

Fluid, 321, 360 
Drastic Purgatives, 46 
Draught, 538 

Black, 440, 538 

Effervescing, 538 
Drink, 554 

Imperial, Formula, 554 
Drops, 497 

Botkin's Cholera, 609 

Table of Drops to a Drachm, 498, 
863 
Dropsy, 637 
Drosera, 271 

Drowning, — See Asphyxia, 583 
Drugs, Their Constituents, 20 
Drug-experimentation, 19 
Dryopteris Filix-mas, 169 

Marginalis, 169 
Duboisia, 271 
Duboisine, 271 
Dulcamara, 272 
Dulcamarin, 272 
Dulcin, 423 
Duodenal Catarrh, 638 
Dutch Liquid, 227 
Dyscrasise, — See Cachexia, 597 
Dysentery, 639 
Dysmenorrhcea, 640 
Dyspepsia, 641 
Dysphagia, 644 



Dyspnoea, 644 
Dysuria, 644 



Ear Affections, 645 

Agents affecting it, 38 
Earache, — See Otalgia, 741 
Eau Sedative, 122, 205 
Ebullition, 527 
Ecballium Elaterium, 274 
Ecbolics, 56 
Ecboline, 274 
Ecchymosis, 645 
Ecgonine, 243 

Eclampsia, — See Puerp. Convulsions, 765 
Ecthyma, 645 
Ectropion, 645 
Eczema, 646 
Efflorescence, 520 
Efflorescent Salts, List of, 552 
j Egg-shells, 201 
Egg, Yolk of, 487 
Eights, The Three, 788 
Elastica, 273 
Elaterin, 274 
Elaterium, 274 
Elder, 430 
Elecampane, 315 
Electuaries, 530 
Electuary for Piles, 530 
Elettaria repens, 213 
Elixir, Aromatic, 172 

McMunn's, 360 

Simple, 172 

of Vitriol, 92 

Yvon's Hypnotic, 703 
Elixiria, 531 
Elm, Slippery, 481 
Elutriation, 526 
Ely's Cream Balm, 834 
Emaciation, 648 
Embrocation, 541 
Emetics, 45 

General or Systemic, 45 

Local, 45 

in Poisoning, 847 
Emetine, 322 
Emissions, 648 
Emmenagogues, 56 

Formulas for, 576 

Pills, 554 
Emollients, 59 
Emphysema of Lungs, 648 
Emplastra, 53* 
Empyema, 649 
Emulsa, 532 
Emulsification, 533 
Emulsin, 87, 125, 404 
Emulsions, 532 
Encephaloma, — See Cancer, 599 

Diagnosis of, 838 
Endarteritis, — See Atheroma, 586 
Endermic Method, 27 



INDEX. 



8 77 



Enepidermic Method, 27 
Endocarditis, 649 

Diagnosis of, 838 
Endometritis, 649 
Enemas, Formulae for, 540, 650 
Enemata, 539, 650 

Enteralgia, — See Colic, Intestinal, 613 
Enteric Fever, — See Typhoid, 797, 841 
Enteritis, 650 
Entropion, 645 

Enuresis, 651 N 

Epidermic Method, 28 
Epididymitis, 651 
Epilation, — See Tinea Circin., 791 
Epilepsy, 652 

Diagnosis of, 839 
Epispastics, 58 
Epistaxis, 654 
Epsom Salt, 335 
Epulis,— See Teeth, 789 
Equinia, — See Glanders, 668 
Erections, 648 
Ergot of Rye, 274 

Antidotes and Antagonists, 856 

of Corn, — See Ustilago, 488 
Ergota, 274 
Ergotin, 275 
Ergotine, 274 
Ergotinine, 274 
Ergotism, 275 
Ericolin, 289, 481 
Erigeron, 277 
Eriodictyon, 277 
Errhines, 40 
Eructations, 642, 663 
Eruptions caused by Drugs, etc., 655 
Erysipelas, 655 

Toxin, 477 
Erythema, 657 
Erythrophloein, 215 
Erythrophlceum Guinense, 215 
Erythroretin, 413 
Erythroxylon Coca, 195, 243 
Escbarotics, 58 
Eserine, 383, 384 
Ethene, 102 

Chloride, 102 

Dichloride, 102 
Ether, 99 

Acetic, 99 

Chloric, 227 

Chlorinated Muriatic, 227 

Hydrobromic, 99, 103 

Hydriodic, 99, 103 

Methylene-di-methyl, 222 

Methylic, 102 

Nitrous, 100, 103 

Petroleum, 182 
Ethereal Oil, 100 

Preparations, 527 
Ethyl Acetate, 99 

Alcohol, 99, 106 

Aldehyde, 107, 373 



Ethyl Bromide, 99, 102 
Carbamate, 222 
Chloride, 102 
Hydrate, 99, 106 
Hydride, 102* 
Hydrosulphide, 455 
Iodide, 99 

Nitrite, 100, 127 

Oxide, 99 
Ethylate of Sodium, 445 
Ethylene Bichloride, 227 
Ethylidene Chloride, 227 

Oxide, 107 
Ethylirtes Chloral-urethan, 221 
Eucalyptene, 278 
Eucalyptol, 278 
Eucalyptolen, 278 
Eucalyptus, 278 
Euchlorine, 233 
Eugenia aromatica, 214 

Jambolana, 324 
Eugenin, 214 
Eugenol, 215 
Euonymin, 279 
Euonymus, 279 
Eupatorin, 279 
Eupatorium, 279 
Euphrasia, 280 
Europhen, 320 
Evaporation, 526 

Spontaneous, 527 
Exalgin, 67, 69 

Exanthemata, Diagnosis of, 840 
Excipients, 533, 544, 549 
Excitants, Cerebral, 33 

Ciliary, 41 

Motor, 32 
Excoriation, — See Intertrigo, 705 
Excretion, Agents affecting, 52 
Exhaustion, 657 
Exodyne, 67 
Exophthalmos, 658 
Exostosis, 658 
Expectorants, 40 
Explosive Compounds, 512 
Expression, 522 
Exsiccation, 520 
Extemporaneous Pharmacy, 516 
Extract, Adrenal, 138 

Bone Marrow, 133 

Goulard's, 395 

Lymphatic, 139 

Orchitic, 135 

Ovarian, 139 

Pancreatic, 139 

Pineal, 137 

Pituitary, 137 

Pond's, 299 

Renal, 139 

Splenic, 139 

Thymus, 133 

Thyroid, 131 

Uterine, 139 



878 



INDEX. 



Extracta, 534 

Extracta Fluida, 535 

Extractive, 535 

Extracts, 534 

Animal, 129 

Eye-bright, 280 

Eye, Agents affecting, 37 
Diseases, 658 

Ointments, Formulae for, 616 
Sensibility, Agents affecting, 38 
Water, Formulae for, 616, 836 

Eyelids, 659 



Fabiana imbricata, 386 
Face, 659 

Face-ache, — See Neuralgia, 731, Tic Dou- 
loureux, 791 
Fainting, — See Syncope, 786 
False Pains, 660 
Farcy, 668 
Fat, — See Obesity, 736 

Hog, 98 

Wool, 98 
Fats and Oils, 345 

as Antidotes, 848 
Fatigue, — See Exhaustion, 657 
Favus, — See Tinea Favosa, 792 
Febricula, — See Fever, Simple, 662 
Febrifuge, 238 
Febrinol, 67 
Feet, 660 

Fehling's Solution, 261, 845 
Fel Bovis, 280 

Tauri, 280 
Felon, — See Onychia, 737 
Fennel, 287 

Fermentation, Lactic, 425 
Ferments, Agents affecting, 59 
Fern. Male, 169 

Marginal Shield, 169 
Ferratin, 283 

Ferrier's Snuff, Formula, 604 
Ferro-cyanide of Potass., 87, 89 

as an Antidote, 850 
Ferrum, 280 

Dialysatum, 283 

Reductum, 280 
Ferula foetida, 1 68 

Galbaniflua, 288 

Sumbul, 461 
Fever, 660 

Bilious Remittent, Diagnosis, 842 

Cerebro-spinal, 722 

Enteric, — See Typhoid, 797, 841 

Hay, 675 

Hectic, 682 

Intermittent, 703 

Miliary, 726 

Milk, — See Lactation, 709 

Pernicious, — See Intermittent Fever, 
Remittent Fever. 

Puerperal, 766 



Fever, Relapsing, 770 

Remittent, 770 

Diagnosis of, 842 

Rheumatic, 770 

Scarlet, 775 

Diagnosis of, 840 

Simple, 662 

Spotted, — See Typhus Fever, also 
Meningitis Cerebro-spinal. 

Surgical, 786 

Traumatic, — See Surgical Fever, 786 

Typhoid, 797 

Diagnosis of, 841 

Typho- malarial, — See Typhoid, 797 

Typhus, 800 

Diagnosis of, 841 

Yellow, 814 

Diagnosis of, 842 
Ficus (Fig), 286 
Filix Mas, 169 
Filtering-paper, 522 
Filtration, 522 
Fir, Balsam of, 465 

Scotch, 393 

Silver, 465 
Firs, 392 
Fish-berries, 386 
Fish-poison, Antidotes and Antagonists, 

856 
Fistula, 662 

Fits, — See Apoplexy, Convulsions, Epi- 
lepsy, Hysteria, Syncope. 
Flatulence, 663 
Flavoring Agents, 545 
Flaxseed, 331 
Flea-bane, 277 

Fleming's Tincture of Aconite, 96 
Flooding, — See Hemorrhage Post-partum, 

Menorrhagia and Metrorrhagia. 
Fluavil, 273 
Fluid, Antiseptic, 470 

Condy's, 338 

Disinfecting, 490 
Fluid Extract, Aromatic, 243 
Fluid Extracts, 535 
Flushing-heats, 663 
Fly-agaric, 104 
Fceniculum, 287 
Fomentation, 541, 760 
Food, Horlick's, 337 

Mellin's, 337 

Parrish's, 381 
Foods, 49 

Foreign Bodies, 583, 663 
Formaldehyde, 107 
Formalin, 107, 287 
Formamide, 225 
Formulae, Hypodermic, 830 
Formyl Iodide, 316 
Fotus, 541 

Fowler's Solution, 165 
Fox -glove, 265 
Fractures, 664 



INDEX. 



8 79 



Franciscea uniflora, 337 

Frangula, 288 

Frangulin, 288 

Frankincense, 466 

Franklinite, 489 

Fraxin, 340 

Fraxinus Ornus, 340 

Freckles, 664 

Friar's Balsam, 183, 455 

Fuchsin, 288 

Fucus Vesiculosus, 288 

Furuncle, — See Boils, 589 

Fusel Oil, 107 

Fusion, 523 



Gaduin, 344 

Gadus Morrhua, 344 

Galactagogues, 57 

Galbanum, 288 

Galla, 84, 288 

Galena, 394 

Gallipots, 565 

Gall-stones, — See Calculi, Biliary, 598 

Gallus Bankiva, 487 

Gamboge, 204 

Antidotes and Antagonists, 856 
Gangrene, 664 

of Lungs, 716 
Garcinia Hanburii, 204 

mangostana, 340 
Garfield Tea, 834 
Gargarysma, 537 

Gargles, Formulae for, 538, 636, 752, 791 
Garlic, 1 17 

Gaseous Preparations, 539 
Gases, Agents affecting, 59 

Antidotes and Antagonists, 856 
Gastralgia, 665 
Gastric Dilatation, 666 

Fever, — See Fever Simple, Gastritis, 
Remittent Fever, Typhoid Fever. 

Pain, 45 

Sedatives, 45 

Tonics, 43 

Ulcer, 668 

Vomiting, Diagnosis, 842 
Gastritis, Acute, 666 

Chronic, 666 
Gastrodynia, 665 
Gaultheria, 289, 425 
Gaultherilene, 289 
Gauze of Carbolic Acid, 73 

of Thymol, 470 
Gelatin, 314 

as an Antidote, 848 

Capsules, 528 
Gelsemine, 289 
Gelsemium, 289 

Antidotes and Antagonists, 856 
Generative System, Agents affecting, 55 
Genitive Case-endings, 829 
Gentian, 290 



Gentianin, 291 
Gentopicrin, 291 
Geranium, 84, 291 
Gigartina, 234 
Gin, 108, 325 
Ginger, 492 
Glanders, 668 
Glandular Affections, 669 

Extracts, 129 
Glass, Antidotes for, 857 

Soluble, 400, 443 
Glauber's Salt, 445 
Glaucoma, 669 
Gleet, 669 
Glonoin, 126 
Glossitis, 670 
Glottis, (Edema of, 670 
Glusidum, 423 
Gluco-pepsine, 375 
Glucose, 424 
Glucosides, 22 
Glucusimide, 423 
Gluten, as an Antidote, 848 
Glycerin, 291 

Preparations, 527 
Glycerites, 538 
Glyceryl, 358 

Borate, 71 

Trinitrate, 126 
Glycocholate, Sodium, 280 
Glycocoll, 379 
Glycogen, 424 

Agents affecting its production, 48 
Glyconin, 487 

Emulsion, 344 
Glycozone, 371 
Glycyrrhetin, 293 
Glycyrrhiza, 293 
Glycyrrhizin, 293 
Glycyrrhizinum Ammoniatum, 293 
Gnoscopine, 359 
Goa-powder, 234 
Godfrey's Cordial, 362 
Goitre, 671 
Gold, 172 

Antidotes and Antagonists, 857 

" Bichloride," 177 

Bromide, 173 

Chloride, 173 

Cure, Keeley's, 834 
Golden Seal, 309 
Gonorrhoea, 671 
Gossypii Radicis Cortex, 294 
Gossypium, 294 
Goulard's Cerate, 395 

Extract, 395 
Gout, 673 

Diagnosis of, 839 
Granatum, 84, 295 

Granular Lids, — See Conjunctivitis, Oph- 
thalmia. 
Granulation, 523 
Granule, 548 



88o 



INDEX. 



Grass, Ribbed, 394 
Worm, 449 

Gravel-root, 280 

Graves' Disease, — See Exophthalmos, 658 

Gray Powder, 302 

Griffith's Mixture, 281 

Grindelia, 296 

Grindeline, 296 

Grippe, — See Influenza, 700 

Guaiac, 297 

Guaiacol, 256, 259 

Guarana, 193, 195, 298 

Guaranine, 193, 195, 197, 298 

Gum Arabic, 66, 480 

as an Antidote, 849 

Sweet, 454 
Gumboil, — See Gums, 694 
Gum-resins, 23 
Gum-tree, Blue, 278 
Gums, 674 
Gun-cotton, 294, 424 
Gunjah, 207 
Gurjun Balsam, 298 
Gutta, 273 
Gutta-percha, 273 
Guttae (Drops), 497 
Gynocardia odorata, 218 
Gypsum, 200 



Haematics, 49 

Hematoxylin, 299 

Hsematoxylon, 84, 298 

Hagenia abyssinica, 264 

Hager's Tincture, 237 

Hair, 675 

Hair-tonic, 675 

Hair Washes, Formulae, 675 

Haller's Dictum, 19 

Halogen Elements, 231 

Hamamelin, 299 

Hamamelis, 84, 299 

Hamburg Tea, 834 

Hamlin's Wizard Oil, 834 

Hands, — See Chapped Hands, 607 

Hashish, 207 

Haustus, 538 

Haw, Black, 486 

Hayah, 215 

Hayden's Viburnum Compound, 486 

Hay-fever, 675 

Head-ache, Bilious Sick, 676 

Congestive, 677 

Nervous, 678 
Heart Affections, 679 

Dilated, 680 

Fatty, 680 

Hypertrophied, 680 

Palpitation, 681 

Valvular Disease, 681 
Heartburn, — See Pyrosis, 768 
Heart's-ease, 487 
Hectic Fever, 682 



Hedeoma, 299 
Helenin, 315 
Hellebore, 300, 483, 484 
Helleborein, 300 
Helleborin, 300 
Helleborus, 300 
Helmbold's Buchu, 834 
Hematemesis, 682 

Diagnosis of, 840 
Hematocele, Pelvic, 683 
Hematuria, 683 
Hemeralopia, 684 
Hemicrania, 684 
Hemiopia, 685 
Hemiplegia, 686 
Hemlock, 251 

Spruce, 393 
Hemoptysis, 686 

Diagnosis of, 840 
Hemorrhage, 687 

Intestinal, 688 

Post-partum, 688 
Hemorrhagic Diathesis, 687 
J Hemorrhoids, 530, 689 
Hemostatics, 59 
Hemp, 207 

Canadian, 156, 207 

Indian, 207 
Henbane, 31 1 
Hepar Sulphuris, 458 
Hepatalgia, 690 
Hepatic Abscess, 692 

Cirrhosis, 690 

Congestion, 690 

Depressants, 48 

Diseases, 692 

Stimulants, 47 

Vomiting, Diagnosis, 842 
Hepatitis, 692 
Hernia, 693 
Herpes, 693 

Zoster, 694 
Hesperidin, 171, 330 
Heuchera, 84 
Hevea, 273 
Hexylamine, 345 
Hiccough, 694 

Hip-joint Disease, — See Coxalgia, 623 
Hive Mixture, 140, 436 

Syrup, 140, 436 
Hives, — See Urticaria, 804 
Hoang Nan, 301 
Hoarseness, — See Aphonia, 579 
Hoffman's Anodyne, 100, 103 
Hoff's Malt Extract, 337 
Hog, 376 
Holloway's Ointment, 834 

Pills, 834 
Homatropine, 180 
Homoeopathic Practices, 509 
Honduras Bark, 215 
Honey, 341 
Honeys (Mellita), 542 



INDEX. 



Hong-Pang Chong, 414 

Hooper's Female Pills, 554 

Hope's Mixture, 634 

Hops, 301 

Hordeolum, — See Eyelids, 659 

Hordeum distichum, 337 

Horehound, 340 

Horlick's Food, 337 

Horse-nettle, 448 

Hostetter's Bitters, 834 

Housemaid's Knee, — See Bursitis, 597 

Humulus, 301 

Hunger, — See Appetite, 581 

Hunyadi Water, 619 

Huxham's Tincture of Bark, 237 

Hwang-Nao, 301 

Hydragogue Purgatives, 46 

Hydrangea, 302 

Hydrargyrism, 305 

Hydrargyrum, 302 

Ammoniatum, 303 

Antidotes and Antagonists, 857 

cum Creta, 302 
Hydrastin, 184, 309 
Hydrastine, 309 
Hydrastinine, 309 
Hydrastis, 309 

Hydrates, — See their metallic titles. 
Hydrides, — " " " " 

Hydrobromates, — See their basic titles. 
Hydrocele, 695 
Hydrocephalus, 695 

Acute, — See Meningitis Tubercular, 

723 

Hydrochlorates, — See their basic titles. 
Hydrocotarnine, 359 
Hydrocotyle, 310 
Hydrogen Dioxide, 370 

Peroxide, 370 

Sulphide, 458 

Sulphuretted, 458 
Hydroleine, 344 
Hydronaphtol, 350 
Hydrophobia, 695 

Toxin, 479 
Hydroquinone, 238, 239, 481 
Hydrothorax, 695 
Hydroxymethane, 107 
Hygrine, 243 
HygK)scopic Bodies, 520 
Hyoscine, 31 1 
Hyoscyamus, 31 1 

Antidotes and Antagonists, 857 
Hyoscyamine, 311 

Hyperidrosis, — See Perspiration, 749 
Flypnal, 143, 221 
Hypnone, 107, 221 
Hypnotics, 34, 221, 703 
Hypochlorites, Antidotes, etc., 857 
Hypochondriasis, 696 
Hypodermic Formulae, 830 

Injections, 25, 832 

Method, 25 

56 



Hypodermic Solutions, 832 

Tablets, 27, 563 
Hypophosphites,38o, — See also their basic 

titles. 
Hyposulphites, 93, — See also their basic 
titles. 

as Antidotes, 850 
Hysteria, 696 

Diagnosis of, 839 



Ice, 160 

Iceland Moss, 218 

Ichthyocolla, 314 

Ichthyol, 458, 460 

Ichthyosis, 697 

Icterus, — See Jaundice, 706 

Ignatia, 314 

Antidotes and Antagonists, 857 
Ignition, 523 

Ileus, — See Intestinal Obstruction, 705 
Ilex Paraguayensis, 195 
Illicium, 315 
Impetigo, 697 
Impotence, 697 
Incineration, 523 
Incompatibility, 51 1 

Chemical, 511 

Dangers of, 514 

Pharmaceutical, 513 

Rules for avoiding, 514 

Therapeutical, 514 
India-rubber, 273 
Indian Corn, 128, 488 

Hemp, 207 

Poke, 483 

Tobacco, 333 
Indigestion, — See Dyspepsia, 641 
Indigo, Wild, 178 
Inflammation, 698 
Influenza, 700 
Infusa (Infusions), 538 
Ingluvin, 376 
Inhalations, 539 
Injection Brou, 540 
Injections, 539 

Antiseptic, 309 

Formulae, 540, 673 

Hypodermic, 25, 832 

Parenchymatous, 27 

Urethral, 540 
Injuries, — See Bruises, Burns, Ecchymosis, 

Fractures, Sprains, Wounds. 
Inoculation, 28 
Inosit, 424 
Insanity, 701 

Insolation, — See Sunstroke, 785 
Insoluble Salts, 512 
Insomnia, 702 
Intemperance, — See Alcoholism, Delirium 

Tremens, Opium Habit. 
Intermittent Fever, 703 
Intertrigo, 705 



882 



INDEX. 



Intestinal Astringents, 47 
Intestinal Diseases, — See Colic, Constipa- 
tion, Diarrhoea, Duodenitis, Dysentery, 
Enteritis, Hemorrhoids, Hernia, Intes- 
tinal Obstruction, Intussusception, Ty- 
phlitis, Tabes Mesenterica, Worms. 
Intestinal Obstruction, 705 

Parasites, — See Worms, 812 
Intussusception, 705 
Inula, 315 
Inulin, 163, 315 

Iodides, 316, — See also their basic titles. 
Iodine, 315 

as an Antidote, 850 

Antidotes and Antagonists, 857 

Carbolated, 315 

Disulphide, 458 
Iodism, 317 
Iodized Cotton, 683 

Phenol, 315 
Iodol, 321 
Iodoform, 316, 320 
Iodum. 315 
Ipecacuanha, 321 

Antidotes and Antagonists, 857 
Ipomcea Jalapa, 323 
Iridin, 323 
Iris, 323 
Irish Moss, 234 
Irisin, 323 
Iritis, 706 
Iron, 280 

as an Antidote, 

Antidotes, 857 

Dialysed, 283, 521 

and Manganese, 337 

. Pijls, 554 
Irritability, 706 
Irritants, Cutaneous, 57 
Ischuria, — See Urinary Disorders, 803 
Isinglass, 314 

Isobutyl-orthocresol Iodide, 320 
Isonandra Gutta, 273 
Iso-naphtol, 349 
Itch, — See Scabies, 774 
Itching, — See Lichen, Prurigo, Pruritus, 

Pediculi, Scabies, Urticaria, etc. 
Ivy, Poison, 415 



Jaborandi, 388 
Jaboridine, 388 
Jaborine, 388 
Jalap, 323 
Jalapin, 323, 436 
Jambul, 324 
James' Powder, 140 
Jamestown Weed, 450 
Jamun, 324 
Japaconitine, 96 
Jasmine, Yellow, 289 
Jateorhiza palmata, 203 
Jaundice, 706 



850 



Javelle Water, Antidotes, 857 

Jeaunel's Antidote, 851 

Jequirity, 65 

Jervine, 483 

Joint Affections, 707 

Juglans, 324 

Juniperin, 325 

Juniper, 325 

Juniperus communis, 325 

Oxycedrus, 325 

Sabina, 422 

Virginiana, 422 



Kairin, 239 

Kairolin, 239 

Kalium, 398 

Kalmia latifolia, 341 

Kamala, 326 

Kaputin, 68 

Kavahin, 326 

Kava-kava, 326 

Kawin, 326 

Keeley Gold Cure, 834 

Kefir, 328 

Keratitis, 708 

Kermes Mineral, 140 

Ketone, 107 

Kidneys, Diseases of, — See Albuminuria, 
Bright' s Disease, Calculi, Colic Renal, 
Diabetes, Dropsy, Gout, Hematuria. 

Kino, 84, 326 

Kinoin, 326 

Kino-red, 326 

Kinovin, 236 

Koch's Lymph, 473 

Kola, 196, 198 

Kolanin, 196 

Kombe arrow-poison, 453 

Koomiss, 327 

Koussin, 264 

Kousso, 264 

Krameria, 84, 326 

Kumyss, 108, 327 

Kumysgen, 327 

Kurung Oil, 398 



Labarraque's Solution, 61, 232 

Antidotes, 857 
Labor, 708 
Lac Sulphuris, 457 
Lactation, 709 
Lactophenin, 378 
Lactopeptine, 375 
Lactose, 425 
Lactuca virosa, 328 
Lactucerin, 328 
Lactucin, 328 
Lactucarium, 328 
Lactyl-para-phenetidin, 379 
Ladies' Slipper, 265 
La Fayette's Mixture, 254 



INDEX. 



88 3 



Lallemand's Specific, 674 
Lanolin, 98 
Lanthopine, 359 
Lapathin, 421 
Lappa, 328 
Larch, 104, 465 
Lard, 98 

Benzoinated, 98, 183 

Oil, 98 
Larix Europaea, 465 
Laryngismus Stridulus, 710 
Laryngitis, 710 
Laryngotomy, 71 1 
Latin Numerals, 828 

Phrases and Terms, 816 
Laudanine, 359 
Laudanosine, 359 
Laudanum, 360 
Laurel, Cherry, 87 

Mountain, 341 
Laurocerasus, 87 
Lavandula, 329 
Lavender. 329 

Laville's Gout Mixture, 251, 834 
Laxatives, 46, 556 
Lead, 394 

Colic, 614 

Plaster, 394 

Salts, Antidotes, etc., 857 

Sugar of, 394 

Water, 395 

and Laudanum, 542 

White, 395 
Lecithin, 136 
Leek, 117 

Legal's Disease, 733 
Lemon, 330 

Lentigo, — See Freckles, 664 
Leopard's Bane, 163 
Leprosy, 712 
Leptandra, 329 
Leptandrin, 329 
Lettuce, 328 
Leucocythaemia, 712 
Leucolin, 219 

Leucoma, — See Corneal Opacities, 621 
Leucorrhcea, 713 
Levigation, 526 
Levulose, 341, 424 
Lice, — See Pediculi, 747 
Lichen, 713 
Lichenin, 218 
Licoperdon giganteum, 329 
Lignum Vitae, 297 
Lily-of-the- Valley, 253 
Lily, Water, 358 

Pond, 84 
Lime, 200, 330 

Antidotes and Antagonists, 857 

Chlorinated, 232 

Kinovate, 236 

Sulphurated, 458 

Water, 200 



Limon, 330 

Linimenta, 540 

Liniments, Formulae, 200, 331, 541 

Linseed, 331 

Lint, Boracic, 71 

Linum, 331 

Lips, — See Chapped Lips, 607 

Lip-salve, Red, 468 

Liquid-ambar orientalis, 454 

Liquids, Normal, 537 

Liquores, 541 

Liquorice Root, 293 

Wild, 65 
Listen ne, 71 
Lithaemia, 714 
Litharge, 395 
Lithium, 332 

Benzoate, 183 
Lithontriptics, 54, 202 
Liver, — See Hepatalgia, etc., 690 
Liver of Sulphur, 458 
Lixiviation, 523 
Lobelacrin, 333 
Lobelia, 333 

Antidotes and Antagonists, 857 
Lobelin, 333 
Lobeline, 333 
Lochia, — See Labor, 708 
Lock-jaw, — See Tetanus, 789 
Locomotor Ataxia, 714 
Lceffler's Solution, 637 
Loganin, 351 
Log- wood, 84, 298 
Lotion, 541 

Black, of Mercury, 304 

Boric, 71 

Evaporating, 700 

Yellow, of Mercury, 304 
Loxopterygium Lorentzii, 170 
Lozenges, 562 
Lugol's Solution, 315 
Lumbago, 715 

Lumbrici, — See Worms, 812 
Lung Diseases, 716 

Gangrene of, 716 
Lupulin, 301 
Lupuline, 301 
Lupus, 717 
Lycetol, 392 
Lycopodium, 334 
Lyctonine, 96 
Lymphangeitis, 718 
Lymphatic Extract, 139 
Lysidin, 391 
Lysol, 74, 79 



Mace, 347 
Maceration, 523 
Macis, 347 
Macrotin, 234 
Magendie's Solution, 361 
Magenta, 288 



884 



INDEX. 



Magma, 524 
Magnesia, 335 

as an Antidote, 849 
Magnesium, 334 

Boro-citrate, 71, 599 

Silicate, 443 
Magnolia, 336 
Magnolin, 336 
Maize, 128, 488 
Malakin, 67, 426 
Malaria, 718 
Male Fern, 169 
Mallein, 480 

Mallotus.phillipinensis, 326 
Malt, 337 

Extract, Hoff's, 337 
Maltum, 337 
Mammary Abscess, 568 
Manaca, 337 
Mandrake, 397 
Manganauro, 173 
Manganese, 337 
Mangano-ferri Peptonatus, 338 
Manganum, 337 
Mangifera indica, 340 
Mango, 340 
Mango-fruit, 340 . 
Mangosteen, 340 
Mania, 719 

Puerperal, 767 
Manna, 340 
Mannit, 340 
Mannite, 295 
Manzanita, 481 
Marasmus, — See Atrophy, Emaciation, 

Tabes Mesenterica. 
Marc, 536 
Margarin, 98, 344 
Marginal Shield Fern, 169 
Marigold, 203 
Marjoram, Wild, 370 
Marrubiin, 340 
Marrubium, 340 
Marsh-mallow, 119 
Mass, Blue, 302 

of Copaiba, 254 

of Ferrous Carbonate, 280 

of Mercury, 302 

Vallet's, 280 
Massae, 542 
Mastic, 340 
Mastiche, 340 
Mastichin, 340 
Mastitis, 720 
Mastodynia, 720 

Masturbation, — See Emissions, 648, Sper- 
matorrhoea, 781 
Mate, 195 

Materia Medica, 17, 65 
Matico, 340 
Matricaria, 341 
May Apple, 397 
McMunn's Elixir of Opium, 360 



Meadow Anemone, 405 

Saffron, 249 
Measles, 720 

Diagnosis of, 840 

False, — See Roseola, 774 

Temperature in, 844 
Measures, Apothecaries', 495 

Approximate, 497 

Domestic, 497 

Metric, 496 

and Weights, 494, 863 

Wine, 495 
Meconidine, 359 
Meconoiosin, 360 
Meconin, 360 
Medicines, Administration of, 23 

Classification of, 30 

Dosage of, 28 

Patent, 833 
Medulline, 137 
Meerschaum, 443 
Mel, 341 
Melachol, 381 

Melaleuca Leucadendron, 199 
Melancholia, 721 

Puerperal, 767 
Melia Azedarach, 177 
Melissa, 342 
Mellin's Food, 337 
Mellita, 542 

Meniere's Disease, — See Vertigo, 809 
Meningitis, Cerebral, 722 

Cerebro-spinal, 722 

Spinal, 723 

Tubercular, 723 
Menispermin, 386 
Menispermum, 342 

Cocculus, 386 
Menopause, — See Climacteric, 613 
Menorrhagia, 724 
Menstrual Disorders, 725 
Menstruum, 523 
Mentagra, 725 
Mentha arvensis, 342 

canadensis, 342 

piperita, 342 

viridis, 343 
Menthol, 342 
Mercaptan, 455 
Mercaptol, 455 
Mercauro, 173, 176 
Mercurio-vegetal, 337 
Mercury, 302 

Antidotes and Antagonists, 857 

Vegetable, 337 
Mesenteric Disease, — See Tabes Mesen- 
terica, 788 
Metabolism, Agents affecting, 49 
Metadioxybenzol, 41 1 
Metallic Salts, Antidotes, etc, 858 
Methacetin, 379 
Methane, 102 
Methene Chloride, 102 



INDEX. 



Methol, 107 
Methyl-acetanilid, 67 
Methyl Alcohol, 102, 107 

Bromide, 102 

Chloride, 102, 227 

Bichlorinated, 226 

Coniine, 251 

Creosol, 256 

Ether, 102 

Ether of Protocatechuic Aldehyde, 483 

Hydrate, 107 

Pyrocatechin, 256 

Salicylate, 289, 426 

Terchloride, 226 
Methylal, 102, 222 
Methylated Spirit, 107 
Methylene Bichloride, 227 

Blue, 343 
Methylene-dimethyl Ether, 222 
Methysticin, 326 
Metric Prescriptions, 506 

System of Weights, etc. , 496 

Table for Conversions, 864 
Metritis, Acute, 725 
Metrorrhagia, 725 
Mezereon, 344 
Mezereum, 344 

Antidotes and Antagonists, 858 
Mica Panis, 550 
Microbe-killer, 835 
Microbes, Agents affecting, 59 

in Water, 159 
Migraine, 684 
Migranin, 143 
Miliary Fever, 726 

Milk, — See Agalactia, 572, Lactation, 709 
Milk of Asafetida, 168 

Papaw, 376 

of Sulphur, 457 

Substances excreted in, 709 
Milk-fever, — See Lactation, 709 
Mindererus, Spirit of, 122 
Mineral Green, 165 

Waters, 157 
Mint, 343 

Miscarriage, — See Abortion, 567 
Mistletoe, 487 
Misturae, 542 
Mixture, A. C. E., 100 

Antimonial and Saline, 700 

Basham's, 282 

Bismuth, for children, 546 

Brown, 293 

Chalk, 200 

Clarke's, 834 

Copaiba, Compound, 254 

Cough, Formulae, 623, 721, 751, 756 

Coxe's Hive, 140, 436 

Diarrhoea, 361 

Ferro-saline, 284 

Griffith's, 281 

Hope's, 634 

Iron, Aromatic, 284 



Mixture, Iron, Compound, 281 
Laxative, 284 

Lafayette's, 254 

Laville's, 250, 834 

Liquorice, Compound, 293 

Magnesia and Asafetida, 168, 335 

Quinine, 546 

Potassium Citrate, 399 

Rhubarb and Soda, 413 

Saline, 700 

Scudamore's, 674 

Squibb' s, 361, 609 
Mixtures, 542 

Anaesthetic, 100 

Compounding of, 545 

Substances suitable to, 543 
Moccasin-plant, 265 
Molasses, 424 
Mole, — See Naevus, 727 
Mollities Ossium, — See Bone Diseases, 

589, Rachitis, 768 
Monkshood, 95 
Monsel's Solution, 282 
Moonseed, Canadian, 342 
Morbilli, — See Measles, 720 
Morphine, 359, 361, 365 

and Atropine, 369 

Antidotes and Antagonists, 859 

Habit, 739 
Morrhuae Oleum, 344 
Morrhuine, 345 
Morrison's Pills, 204, 835 
Moschus, 346 
Mosquitoes, 784 
Motor Depressants, 32 

Excitants, 31 
Mouth Diseases, — See Aphthae, Cancrum 
Oris, Gums, Parotitis, Ptyalism, Stoma- 
titis, Toothache, Tongue. 
Mouth Washes, Formulae, 675 
Mucilages, 546 
Mucilagines, 546 
Mucus in Urine, Test for, 846 
Mullein, 486 

Mumps, — See Parotitis, 747 
Muscae Volitantes, 726 
Muscarine, 104 

Antidotes and Antagonists, 858 
Muscular Disorders, — See A trophy, Chorea, 
Hydrophobia, Laryngismus, Lumbago, 
Myalgia, Pleurodynia, Rheumatism, 
Tetanus, Torticollis. 
Mushrooms, Antidotes, etc., 858 
Musk, 346 
Mustard, 443 
Myalgia, 726 
Mydriasis, 37, 180 
Mydriatics, 37 
Myelitis, 727 
Mykose, 275 
Myopia, 727 
Myotics, 37 
Myrcia, 347 



SS6 



INDEX. 



Myrica, 84 

cerifera, 217 
Myricin, 217 
Myristica, 347 
Myristicol, 347 
Myronate, Potassium, 443 
Myrosin, 443 
Myrrh, 348 
Myrrhin, 348 
Myrrhol, 348 
Myrtle, 84, 217, 348 
Myrtol, 348 
Myrtus communis, 348 

Chekan, 349 
Myxcedema, 727 



Nsevus, 727 
Nails, Ingrowing, 728 
Napelline, 96 
Naphtalene, 349 
Naphtalin, 239, 349 
Naphtol, 349 

Camphorated, 350 
Narceine, 359, 366 
Narcosis, 363 
Narcotics, 34 

Antidotes and Antagonists, 858 
Narcotine, 359, 362, 365 
Nasal Affections, 728 
Natrium, 444 
Nausea, 728 
Necrosis, 729 
Nectandra, 374 
Nepenthe, 362 
Nephritis, Acute, 837. — See also Bright's 

Disease, 590 
Nervous Affections, 729 

Exhaustion, — See Neurasthenia, 733 
Nervousness, 730 

Nervous System, Agents affecting, 31 
Neuralgia, 731 

Ovarian, 742 
Neurasthenia, 733 
Neuritis, 734 
Neurodin, 68 
Nicotiana Tabacum, 461 
Nicotianin, 461 
Nicotine, 461 

Antidotes and Antagonists, 861 

Bitartrate, 462 
Niemeyer's Pill, 756 
Nightmare, 735 
Nightshade, Black, 272 

De.iclly, 179 

Woody, 272 
Night Sweats, — See Hectic Fever, Per- 
spiration, Phthisis. 
Nipples, Fissured, Sore, 735 
Nitrates, — See their metallic titles. 

Antidotes and Antagonists, 860 
Nitre, 400, 445 

Chili, 445 



Nitre, Sweet Spirit of, 100 

Nitrites, 126, — See also their basic titles. 

Nitro-benzene, 238 

-benzol, 125 

Antidotes, etc., 858 

-glycerin, 126 

Antidotes, etc., 858 
Nitrous Ether, 100, 103 

Oxide, 102 

Antidotes, etc., 858 
Nodes, 735 
Normal Liquids, 537 
Norwood's Tincture, 484 
Norway Spruce, 392 
Nose-bleed, — See Epistaxis, 654 
Nucin, 325 
Nuclein, 133 
Numerals, Latin, 828 
Nutgall, 84, 288 
Nutmeg, 347 
Nux Vomica, 351 

Antidotes and Antagonists, 858 
Nyctalopia, 684 
Nymphaea, 84 

Odorata, 358 
Nymphomania, 736 



Oak -bark, 84, 409 
Oak, Dyer's, 288 

Poison, 415 

White, 409 
Oat, 177 
Obesity, 736 
Odontalgia, 736 
Oesophageal Affections, 737 
Official Operations, 519 

Preparations, 527 
Oil of Allspice, 390 

of Almond, Bitter, 125 
Expressed, 126 

of Amber, 455, 466 

of Anise, 139 

of Anthemis, 140 

of Aurantium Cortex, 172 
Flores, 172 

of Bay, 347 

Benne, 442 

of Bergamot, 185 

of Betula, 426 

of Birch, 426 

of Cade, 325 

of Cadinum, 325 

of Cajuput, 199 

Camphorated, 205 

of Caraway, 214 

of Carum, 214 

Carron, 200, 331 

of Cassia, 243 

Castor, 417 

of Caryophyllus, 214 

of Cedar, 432 

Chamomile, 140 



INDEX. 



887 



Oil, Chaulmoogra, 218 
of Chenopodium, 219 
of Cinnamon, 243 
of Cloves, 214 
Cod-liver, 344 
of Copaiba, 254 
of Coriander, 255 
of Cotton-seed, 294 
Croton, 471 
of Cubeb, 260 
Disinfection, 75 
of Erigeron, 277 
Ethereal, 100 
of Eucalyptus, 278 
of Fennel, 287 
of Fleabane, 277 
Fusel, 107 

of Gaultheria, 289, 426 
of Gossypium-seed, 294 
Hamlin's Wizard, 834 
of Hedeoma, 299 
of Hemlock, 394 
Hydrated, 344 
Jecoris Aselli, 344 
of Juniper, 325 
Kurung, 398 
Lard, 98 

of Lavender- flowers, 329 
of Lemon, 330 
of Linseed, 331 
of Linum, 331 
of Mace, 347 
of Mentha Piperita, 342 
of Mentha Viride, 343 
of Mirbane, 125 
of Morrhua, 344 
of Mustard, Volatile, 443 
of Myrcia, 347 
of Myristica, 347 
of Myrtle, 348 
of Neroli, 172 
of Nutmeg, 347 
Olive, 358 

of Orange flowers, 172 
of Orange-peel, 172 
of Origanum, 370 
of Pennyroyal, 299 
of Peppermint, 342 
Phosphorated, 380 
of Pimenta, 390 
of Pinus Silvestris, 393, 466 
of Pix Liquida, 393 
of Pongamia, 398 
of Ricinus, 417 
of Rose, 419 
of Rosemary, 419 
of Rue, 421 
of Ruta, 421 
of Sabina, 422 
Salad, 358 
of Sandalwood, 432 
of Santal, 432 
of Sassafras, 435 



Oil of Savine, 422 

of Scotch Fir, 393 

Sequah's, 836 

of Sesamum, 442 

of Sinapis, Volatile, 443 

of Spearmint, 343 

of Spruce, 394 

St. Jacob's, 96, 836 

Sweet, 358 

of Succinum, 455, 466 

of Tabacum, 462 

of Tanacetum, 464 

of Tansy, 464 

of Tar, 392 

Teel, 442 

of Terebinthina, 465 

of Theobroma, 468 

of Thuja, 466, 469 

of Thyme, 469 

of Tiglium, 471 

of Tobacco, 462 

of Turpentine, 465 

as an Antidote, 849 

of Valerian, 482 

of Wintergreen, 289, 426 

Wizard, 834 

Wood, 298 
Oils, as Antidotes, 848 

Expressed, 522 

and Fats, 345 

Fixed, 522 
Ointment, 217 

Antipruritic, 565 

Basilicon, 410 

Blue, 302 

Boracic, 71 

Calamine, 491 

of Carbolic Acid, 73 

Citrine, 303, 304 

Diachylon, 395 

Holloway's, 834 

Pagenstecker's, 617 

of Rose Water, 218 

Spermaceti, 218 

Tar, 393 

White Precipitate, 303 
Ointments, 563 

Compounding, 564 

Formulae for, 565 
Olea Europaea, 358 
Oleaginous Preparations, 527 
Oleata, 546 
Oleates, 90, 546 
Olein 98, 344, 358 
Oleoresina, 546 
Olive, 358 
Onion, 117 
Onychia, 737 

Operations, Pharmaceutical, 519 
Ophthalmia, 738 
Opisthotonos, — See Tetanus, 789 
Opium, 359 

Antidotes and Antagonists, 859 



INDEX. 



Opium, Denarcotized, 360 

Deodorized, 360 

Habit, 739 
Opodeldoc, 434 
Orange, 171, 330 

Blossom, 835 
Orchitic Extract, 135 
Orchitis, 740 
Ordeal Bark, 215 
Oregon Grape, 184 
Origanum, 370 
Ortho-dihydroxy-benzene, 239 
Otalgia, 741 
Otitis, 741 
Otorrhcea, 742 
Ouabain, 454 
Ovarian Extract, 139 

Neuralgia, 742 

Tumors, — See Cysts, 627 
Ovaritis, 742 
Ovis Aries, 442 
Oxaluria, 743 
Ox-gall, 280 
Oxides, 370. — See also their metallic 

titles. 
Oxidizers, 513 
Oxyethyl-acetanilid, 378 

-chinolin, 239 
Oxygen, 370 
Oxymel, 341 

Oxymethyl-acetanilid, 379 
Oxytocics, 56 
Oyster-shell, 200 
Ozsena, 743 
Ozone, 370 



Pagliari's Styptic, 688 
Pain, 368, 744 

Gastric, 45 
Pains, After-, 572 

Chest, 607 

False, 660 
Paints, 547 

Palmitate of Cetyl, 218 
Palmitin, 358 
Pancoast's Styptic, 687 
Pancreas, Agents affecting, 48 
Pancreatic Extract, 139 
Pancreatin, 376 
Pancreatine, 137 
Pancreopepsine, 375 
Pannus, — See Corneal Opacities, 621 
Pansy, 487 
Papain, 376 
Papaiva, 376 

Papaver somniferum, 359 
Papaverine, 359 
Papaw Milk, 376 
Paper, Filtering, 522 
Papers (Chartse), 529, 555 
Papine, 360 
Papoid, 376 



Para Rubber, 273 
Parachinanisols, 239 
Paraconiine, 25 1 
Paracoto Bark, 256 
Paracotoin, 256 
Paraldehyde, 107, 373 
Paralysis, 745, 782 

Agitans, 746 

of the Bladder, 588 
Para-acetphenetidin, 378 
Para-dihydroxy-benzene, 239 
Paramenispermin, 386 
Paramorphine, 359 
Paraphenetol Carbamide, 423 
Paraphimosis, — See Phimosis, 752 
Paraplegia, — See Paralysis, 745, 782 
Parasiticides, 61 
Paregoric, 360 
Pareira, 374 

Parenchymatous Injection, 27 
Paresis, — See Paralysis, 745, 782 
Parigenin, 434 
Parilla, Yellow, 342 
Parillin, 434 
Paris Green, 165 
Paronychia, 737 
Parotitis, 747 
Parsley, 156 

Parrish's Chemical Food, 381 
Participles, Latin, 829 
Parvule, 548 
Paste, Black, 673 

Vienna, 399 
Pasteur's Inoculation, 479 
Pastilles, 562 
Pasque-flower, 405 
Patent Medicines, 833 
Paullinia curare, 263 

Cupana, 195, 298 
Pavy's Solution, 845 
Pearson's Solution, 165 
Pectin, 409 
Pediculi, 747 
Pelletierine, 295 
Pellitory, 408 
Pelosine, 374 
Pemphigus, 747 
Pencils, 558 
Penis, — See Chancre, Chancroid, Chordee, 

Gleet, Gonorrhoea, Phimosis, Urethra. 
Pennyroyal, 299 
Pennywort, 310 
Pental, 102 
Pepo, 374 
Pepper, African, 21 1 

Black, 390 

Cayenne, 21 I 

Water, 398 
Peppermint, 342 
Pepper-vine, 390 
Pepsin, 375 
Pepsinum, 375 
Peptenzyme, 375 



INDEX. 



889 



Peptogenic Milk Powder, 375 
Pepto-mangan, 338 
Perchloride of Iron, 281 
Percolation, 523 
Pericarditis, 748 

Diagnosis of, 838 
Periostitis, 748 
Peritonitis, 748 

Puerperal, 767 

Tubercular, 749 
Permanganate, Potassium, 337 

as an Antidote, 339, 850 
Pernicious Fever, — See Intermittent Fever, 

703, Remittent Fever, 770 
Peroxide, Barium, 179 

Hydrogen, 370 
Perry Davis's Pain-Killer, 835 
Persimmon, 84 
Perspiration, 749 
Pertussis, 750 
Peruvian Bark, 235 
Petrolatum, 377 
Petroleum Ether, 182 

Ointment, 378 
Petroselinum sativum, 156 
Peumus Boldo, 187 
Phaeoretin, 413 
Phagedena, — See Chancre, Chancroid, 

Gangrene, Ulcers. 
Phannaceutical Incompatibility, 513 

Operations, 519 

Preparations, 527 

Rules, 518 
Pharmaceutists, — Their objectionable prac- 
tices, 508, 516, 539 
Pharmacodynamics, 17 
Pharmacology, 1 7 
Pharmacopoeias, List of, 493 
Pharmacy, 493 

Extemporaneous, 516 

Official, 519 

Rules for neophytes, 518 
Pharyngitis, 75 1 
Phaseo-mannit, 424 
Phenacetin, 378 

Antidotes and Antagonists, 859 
Phenatol, 68 
Phenazone, 142 
Phenocoll Hydrochloride, 379 
Phenol, 72, 238 

Camphor, 74 

Iodized, 74, 315 

Sodique, 74 
Phenolid, 68 
Phenols, 74 
Phenopyrin, 143 
Pheno-resorcin, 74 
Phenosalyl, 74, 80 
Phenyl, 238 

Alcohol, 72 

Hydride, 182 

Salicylate, 426 
Phenyl-acetamide, 66 



Phenyl-dimethyl-pyrazolon, 142 
Phenyl-methyl-acetone, 107, 221 
Phimosis, 752 
Phlebitis, 752 

Phlegmasia Alba Dolens, 752 
Phlegmon, 753 
Phlorol, 256 
Phosphates, 381 
Phosphide, Zinc, 380 
Phosphites, 380 
Phospho-albumen, 137 
Phosphorus, 380 

Antidotes and Antagonists, 859 
Photophobia, 753 
Phthisis, 753 

Diagnosis of, 840 

Temperature in, 844 
Physeter macrocephalus, 217 
Physiological Antagonism, 62 
Physostigma, 383 

Antidotes and Antagonists, 860 
Physostigmine, 383, 384 
Phytolacca, 385 
Phytoline, 386 
Pichi, 386 

Picrsena excelsa, 409 
Picrates, 92 
Picroglycion, 272 
Picropodophyllin, 398 
Picrotoxin, 386 

Antidotes and Antagonists, 860 
Pierce's Favorite Prescription, 835 

Golden Discovery, 835 
Pigmenta, 547 
Piles, 530, 689 _ 
Pill, Anaphrodisiac, 554 

Ayer's, 833 

Blancard's, 281 

Blaud's, 281 

Blue, 302 

Brandreth's, 833 

Cathartic, Compound, 250 
Vegetable, 250 

Chalybeate, 281 

Ferruginous, 554 

Holloway's, 834 

Lady Webster's, 1 19 

Morrison's, 204, 835 

Niemeyer's, 756 

Plummer's, 140, 142 

Tanjore, 784 
Pill-mass, 548 
Pills, 547 

Coated, 552 

Compressed, 553 

Excipients for, 549 

Formulae for, 554 

Official, 547 

Process of making, 548 

Substances suitable for, 550 
Pilocarpidine, 388 
Pilocarpine, 388 

Antidotes and Antagonists, 860 



890 



INDEX. 



Pilocarpine-phenyl -hydroxide, 74 
Pilocarpus, 388 
Pilulse, 547 
Pimenta, 390 
Pimpinella Anisum, 139 
Pimples, — See Acne, 569 
Pine, Prince's, 219 

Yellow, 465 
Pineapple, 376 
Pineal Extract, 137 
Pinene, 348, 466 
Pines, 392 
Pinipicrin, 469 
Pinites succinifer, 455 
Pink, Carolina, 448 
Pink-root, 448 

Demarara, 449 
Pinus, 392, 465 

australis. 466 

Canadensis, 393 

palustris, 392, 465 

sylvestris, 466 

Treda, 466 
Piper, 390 

angustifolium, 340 

cubeha. 260 

methysticum, 326 

nigrum, 390 
Piperazin, 391 
Piperin, 390 
Pipsissewa, 219 
Piscidia, 392 
Piscidin, 392 
Pissenlit, 464 
Pistacia Lentiscus, 340 

Terebinthus, 465 
Pitaya Bark, 236 
Pitch, 392 

Pituitary Extract, 137 
Pityriasis, 756 
Pix, 392 

Pix Liquida, 392 
Planat's Tincture, 387 
Plantago, 394 
Plantain. 394 
Plaster, Adhesive, 410 

Anodyne, 532 

Cantharidal, 209 

Counterirritant, 532 

Court, 314 

Diachylon, 395 

Isinglass, 314 

Pitch, 393 

Strengthening, 282 

Vesicating, 532 

Warming, 209, 393 
Plasters, 531 

Formulae for, 532 
Plethora, 757 

Abdominal, 567 
Pleurisy, 757 

Diagnosis of, 840 
Pleurisy-root, 169 



Pleuritis, 757 
Pleurodynia, 758 
Pleuropneumonia, 758 
Plum, 404 
Plumbum, 394 
Plummer's Pills, 140, 142 
Pneumonia, 758 

Diagnosis of, 840 
Podophyllin, 398 
Podophyllitoxin, 398 
Podophyllum, 397 
Poison Ivy, 415 

Nut, 351 

Oak, 415 

Antidotes and Antagonists, 860 

Sumach, 415 
Poisoning, 61, 847. — See also the several 
poisons under their titles in Part I. 

Antidotes and Antagonists, 61, 847 

Treatment of, — Indications for, 61 
General Principles of, 847 
Poisonous Compounds, 513 
Poisons, Energetic, 847 
Poke-berry, 385 
Poke, Indian, 483 
Poke-root, 385, 483 
Polygala Senega, 439 
Polygonum, 398 
Polvporus fomentarius, 104 

officinalis, 104 
Polypus, 760 

Polyuria, — See Diabetes Insipidus, 630 
Pomade de Bareges, 757 
Pomegranate, 84, 295 
Pond's Extract, 299 
Pond Lily, 84 
Pongamia, 398 
Poplar, 425 
Poppy, White, 359 
Populus, 425 
Porphyrization, 526 
Porphyroxin, 360, 430 
Porrigo Capitis, — Tinea Tonsurans, 792 
Porter, 108 
Port Wine, 108 
Potash, 399 

Antidotes, etc. , 860 
Potassa, 399 

Alum, 120 

cum Calce, 399 

Sulphurata, 458 
Potassio- ferric Tartrate, 283 
Potassium, 398 

Bichromate, 83, 860 

Cyanide, 87, 89, 856 

Ferro-cyanide, 87, 89 

Myronate, 443 

Nitrite, 127 

Permanganate, 337, 850 

Silicate, 443 

Tartra-borate, 71, 599 
Potato, 272 

Spirit, 107 



INDEX. 



Potentilla Sarmentosa, 749 
Potus, 554 
Poultices, 529, 760 

List of Br. Official, 529 
Powder, Antimonial, 140 

Aromatic, 243 

Bleaching, Antidotes, 857 

Dover's, 321, 360 

Effervescing, 400 

Gray, 302 

James', 140 

Liquorice, 293 

Purgative, 323 

Seidlitz, 400 

Tully's, 361 
Powders, 554 

Formulae for, 556 

Substances suitable to, 555 
Prairie Flower, 836 
Precipitant Solutions, Table of, 512 
Precipitate, White, 303 

Red, 303 
Precipitation, 524 
Pregnancy, Disorders of, 760 

Vomiting of, 810 
Premna tatiensis, 472 
Preparations, 527 
Prepositions, Latin, 830 
Prescription Writing, 500 

Latin Phrases used in, 816 
Prescriptions, 499 

Analysis of, 500 

Blanks for, 510 

Contractions, 508, 816 

Filling of, 517 

Latin Phrases used, 816 

Metric, 506 

Renewals, 508 

Table of Doses, — See cover. 

Tonic, 577 
Prickly Heat, — See Lichen, 713 
Pride of China, 177 
Prince's Pine, 219 
Principles in Drugs, 20 

in Extracts, 535 
Prinos, 404 

Proctitis, — See Rectum, 769 
Prodigiosus Toxin, 477 
Prolapsus Ani, 761 

Uteri, 761 
Pronunciation, 829 
Propyl Oxide, 344 
Propylamine, 164 
Prosopalgia, — See Neuralgia, Odontalgia, 

Tic Douloureux. 
Prostate, Hypertrophied, 761 
Prostatitis, 761 
Prostatorrhcea, 762 
Protectives, 59 
Protonuclein, 135 
Protopine, 359 
Prune, 404 
Prunum, 404 



Prunus Amygdalus, 125 

domestica, 404 

Laurocerasus, 87 

Serotina, 404 

Yirginiana, 87, 404 
Prurigo, 762 
Pruritus, 762 
Pseudaconitine, 96 
Pseudo-jervine, 483 
Pseudo-morphine, 359 
Pseudotropine, 31 1 
Psoriasis, 764 
Pterocarpus marsupium, 326 

santalinus, 432 
Pterygium, 764 
Ptosis, 764 

Ptyalism, 43, 305, 765 
Puccine, 430 
Puerperal Convulsions, 765 

Disorders, 766 

Fever, 766 

Mania, 767 

Melancholia, 767 

Peritonitis, 767 
Puff-ball, 329 
Pulmonary Sedatives, 39 
Pulsatilla, 405 

Antidotes and Antagonists, 860 
Pulse, 767 

and Temperature, 844 
Pulveres, 554 
Pulverization, 526 
Pulvis Purgans, 323 
Pumpkin-seed, 374 
Punica Granatum, 295 
Purgatives, 46 
Purging Agaric, 104 

Cassia, 216 
Purpura, 767 

Pus in Urine, Test for, 846 
Pustule, Malignant, — See Anthrax, 578 
Pustules, — See Anthrax, Ecthyma, Erup- 
tions, Impetigo, Variola. 
Pustulants, 58 
Pyaemia, 768 
Pyrethrine, 408 
Pyrethrum, 408 
Pyretine, 68 
Pyridine, 239, 462 
Pyrocatechin, 238, 239, 392 
Pyrogallol, 84, 238 
Pyrrol, 321 
Pyrosis, 768 
i Pyroxylin, 294, 424, 530 
Pyrozone, 371 



Quaker Button, 351 

Quantities, Table of, — .See Cover. 

Quassia, 408 

Quassin, 409 

Quebrachine, 170 

Quebracho, 170 



892 



INDEX. 



Queen's Delight, 449 

Root, 449 
Quercin, 409 
Quercitrin, 409, 418 
Quercus Alba, 84, 409 

Lusitanica, 288 

Tinctoria, 409 
Quicksilver, 302 
Quillaja, 410 
Quinalgen, 68, 220 
Quince-seed, 264 
Quinetum, 238 
Quinicine, 236 
Quinidine, 236 
Quinine, 236 

Antidotes and Antagonists, 860 

Mixture, 544, 546 

Poisoning by, 240 

Solutions of, 544 
Quinoidin, 238 
Quinoline, 219 
Quinquinina, 238 
Quinsy, — See Tonsillitis, 793 



Rabies, — See Hydrophobia, 695 

Toxin, 479 
Rachitis, 768 

Radam's Microbe-killer, 835 
Radway's Ready Relief, 835 

Resolvent, 835 
Raspail's Eau Sedative, 122, 205 
Raspberry, 420 

Rat-pastes, Antidotes, etc., 860 
Recamier Balm, etc., 835 
Rectum, Absorption by, 24 

Diseases of, 769 

Prolapse of, 761 

Ulceration of, 769 
Red Gum, — See Strophulus, 785 
References and Bibliography, 566 
Refrigerants, 43 
Relapsing Fever, 770 
Remittent Fever, 770 

Diagnosis of, 842 
Renal Depressants, 52 

Extract, 139 
Renewals of Prescriptions, 508 
Resin, 22, 410, 466 

Cerate, 410 

Plaster, 410 
Resina, 410, 466 
Resinae, 556 
Resinol, 393 
Resins, 22, 556 
Resolvents, 50 
Resorcin, 74, 238, 41 1 

Antidotes and Antagonists, 860 
Resorcinol, 41 1 

Respiration, — See Bronchitis, Croup, Dysp- 
noea, Emphysema, Pneumonia, etc. 
Respiration, Agents affecting, 39 

Artificial, 583 



Respiratory Depressants, 39 

Stimulants, 39 
Restoratives, 49 
Retina, Affections of, 770 
Retinol, 393 
Revalenta Arabica, 835 
Rhamnoxanthin, 288 
Rhamnus Frangula, 288 

Purshiana, 412 
Rhaphidophora vitiensis, 47 
Rhatanine, 326 
Rhatany, 84, 326 
Rheum, 413 
Rheumatism, Acute, 770 

Chronic, 772 

Diagnosis of, 839 

Gonorrhceal, 774 

Muscular, 774 
Rheumatoid Arthritis, 581 
Rhinacanthin, 414 
Rhinacanthus, 414 

Rhinitis, — See Catarrh Acute Nasal, In- 
fluenza, Nasal Affections. 
Rhceadine, 359 
Rhubarb, 413 
Rhus, 414, 415 

Antidotes and Antagonists, 860 
Ricin, 147, 417 
Ricinine, 417 
Ricinolein, 417 
Ricinus communis, 417 
Rickets, — See Rachitis, 768 
Rigors, — See under Fever, 660 
Ring-worm, 791, 792 
Risus sardonicus, 353 
Roasting, 525 
Rochelle Salt, 400 
Rosa, 84, 418 
Rosanilin, 288 
Rose, 84, 418 

Attar of, 419 

Honey of, 341, 419 
Roseine, 288 
Rosemary, 84, 419 
Roseola, 774 
Rosmarinus, 419 
Rottlera, 326 
Rottlerin, 326 
Rubber, India, 273 
Rubefacients, 57 
Rubeola, — See Measles, 720 
Rubidium, 420 
Rubijervine, 483 
Rubini's Tincture, 205 
Rubus, 84, 420 
Rue, 421 
Rules for Incompatibility, 515 

for Pharmaceutists, 518 
Rum, 108 

Bay, 347 
Rumex,420 
Rumicin, 421 
Rupia, — See Pemphigus, 747 



INDEX. 



393 



Ruta, 421 
Russian Spirit, 773 
Rye, 274 



Sabadilla, 484 
Sabina, 442 

Antidotes and Antagonists, 861 
Saccharin, 423 
Saccharum, 423 

Lactis, 425 
Sacred Bark, 412 
Safflower, 260 
Saffron, 260 

American, 260 

Meadow, 249 
Saffron- tea, 260 
Safrol, 204, 435 
Sage, 429 

Sage's Catarrh Remedy, 835 
Sal-ammoniac, 122 
Salbromalide, 67 
Salfene, 68 
Salicin, 425 
Salicylate, Para-amidol, 426 

Physostigmine, 384 

Sodio-Theobromine, 198 
Salicylates, 426 
Salicyl-bromalide, 67 
Salicyl-para-phenetidin, 67, 426 
Saligenin, 427 
Saline Mineral Waters, 158 

Purgatives, 46 
Salipyrin, 143, 426, 429 
Saliva, Agents affecting, 43 
Salivation, 43, 305, 765 
Salix, 425 

Nigra, 425 
Salol, 426, 428 
Salophen, 426, 429 
Salt, common, 445 

Epsom, 335 

Glauber's, 445 

Rochelle, 400 
Saltpetre, 400 

Antidotes and Antagonists, 860 

Chili, 445 
Salt-rheum, — See Eczema, 646 
Salts, Deliquescent, List of, 552 

Efflorescent, List of, 552 

Insoluble, 512 

Metallic, Antidotes, etc., 858 
Salve, Red Lip, 468 
Salvia, 429 
Salviol, 430 
Sambucus, 430 
Sandal-wood, 431 

Oil, 432 
Sand-brier, 448 
Sanford's Catarrh Cure, 835 
Sanguinaria, 43c 

Antidotes and Antagonists, 861 
Sanguinarine, 430 



Sanitas, 61, 371, 466 
Santalum Album, 431 

citrinum, 431 

Rubrum, 432 
Santonica, 432 
Santonin, 432 
Sapo, 433 
Sapogenin, 439 
Saponification, 433 
Saponin, 217, 410, 439 
Saprol, 75 
Sarcinae, 774 

Sarcocele, — See under Cancer, Testicles. 
Sarsaparilla, 434 

Ayer's, 833 
Sassafras, 435 

Swamp, 336 
Sassy Bark, 215 
Saunders, Red, 432 
Savine, 422 

Antidotes and Antagonists, 861 
Sayre's Method for Chloroform, 231 
Scabies, 774 

Scald-head, — See Eczema, Tinea. 
Scalds, 597 
Scammonium, 435 
Scammony, 435 
Scarlet Fever, 775 

Diagnosis of, 840 

Temperature in, 844 
Scheele's Acid, 87 

Green, 165 
Sciatica, 776 
Scilla, 436 
Scillin, 436 
Scillipicrin, 436 
Scillitin, 436 
Scillitoxin, 436 
Scirrhus, — See Cancer, 599 

Diagnosis of, 838 
Sclererythrin, 275 
Scleroderma, 778 
Scleromucin, 275 
Sclerosis, 778 
Scleroxanthin, 275 
Scoparin, 437 
Scoparius, 437 
Scopolamine, 311 
Scopoleine, 311 
Scopolia carniolica, 311 
Scorbutus, — See Scurvy, 779 
Screaming, — See Nightmare, 735 
Scrofulosis, 778 
Scudamore's Mixture, 674- 
Scurvy, 779 
Scutellaria, 439 
Scutellarin, 439 
Sea-sickness, 779 
Seborrhcea, 779 
Sea-wrack, 288 
Secale cereale, 274 
Secaline, 488 
Sedative, Battley's, 361 



894 



INDEX. 



Sedatives, 31 

Cardiac, 31, 42 
Gastric, 45 
General, 45 
Pulmonary, 39 
Urinary, 53 
Uterine, 57 
Vascular, 42 
Vesical, 53 

Seidlitz Powder, 400 

Seigel's Syrup, 835 

Senega, 439 

Senegin, 439 

Senna, 440 

Sennacrol, 440 

Sennapicrin, 440 

Separation, 524 

Septicaemia, 768 

Sequah's Oil, 836 

Prairie Flower, 836 

Serpentaria, 441 

Serpent-venom, Antidotes, etc., 861 

Serum, Antitoxic, 147 
Artificial, 734 

Serum-therapy, 148 

Sesamum, 442 

Sevum, 442 

Shampoo Mixtures, 675 

Shells, 196 

Sheep, 442 

Sherry Wine, 108 

Shingles, — See Herpes Zoster, 694 

Shock, Surgical, 779 

Sialogogues, 43 

Sickness at Stomach, — See Nausea, Sea- 
sickness, Vomiting. 

Sick-room, 780 

Siddhi, 207 

Silicates, 442 

Silicious Mineral Waters, 158 

Silver, 161 

Antidotes and Antagonists, 861 

Sinalbin, 443 

Sinapine, 443 

Sinapis, 443 ^ 

Singultus, — See Hiccough, 694 

Sinigrin, 443 

Sinistrin, 436 

Skin, Agents affecting, 57 
as an Absorbent, 27 

Skin Diseases, — See Acne, Anthrax, Boils, 
Burns, Carbuncles, Chapped Hands and 
Lips, Chilblains, Condylomata, Ecchy- 
mosis, Ecthyma, Eczema, Elephantiasis, 
Eruptions, Erysipelas, Erythema, 
Freckles, Herpes, Herpes Zoster, Ich- 
thyosis, Impetigo, Intertrigo, Lichen, 
Lupus, Mentagra, Naevus, Onychia, 
Pemphigus, Phlegmon, Pityriasis, 
Prurigo, Pruritus, Psoriasis, Roseola, 
Scabies, Scleroderma, Seborrhcea, 
Strophulus, Syphilis, Tinea, Ulcer, 
Urticaria, Wart, Wen. 



Skull-cap, 439 

Sleep, Abnormal, — See Delirium, Insom- 
nia, Nightmare, Somnambulism. 
Slippery Elm Bark, 481 
Smallpox, — See Variola, 808 

Diagnosis of, 840 
Smart-weed, 398 
Smell, Agents affecting, 38 
Smilacin, 434 
Smilax, 434 
Snake-root, Black, 234 

Virginia, 441 
Sneezing, 780 

Agents producing, 40 

See also Catarrh, Hay Fever, Influ- 
enza. 
Soaloin, 1 18 
Soap, 433 

as an Antidote, 849 

Bark, 410 
Soda, 445 

Antidotes and Antagonists, 861 

Caustic, 444 

Chlorata (Chlorinated), 232 

Water, 80 
Sodio-Theobromine Salicylate, 198 
Sodium, 444 

Benzoate, 183 

Bisulphite, 93 

Hyposulphite, 93 

as an Antidote, 850 

Nitrite, 157 

Silicate, 443 

Sulphite, 93 

Sulpho-carbolate, 73 

Tetra-borate, 71 
Solanine, 272 
Solanum Carolinense, 448 

Dulcamara, 272 
Solid Preparations, 527 
Soluble Substances, 543 
Solution, 524 

Aids to, 544 

Alkaline Cupric Tartrate, 261 

Antiseptic, 309, 709 

Circulatory, 525 

Clemens', 165 

Crocq's, 383 

Donovan's, 165 

Fehling's, 261, 845 

Fowler's, 165 

Glass, 443 

Labarraque's, 61, 232 

Lceffler's, 637 

Lugol's, 315 

Magendie's, 361 

Monsel's, 282 

Pavy's, 845 

Pearson's, 165 

Quinine, 544 

Saturated, 524 

Villate's, 263, 601 
Solutions (Liquores), 541 



INDEX. 



8 95 



Solutions, Hypodermic, 832 

Precipitant, Table of, 5 J 2 

Stock, 518 
Solutol, 75 
Solvents, 525 
Solved, 75 
Somnal, 221, 224 
Somnambulism, 780 
Sores, 800 

Bed, 587 
Sorghum, 423 
Sorrel, 420 
Soz-albumin, 476 
Sozodont, 836 
Spanish Flies, 209 
Sparteine, 437 
Spasmodic Affections, 781 
Spearmint, 343 
Specific Gravity and Volume, 498 

Table of, 862 
Spermaceti, 217 
Spermatorrhoea, 781 
Spermine, 137 
Spigelia, 448 
Spina Bifida, 782 
Spinal Concussion, 782 

Congestion, 782 

Inflammation, — See Meningitis, Mye- 
litis, etc. 

Irritation, 782 

Paralysis, 782 

Softening, 782 
Spirit, Methylated, 107 

Perfumed, 108 

Potato, 107 

Proof, 108 

Rectified, 108 

Russian, 773 

Wood, 107 
Spirits (Spiritus), 557 
Splenic Affections, 783 

Extract, 139 
Spongia Usta, 778 

Spotted Fever, — See Typhus Fever, Men- 
ingitis Cerebro-spinal. 
Sprains, 783 
Spruces, 392 
Spunk, 104 

Squamae, — See Ichthyosis, Pityriasis, Pso- 
riasis, etc. 
Squaw-root, 217 
Squibb's Mixture, 361, 609 
Squill, 436 

St. Ignatius' Bean, 314 
St. Jacob's Oil, 96, 836 
St. Mary's Thistle, 214 
St. Vitus' Dance, — See Chorea, 611 
Stains, 783 
Stammering, 783 
Staphisagria, 449 
Starch, 128, 424 

as an Antidote, 849 
Star- wort, 1 17 



Statice, 84 
Stavesacre, 449 
Stearin, 98 
Sterility, 784 
Sternutatories, 40 
Stigma' a Maydis, 488 
Stillingia, 449 
Stimulants, 31 

Cardiac, 41 

Hepatic, 47 

Local, ^3 

Pancreatic, 48 

Respiratory, 39 

Vascular, 42 
Stings, 784 
Stock Solutions, 518 
Stomach Diseases, — See Dyspepsia, Gas- 

tralgia, Gastric Ulcer, Gastritis, etc. 
Stomachics, 43 
Stomatitis, 785 
Stone, — See Calculi, 55, 598 
Storax, 454 
Strabismus, 785 
Straining, 519 
Stramonium, 450 

Antidotes and Antagonists, 861 
Strangury, — See Cystitis, Dysuria. 
[ Stricture, — See Rectum, 769 

Urethral, 802 
Strontium Salts, 451 
Strophanthin, 453 
Strophanthus glabrus, 454 

hispidus, 453 
Strophulus, 785 
Strychnine, 301, 314,351 

Antidotes and Antagonists, 858 
Strychnos Ignatii, 314 

Gautheriana, 301 

Nux Vomica, 351 
Sturgeon, 314 
Stye, — See Eyelids, 659 
Styptic Collodion, 94, 294 
Styptics, 59. 687, 688 
Styracin, 454 
Styrax, 454 

Benzoin, 183 
Styrol, 454 
Sublimation, 525 
Substances best given alone, 515 

difficult to combine in pill, 551 

suitable for mixtures, 543 

suitable for pills, 550 

suitable for powders, 555 

unsuited to pill-form, 551 
Succinum, 455 
Sudorifics, 54 
Suet, 442 
Sugar, 423 

of Lead, 394 

of Milk, 425 

in Urine, — See Diabetes Mellitus, 630 
Tests for, 845 
Sulphates, — See their basic titles. 



8 9 6 



INDEX. 



Sulphates as Antidotes, 850 
Sulphides, 458 
Sulphites, 93 
Sulpho-carbolates, 73, 79 
Sulpho-cyanate, Acrinyl, 443 
Sulpho-cyanide, Allyl, 443 
Sulpho-ichthyolates, 458 
Sulphonal, 455 

Antagonists, 861 
Sulphur, 457 

Antidotes and Antagonists, 861 
Sulphurated Antimony, 140 

Lime, 458 

Potassa, 458 
Sulphuretted Hydrogen, 458 
Sulphurous Mineral Waters, 158 
Sumach, 414, 415 
Sumbul, 461 
Sun-dew, 271 
Sunstroke, 785 
Suppositoria, 557 
Suppositories, Formulae, 558 

Official in Br. Phar., 559 
Suppuration, 785 
Surgeon's Agaric, 104 
Surgical Fever, 786 
Sus scrofa, 376 
Svapnia, 360 
Swallowing, — See Dysphagia, GEsophs 

geal Affections. 
Swamp Sassafras, 336 
Sweet Bay, 336 

Flag, 199 

Gum, 454 
Swertia Chirata, 220 
Swift's Specific, S. S. S., 836 
Sycosis, 786 

Sydenham's Laudanum, 360 
Syncope, 786 
Synovitis, 786 
Syphilis, 787 

Diagnosis, 838 
Syrup, Siegel's, 835 

Mrs. Winslow's Soothing, 362 
Syrupi (Syrups), 559 



Tabacum, 461 

Tabes Mesenterica, 788 

Table of Antagonistic Drugs, 64 

Drops in a Drachm, etc., 498, 863 

Latin Words, Phrases, etc., 816 

Metric Conversion, 864 and cover 

Precipitant Solutions, 512 

Prescription Doses and Quantities, - 
See cover. 

Specific Gravities and Volumes, 862 
Tables of Differential Diagnosis, 837 

of Weights and Measures, 495, 863 
Tablets. 562 

Compressed, List of, 563 

Hypodermic, List of, 27, 563 

of Nitroglycerin, 127 



Taeniafuges, 49, 170, 296, 812 

Taeniae, — See Tapeworms (below). 

Tag Alder, 1 18 

Tamarind, 464 

Tamar-Indien, 440, 836 

Tamarindus, 464 

Tanacetin, 464 

Tanacetum, 464 

Tannigen, 95 

Tannin, 94 

as an Antidote, 848 
Tansy, 464 

Tapeworms, 49, 1 70, 296, 812 
Tar, 392 
Tar-water, 393 
Taraxacerin, 464 
Taraxacin, 464 
Taraxacum, 464 
Tartar, Cream of, 400 

Crude, 399 

Emetic, 140 

Antidotes and Antagonists, 853 
Tartraborate of Potassium, 71, 599 
Tartrate, Ammonio- ferric, 283 

Antimony and Potassium, 140 

Potassio-ferric, 283 

Potassium and Sodium, 400 
Tartrates, 95 
Taste, Agents affecting, 38 

Disordered, 789 
Taurocholate of Sodium, 280 
Tea, 195 

Boneset, 280 

Flaxseed, 331 

Garfield, 834 

German Breast, 1 19 

Hamburg, 834 

Linseed, 331 

Saffron, 260 

Tansy, 464 

Worm, 449 
Teel Oil, 442 
Teeth, 789 

Agents affecting, 43 
Teething, — See Dentition, 629 
Temperature in Disease, 842 

Drugs affecting, 50 
Tenesmus, — See Dysentery, 639 
Terebene, 466 
Terebinthene, 466 
Terebinthina, 465 
Terpin, 466 
Terpinene, 466 
Terpinol, 466 
Testa Praeparata, 200 
Testicles, 789 
Testicular Juice, 135 
Testing, 525 
Tests for Morphine, 362 

Urinary Constituents, 845 
Tetanus, 152, 789 
Tetraborate, Sodium, 71 
Tetrachloride, Carbon, 102, 228 



INDEX. 



8 97 



Tetra-hydromethyl-chinolin, 239 

Tetra-hydroparamethyl-oxychinolin , 239 

Tetra-iodo-pyrrol, 321 

Tetra-methyl-Thionine Chloride, 343 

Tetronal, 457 

Tetter, — See Herpes, Pityriasis, Psoriasis. 

Thallin, 239 

Thea sinensis, 193 

Thebaine, 359, 366 

Theine, 193, 195, 197, 198 

Theism, 195 

Theobroma Cacao, 195, 468 

Theobromine, 195, 197, 468 

Therapeutical Incompatibility, 514 

Therapeutics, 17 

Applied, 18, 566 

Empirical, 18 

Natural, 17 

Rational, 18 

Special, 566 
Theriaca, 424 
Thermodin, 68 
Thermometer, Clinical, 842 
Thimble-berry, 420 
Thiol, 458, 461 
Thirst, 790 

Agents allaying, 43 
Thistle, Blessed, 214 

St. Mary's, 214 
Thompson's Eye-water, 836 

Tincture, 380 
Thorn-apple, 450 
Thorough-wort, 279 

Throat, — See Aphonia, Croup, Diphtheria, 
Laryngitis, Pharyngitis, Scarlet Fever, 
Tonsillitis, etc. 
Throat, Sore, 790 
Thrush,— See Aphthae, 580 
Thuja, 469 
Thujetin, 469 
Thujin, 469 
Thus Americanum, 466 
Thyme, Garden, 469 
Thymene, 470 
Thymol, 470 
Thymus (gland) Extract, 133 

vulgaris, 469 
Thyreoidin, 133 
Thyreo-antitoxin, 133 
Thyroid Extract, 133 
Tic Douloureux, 791 
Tiglii Oleum, 471 

Tin, Antidotes and Antagonists, 861 
Tincture, Fleming's, 96 

Hager's, 237 

Huxham's, 237 

Norwood's, 484 

Planat's, 387 

Pyrexialis, 237, 242 

Rubini's, 205 

Thompson's, 380 

Warburg's, 237, 242 
Tincturse (Tinctures), 560 

57 



Tinea Circinata, 791 

Decalvans, 792 

Favosa, 792 

Sycosis, — See Mentagra, 725 

Tonsurans, 792 
Tobacco, 461 

Antidotes and Antagonists, 861 

Indian, 333 

Symptoms, — See Amaurosis, Ner- 
vousness. 
Toe-nails, — See Nails, 728 
Tolene, 178 
Toluene, 423 
Toluifera Pereirae, 177 

Balsamum, 178 
Tomato, 272 
Tonga, 472 
Tongine, 472 
Tongue, 793 
Tonics, 49 

Cardiac, 41 

Formulae, 572, 577, 734 

Gastric, 43 

Hair, 675 

Nerve, 730, 734, 740 

Pills for Women, 554 

Uterine, 57 

Vascular, 42 

Vesical, 53 
Tonsillitis, 793 
Tonsils, Enlarged, 794 

Ulcerated, 794 
Toothache, — See Odontalgia, 736 
Toothrash, — See Strophulus, 785 
Torrefaction, 525 
Torticollis, 795 
Torulae, — See Sarcinae, 774 
Toxalbumins, 472, 476 
Toxicological Antagonism, 63 
Toxicology, 17, 61, 847 
Toxin, Cholera, 478 

Erysipelas, 477 

Prodigiosus, 477 

Rabies, 479 

Tuberculosis, 473 
Toxins, 472 

Tracheitis, — See Croup, 624 
Trachoma, — See Conjunctivitis Granular, 

617, Ophthalmia, 738 
Tragacantha, 480 
Transfusion, 25 
Traumaticin, 273 
Traumatic Fever, 786 
Treacle, 424 
Tree of Heaven, 105 
Tremor, 795 
Tri-bromo-methane, 187 
Trichiniasis, 795 
Trichloraldehyde, 220 
Tricophytosis capitis, — See Tinea, 791 
Trimethylamine, 163, 164, 275, 301, 344 
Trihydroxy-benzene, 84, 238 
Trikresol, 74, 79 



898 



INDEX. 



Trimethyl-ethylene, 102 

-xanthin, 193 
Trinitrin, 126 
Trinitrophenol, 92 
Trional, 456 
Trismus, 796 
Triticin, 480 
Triticum, 480 
Trituration, 526 
Triturationes, 561 
Triturations, their advantages, 561 

of Elaterin, 274 

Formulae, 562 

of Mercury, 303, 562 
Troches, 562 
Trochisci, 562 
Tropeius, 180 
Tropical Fruit-Laxative, 440 
Tropin, 180 
Trypsin, 376 
Tubercular Laryngitis, 71 1 

Meningitis, 723 

Peritonitis, 749 

Phthisis, Diagnosis, 840 
Tuberculin, 473 
Tuberculocidin, 476 

Tuberculosis, 153. — See also Tubercular 
Laryngitis, etc., above, also Phthisis, 
Scrofulosis, Tuberculous Affections. 

Acute, 796 

Antitoxin, 153 
Tuberculous Affections, 796 
Tully's Powder, 361 
Tumenol, 458, 461 
Tumors, 797 

Diagnosis of, 838 

Uterine, 806 
Turnera aphrodisiaca, 265 
Turpentine, 465 

as an Antidote, 849 

Antidotes and Antagonists, 862 
Turpeth Mineral, 303 
Tympanites, 797 
Typhlitis, 797 
Typhoid Fever, 797 

Diagnosis of, 841 

Temperature in, 844 
Typho-malarial Fever, — See Typhoid, 797 
Typhus Fever, 800 

Diagnosis of, 841 
Tyrotoxicon, Antidotes, etc., 862 



Ulcers and Sores, 800 
of Rectum, 769 
of Stomach, 668 
of Tonsils, 794 
of Uterus, 806 

Ulmus, 481 

Umbelliferon, 288 

Umbrella-tree, 336 

Unguenta, 563 

Unguentum, 217, 563 



Uraemia, 802 

Urea, Agents affecting, 48 

in Urine, Test for, 846 
Urethan, 222 
Urethral Stricture , 802 

Injections, 540 
Urethritis, 802 
Urginea maritima, 436 
Uric Acid Diathesis, — See Lithaemia, 714 
Urinary Astringents, 53 

Disorders, 803 

Sedatives, 53 
Urine, Acidifiers of, 53 

Alkalinizers of, 53 

Articles coloring, 844 

Examination of, 844 
Urticaria, 804 
Ursone, 289, 481 
Ustilago,488 
Uterine Affections, 804 

Alteratives, 57 

Cancer, 804 

Congestion, 805 

Depressants, 57 

Displacements, 806 

Extract, 139 

Hypertrophy, 805 

Prolapse, 761 

Tonics, 57 

Tumors, 806 

Ulceration, 806 
Uva Ursi, 481 
Uvula, 807 



Vaccination, 807 

Vaginismus, 807 

Vaginitis, 807 

Valerene, 482 

Valerian, 265, 481 

Valerianate, Butyl, 140 

Valerianates, 482 

Valerol, 301, 482 

Vallett's Mass, 280 

Van Buskirk's Sozodont, 836 

Vanilla, 483 

Vanillin, 483 

Vao, 263 

Vapores (Vapors), 539 

Vaporization, 526 

Varicella, 807 

Varicocele, 808 

Varicosis, 808 

Variola, 808 

Diagnosis of, 840 
Vascular Sedatives, 42 

Stimulants, 42 

Tonics, 42 
Vaselin, 378 

Vegetable Drugs, their Constituents, 20 
Veins, — See Phlebitis, Phlegmasia, Vari- 
cosis. 
Veins, Transfusion by, 25 



INDEX. 



8 99 



Velatine, 242 

Vellarine, 310 

Venice Turpentine, 465 

Venom, Insect, Antidotes, 854 

Serpent, Antidotes and Antagonists, 
861 
Venous Medication, 25 
Veratralbine, 483 
Veratrine, 484 
Veratroidine, 483 
Veratrum Album, 484 

Sabadilla, 484 

Viride, 483 

Antidotes and Antagonists, 862 
Verbascum, 486 
Verbs, Latin, 829 
Verdigris, 262 
Vermicides, 48 
Vermifuges, 48, 296, 812 
Veronica Virginica, 329 
Vertigo, 809 

Verruca, — See Warts, 81 1 
Vesical Tonics, 53 

Sedatives, 53 
Vesicants, 58 
Viburnin, 486 
Viburnum, 486 
Vienna Paste, 399 
Villate's Solution, 263, 601 
Vina (Wines), 108, 563 
Vinegar, 70 

Bitters, 836 
Vinegars (Aceta), 528 
Vinum, 108 
Viola Cucullata, 487 

Tricolor, 487 
Violet, 487 
Violine, 487 
Viscin, 487 
Viscum, 487 

Visions, Agents producing, 38 
Vita Nuova, 836 
Vitellin, 487 
Vitellus, 487 
Vitriol, Elixir of, 92 
Volkmann' s Antiseptic Fluid, 470 
Vomiting, 809 

of Pregnancy, 810 

Diagnosis of, 842 
Vulva, Eczema, etc., 81 1 
Vulvitis, 811 



Wade's Bougies, 558 
Wafers, 555 
Wahoo, 279 

Walker's Vinegar Bitters, 
Walnut, White, 324 
Warburg's Tincture, 237, 
Warming-plaster, 209 
Warner's Safe Cure, 836 
Warts, 811 



836 



242 



Wash, 541 

Black, 304 

Hair, 675 

Lead and Opium, 542 

Mouth, 675 

Nasal, 540 

Yellow, 304 
Washing, 527 

Waste, Agents promoting, 50 
Wasting, — See Atrophy, Emaciation. 

Diseases, — See Emaciation, 648 
Water, 157 

of Carbolic Acid, 73 

Carbonated, 80, 82 

Cherry-laurel, 87, 89 

Cologne, 108 

of Crystallization, 520 

Distilled, 157 

Eye, Thompson's, 836 

Hunyadi, 619 

Javelle, Antidotes, 857 

Oxygenated, 370 

Sedative, 122, 205 

Soda, 80, 82 
Water-brash, — See Pyrosis, 768 

-lily, 358 

-pepper, 398 
Waters (Aquae), 528 

Mineral, 80, 157 

Nomenclature, 157 
Wax, 217 

Myrtle, 84, 217 
Weakness, — See Adynamia, Exhaustion. 
Weight of a Drachm in Grains, 863 
Weights and Measures, 494, 863 

Apothecaries', 495, 863 

British Pharmacopceial, 495 

Metric, 496, 863 
Wen, 812 
Whiskey, 106, 107 
White-leg, — See Phlegmasia, 752 
White-swelling, — See Joints, Synovitis. 
Whitlow, — See Onychia, 737 
Whooping-Cough, — See Pertussis, 750 
Willow, 425 
Wine, 108 

Wines (Vina), 108, 563 
Winslow's (Mrs.) Soothing Syrup, 362 
Winterberry, 404 
Wintergreen, 289, 425 
Witch-hazel, 84, 299 
Wood Oil, 298 

Spirit, 107 
Woorara, 263 

Words and Phrases, Latin, 816, 830 
Worms, 48, 296, 812 
Worm-grass, 449 
Wormseed, 219 

Levant, 432 
Worm Tea, 449 
Wormwood, 66 
Wounds, 813 

Poisoned, Antidotes, etc., 862 



900 



INDEX. 



Writers' Cramp, — See Spasmodic Affec- 
tions, 781 
Wry-neck, — See Torticollis, 795 



Xantho-puccine, 309 
Xanthoxyline, 488 
Xanthoxylum, 487 
Xeroderma, — See Ichthyosis, 697 



Yam, Wild, 271 
Yellow Fever, 814 
Diagnosis of, 842 



Yerba Santa, 277 
Yolk of Egg, 487 
Yvon's Hypnotic Elixir, 703 



Zea, 488 

Zea Mays, 128, 423, 488 

Zinc, 489 

Phosphide, 380 

Salts, Antidotes, etc., 862 
Zincite, 489 
Zincum, 489 
Zingiber, 492 
Zona, — See Herpes Zoster, 694 



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eases of Children, Chicago Medical College. Second Edition, Enlarged. 

No. 15. GENERAL PATHOLOGY AND MORBID ANATOMY, gi Illustrations. By H. New- 
berry Hall, ph.g., m.d., Professor of Pathology and Medical Chemistry, Chicago Post-Graduate Medical 
School : Member Surgical Staff, Illinois Charitable Eye and Ear Infirmary ; Chief of Ear Clinic, Chicago 
Medical College. 

No. 16. DISEASES OF NOSE AND EAR. Illustrated. Same Author as No. 15. 

Price, each, .80. Interleaved, for taking Notes, $1.25. 

P. BLAKISTON, SON & CO., Publishers, 

1012 Walnut Street, Philadelphia. 
The Prices of all Books are Net. 



Published Annually for 45 Years. 



The Physicians Visiting List. 

(LINDSAY & BLAKISTON'S.) 

Special Improved Edition for 1896. 



In order to improve and simplify this Visiting List we have done away with the two 
styles hitherto known as the " 25 and 50 Patients plain." We have allowed more space 
for writing the names, and added to the special memoranda page a column for the 
"Amount" of the weekly visits and a column for the "Ledger Page." To do this with- 
out increasing the bulk or the price, we have condensed the reading matter in the front 
of the book and rearranged and simplified the memoranda pages, etc., at the back. 

The Lists for 75 Patients and 100 Patients will also have special memoranda page as 
above, and hereafter will come in two volumes only, dated January to June, and July to 
December. While this makes a book better suited to the pocket, the chief advantage is 
that it does away with the risk of losing the accounts of a whole year should the book 
be mislaid. 

Before making these changes we have personally consulted a number of physicians 
who have used the book for many years, and have taken into consideration many sugges- 
tions made in letters from all parts of the country. 



CONTENTS. 



PRELIMINARY MATTER.— Calendar, 1 896-1 897— Table of Signs, to be used in keeping records — 
The Metric or French Decimal System of Weights and Measures — Table for Converting Apothecaries' 
Weights and Measures into Grams — Dose Table, giving the doses of official and unofficial drugs in both 
the Engli-h and Metric Systems — Asphyxia and Apnea — Complete Table for Calculating the Period of 
Utero-Gestat ion— Comparison of Thermometers. 

VISITING LIST. — Ruled and dated pages for 25, 50, 75, and 100 patients per day or week, with blank page 
opposite each on which is an amount column, column for ledger page, and space for special memoranda. 

SPECIAL RECORDS for Obstetric Engagements, Deaths, Births, etc., with special pages for Addresses 
of Patients, Nurses, etc., Accounts Due, Cash Account, and General Memoranda. 



SIZES AND PRICES. 

REGULAR EDITION, as Described Above. 
BOUND IN STRONG LEATHER COVERS, WITH POCKET AND PENCIL. 

For 25 Patients weekly, with Special Memoranda Page, |i 00 

50 " " " " " 1 25 

2vois./>r ua Tyi° J u " e \ ...... 200 



5° " " " " " 2vo, n July to December/ 

75 - - « " - -oi,{j-;^^ e x r } 

- « - - « - -ol,{J-^ D °JXr} "5 

PERPETUAL EDITION, without Dates. 
No. 1. Containing space for over 1300 names, with blank page opposite each Visiting List page. 

Bound in Red Leather cover, with Pocket and Pencil, |i 25 

No. 2. Same as No. 1. Containing space for 2600 names, with blank page opposite, I 50 

MONTHLY EDITION, without Dates. 

No. 1. Bound, Seal leather, without Flap or Pencil, gilt edges, 75 

No. 2. Bound, Seal leather, with Tucks, Pencil, etc., gilt edges, 1 00 

gg^All these prices are net. No discount can be allowed retail purchasers. 
Circular and sample pages upon application. 

P. BLAKISTON, SON & CO., Publishers, Philadelphia, 



A TABLE OF PRESCRIPTION DOSES AND QUANTITIES. 
Designed and Calculated by Dr. Sam'l O. L. Potter', M.R.C.P. Lond. 



Grains 
in Entire 

Mixture 


Grains in each 5 close 


in a m 


xture of 


Grains 
in Entire 
Mixture 


Grains in each 5 dose 


D a mixture 


of 


5 i o'J 


2 
3 "J 


5 iv 


Sv, 


ovnj 


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s. 


*, 


5iU 


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5v. 


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i 


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riv 








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4 


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71 


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5 2 1 26 T 


i/l 


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6 


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5 

1 2 


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1 

3 


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vnj (31) 


60 1 30 


20 


15 


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71 


5 


31 


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♦ 


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1 
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3 


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4 


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1 o3 I t3 i 15 
2 T X F T2 


1 1 

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1 
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3* *? 


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1 


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7 


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51 


XXIX 


3g" I f r I o 


1 1 

T2 


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9 


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35 


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67 


XXX ( 5 ss) 


l'3* if n 


1 5 

TF 


! 


5 

TT 


5 

TF 


1 
T 


XVI ( I IJ 1 


120 60 


40 


30 


20 


15 


10 


71 



Explanation. — Tn Writing a Prescription look for the dose of the ingredient (say gr. .?.,) in 
the column headed by the size of your mixture ( % vi) ; then on that line in the left marginal column is 
the quantity (gr. ijss) you must put into the entire mixture to get your dose in each drachm thereof. 
In Reading a Prescription find the quantity of any ingredient called for in the left marginal cohimn 
(say gr. 3^f), and on the same line in the column headed by the number of ounces in the mixture (5 ill) 
you will find the quantity ( gr. £%) in each drachm dose. Of course when the dose is more or less than 
51 the result must be proportionately multiplied or divided accordingly. 

Copyrighted, 1894, by P. Blakiston, Son & Co. 



